TY - JOUR
T1 - Nasal Morbidity and Quality of Life After Endoscopic Transsphenoidal Surgery: A Single-Center Prospective Study
AU - Schreiber, Alberto
AU - Bertazzoni, Giacomo
AU - Ferrari, Marco
AU - Rampinelli, Vittorio
AU - Verri, Paolo
AU - Mattavelli, Davide
AU - Fontanella, Marco
AU - Fontanella, Marco Maria
AU - Nicolai, Piero
AU - Doglietto, Francesco
PY - 2019
Y1 - 2019
N2 - Objective: The aim of this study was to assess nasal morbidity of endoscopic transsphenoidal approaches (ETAs) for treatment of sellar and parasellar diseases through evaluation of quality of life (QoL) and nasal function. The impact of different ETAs, according to extent and reconstruction technique, was also studied. Methods: Patients undergoing ETA for treatment of sellar or parasellar lesions were prospectively recruited and examined preoperatively and at 6 months after surgery according to the following workup: nasal endoscopy, rhinomanometry, acoustic rhinometry, University of Pennsylvania Smell Identification Test, Anterior Skull Base Nasal Inventory–12, Sino-nasal Outcome Test–22, and Short-Form Health Survey–36 (SF-36). Results: Of 34 patients initially recruited, 29 completed follow-up examinations. Seven patients (24.14%) developed turbinoseptal synechiae; anterior septal perforations were observed in 3 patients (10.35%). More extended surgical dissection was associated with the presence of postoperative septal perforation and synechiae. No significant difference was noted between preoperative and postoperative results on the University of Pennsylvania Smell Identification Test, acoustic rhinometry, Sino-nasal Outcome Test–22, or Anterior Skull Base Nasal Inventory–12. There was a significant increase in nasal airflow after surgery and improvement of the Short-Form Health Survey–36 score in 4 of 8 domains. Conclusions: The modular ETA technique is associated with minimal morbidity and preserves nasal patency, airflow, and olfactory function. Quality of life is not affected and although small septal perforations and synechiae can be observed, nasal physiology is not compromised. Nonetheless, careful manipulation of sinonasal structures is recommended to minimize postoperative sequelae.
AB - Objective: The aim of this study was to assess nasal morbidity of endoscopic transsphenoidal approaches (ETAs) for treatment of sellar and parasellar diseases through evaluation of quality of life (QoL) and nasal function. The impact of different ETAs, according to extent and reconstruction technique, was also studied. Methods: Patients undergoing ETA for treatment of sellar or parasellar lesions were prospectively recruited and examined preoperatively and at 6 months after surgery according to the following workup: nasal endoscopy, rhinomanometry, acoustic rhinometry, University of Pennsylvania Smell Identification Test, Anterior Skull Base Nasal Inventory–12, Sino-nasal Outcome Test–22, and Short-Form Health Survey–36 (SF-36). Results: Of 34 patients initially recruited, 29 completed follow-up examinations. Seven patients (24.14%) developed turbinoseptal synechiae; anterior septal perforations were observed in 3 patients (10.35%). More extended surgical dissection was associated with the presence of postoperative septal perforation and synechiae. No significant difference was noted between preoperative and postoperative results on the University of Pennsylvania Smell Identification Test, acoustic rhinometry, Sino-nasal Outcome Test–22, or Anterior Skull Base Nasal Inventory–12. There was a significant increase in nasal airflow after surgery and improvement of the Short-Form Health Survey–36 score in 4 of 8 domains. Conclusions: The modular ETA technique is associated with minimal morbidity and preserves nasal patency, airflow, and olfactory function. Quality of life is not affected and although small septal perforations and synechiae can be observed, nasal physiology is not compromised. Nonetheless, careful manipulation of sinonasal structures is recommended to minimize postoperative sequelae.
KW - Endoscopic surgery
KW - Nasal morbidity
KW - Transsphenoidal approach
KW - Pituitary
KW - Quality of life
KW - Olfaction
KW - Endoscopic surgery
KW - Nasal morbidity
KW - Transsphenoidal approach
KW - Pituitary
KW - Quality of life
KW - Olfaction
UR - http://hdl.handle.net/10807/268841
U2 - 10.1016/j.wneu.2018.11.212
DO - 10.1016/j.wneu.2018.11.212
M3 - Article
SN - 1878-8750
VL - 123
SP - 557
EP - 565
JO - World Neurosurgery
JF - World Neurosurgery
ER -