Article
The impact of previous nasal surgery and pain on sino-nasal outcome and quality of life after transsphenoidal endoscopic resection of pituitary adenomas
Der Einfluss von Nasen-Voroperationen und Schmerzen auf sinu-nasales Outcome und Lebensqualität nach transsphenoidaler endoskopischer Resektion von Hypophysenadenomen
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Published: | May 25, 2022 |
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Objective: The transnasal binostril endoscopic resection of pituitary adenomas is regarded as a minimally invasive treatment nowadays. However, sino-nasal outcome and quality of life (QoL) might still be impaired after the resection of pituitary adenomas, depending on patients' prior medical history and health status. A systematic postoperative comparison is required to assess differences in perceived sino-nasal outcome and QoL.
Methods: In this single-center observational study, we collected data from 98 patients (46 female, mean age: 54.37), operated between August 2016 and August 2021, at a three months follow-up after pituitary adenoma resection. We utilized dependent t-tests to compare patients with or without previous nasal surgery or pain with the sino-nasal outcome test for neurosurgery (SNOT-NC), which queries post-surgical sino-nasal outcome in several subdomains, and the QoL inventory Short Form (SF)-36.
Results: At the three-month follow-up, patients with previous nasal surgery (n = 22) showed an aggravated sino-nasal outcome in each SNOT-NC domain (all p ≤ .034). Moreover, QoL was reduced in patients with previous nasal surgery, as reflected in the mental health component score (MCS) of the SF-36 (p = .001) and several SF-36 subdomains (all p ≤ .036). Patients with pain before surgery (n = 19) showed increased visual impairment (p = .024; SNOT-NC) and ear/head discomfort (p = .044; SNOT-NC). Furthermore, a reduction of the physical health component score (PCS) of the SF-36 (p = .047), as well as further impairments in several SF36 subdomains (all p ≤ .035) were observed in these patients.
Conclusion: Our data show that patients with previous nasal surgery or pain before surgery have an increased risk of an aggravated sino-nasal outcome and QoL. To induce realistic patient expectations, these patients should be thoroughly informed about such potential consequences of transnasal neurosurgical procedures.