Long-Term Sinonasal Function Following Transnasal Pituitary Surgery: A Comparison of Surgical Approach

• Published in: American journal of rhinology & allergy 2020-05, Vol.34 (3), p.361-368
• Main Authors: Cho, Jemma, Grayson, Jessica W., Christensen, Jenna, Winder, Mark J., Sheehy, John, Steel, Tim, Bentivoglio, Peter, Barham, Henry P., McCormack, Ann, Harvey, Richard J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cross-Sectional Studies; Endoscopy; Female; Humans; Male; Middle Aged; Neurosurgical Procedures - methods; Nose - surgery; Paranasal Sinuses - physiology; Pituitary Diseases - surgery; Quality of Life; Skull - surgery; Surveys and Questionnaires; Time Factors; Treatment Outcome
• ISSN: 1945-8924; 1945-8932
• DOI: 10.1177/1945892419896788

Background Surgical approaches to the pituitary have undergone significant changes from transcranial, sublabial, direct transnasal microscopic, and now endoscopic. This study compares sinonasal outcomes from patients from these techniques. Methods A cross-sectional study of patients who underwent pituitary surgery in a tertiary setting was conducted. Patients were recruited via phone, mail, e-mail, and in person. Surveys with questions on nasal function, subsequent nasal treatment, the Nasal Symptom Score (NSS), Sinonasal Outcome Test-22 (SNOT-22), Chronic Sinusitis Survey (CSS), and Short Form 36 version 2 (SF-36v2) were obtained. Results A total of 252 surveys were sent, of which 165 were returned (65.48% response rate) and 16 were excluded (3 records destroyed, 13 transcranial approach). A total of 149 patients (age 60.10 ± 13.99 years, 47.83% female) were assessed with the following breakdown: sublabial (n = 69), transnasal microscopic (n = 28), and endoscopic (n = 52) approaches. Sublabial and transnasal microscopic, compared to endoscopic, had more sinus treatment (30.43%, 39.29%, and 15.38%; P = .05), medication use (28.99%, 32.14%, and 11.54%; P = .04), and new allergy symptoms (21.74%, 7.14%, and 1.92%; P