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72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Beyond the sella region – transnasal endoscopic surgery for pituitary adenoma and its effects on nasal health and patients’ quality of life

Über die Sella hinaus – Hypophysenadenome und die Effekte der transnasalen endoskopischen Mikrochirurgie auf Nasengesundheit und Lebensqualität

Meeting Abstract

  • presenting/speaker Julia J. Feldheim - University Hospital Essen, Department of Neurosurgery, Essen, Deutschland
  • Ilonka Kreitschmann-Andermahr - University Hospital Essen, Department of Neurosurgery, Essen, Deutschland
  • Mehdi Chihi - University Hospital Essen, Department of Neurosurgery, Essen, Deutschland
  • Thiemo Florin Dinger - University Hospital Essen, Department of Neurosurgery, Essen, Deutschland
  • Oliver Gembruch - University Hospital Essen, Department of Neurosurgery, Essen, Deutschland
  • Ramazan Jabbarli - University Hospital Essen, Department of Neurosurgery, Essen, Deutschland
  • Karsten Henning Wrede - University Hospital Essen, Department of Neurosurgery, Essen, Deutschland
  • Ulrich Sure - University Hospital Essen, Department of Neurosurgery, Essen, Deutschland
  • Yahya Ahmadipour - University Hospital Essen, Department of Neurosurgery, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV266

doi: 10.3205/21dgnc253, urn:nbn:de:0183-21dgnc2532

Published: June 4, 2021

© 2021 Feldheim et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: The preferred neurosurgical route to resect lesions of the skull base, such as pituitary adenomas, is the transnasal endoscopic approach. Though commonly accepted as a gentle treatment, it has been reported that nasal health may be diminished after surgery. A systematic pre-/postoperative comparison is required to assess the amount of nasal distress after transnasal surgery and provide a basis for prophylactic supportive treatment to minimise side effects.

Methods: In this prospective single-centre observational study, we collected data with signed informed consent from a total of 77 patients operated between August 2016 and June 2020 with initial assessment and three months follow-up. All patients were diagnosed with pituitary adenoma operated at our institution via the endoscopic transnasal binostril transsphenoidal approach. We evaluated the quality of life with the standardised short form-36 inventory (SF-36) and nasal health with the sino-nasal outcome test for neurosurgery (SNOT-NC).

Results: The SF36 score, including its independent subcategories, was not significantly changed through endoscopic surgery. Also, SNOT-NC aggregate value did not change from pre- to postoperative (χ² p=0.520). However, patients reported a significant decrease in the ability to smell (χ² p=0.003), increase in nasal dryness (χ² p=0.001) and a weird nasal smell (χ² p<0.001). On the other hand, auricular pain decreased (χ² p<0.001) as well as orbital pain (χ² p=0.003) and dryness (χ² p=0.01). We observed a tendency towards improved nasal symptoms when nose drops were regularly used after surgery (χ² p=0.052). These observations were independent of the hormonal activity.

Conclusion: We could show that in patients with pituitary adenoma neither quality of life nor nasal health appeared to be significantly altered by endoscopic transsphenoidal resection. Furthermore, decreased auricular and orbital pain, as well as orbital dryness, proved an additional treatment success. Prophylactic symptomatic therapy of occurring symptoms like nasal dryness or impairment of smell by nose drops may reduce long-term side effects and improve patients’ outcome.