Impact of endoscopic endonasal pituitary surgery on nasal airway patency

Authors

  • Alimohamad Asghari ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
  • Elahe Amini Skull Base Research Center, ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Maryam Hosseini ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Maryam Jalessi Skull Base Research Center, ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran Universi-ty of Medical Sciences, Tehran, Iran.
  • Mohammad Farhadi ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
  • Seyyed Behzad Pousti ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Abstract:

  Background: Nose is used as a corridor in endoscopic endonasal transsphenoidal approach (EETSA) for pituitary adenoma. Thus, it may affect the nasal airway patency, function and sinonasal-related quality of life. The aim of this study is to objectively and subjectively evaluate these effects.   Methods: In this prospective study, 43 patients with pituitary adenoma who were candidates for EETSA from March 2012 to October 2013 were enrolled. The patients were evaluated preoperatively using acoustic rhinometry and rhinomanometry (with/without the use of decongestant drops) and asked to complete the 22-Item Sino-nasal Outcome Test (SNOT-22) questionnaire.  The tests were repeated at one and three months postoperatively. The preoperative data were compared with the first and second postoperative ones using paired-sample t-test.   Results: Without the use of decongestant drops, the total airway resistance increased significantly (p=0.016), and the nasal airflow decreased significantly (p=0.031) in the first postoperative evaluation. However, in the 3rd postoperative month, the difference was not significant. With the use of decongestant drops, the objective parameters showed no significant changes compared to preoperative data even at the first evaluation. The SNOT-22 scores also did not differ significantly in 1st and 3rd postoperative months. The first postoperative SNOT-22 showed a strong correlation with the second minimal cross-sectional area on simultaneous evaluation, and with the preoperative total airway resistance.   Conclusion: EETSA has a transient adverse effect on the nasal patency that quickly improves, making it a safe approach for the sinonasal system. Rhinomanometry is the most sensitive test for detecting these nasal functional changes objectively.

Upgrade to premium to download articles

Sign up to access the full text

Already have an account?login

similar resources

Endoscopic endonasal pituitary and skull base surgery.

Here we describe the procedures of endoscopic pituitary and skull base surgery in our institute. We also review the literature to reveal recent advances in this field. Endonasal approach via the sphenoid ostium was carried out for pituitary lesions without the nasal speculum. Postoperative nasal packing was basically not needed in such cases. For meningiomas, craniopharyngiomas, and giant pitui...

full text

Endoscopic endonasal pituitary surgery: a rhinologist point of view

Endoscopic endonasal approaches are increasingly becoming the state of art in transsphenoidal pituitary surgery. The goal of this study is first to briefly introduce nasal and sphenoidal phases of the approach along with reconstruction phase. Then, the key points of radiologic studies of various parts of the surgery with images and movies are discussed. Difficult cases from 350 surgeries will b...

full text

Endonasal endoscopic transsphenoidal pituitary surgery for pituitary adenoma: a retrospective analysis of surgical outcome.

The purpose of this retrospective joint rhino-neurosurgical study from January 1998 until September 2009 is to document the demographic data, clinical presentations, radiological findings, approaches and incidence of residual tumour. Forty-seven patients with pituitary adenoma underwent trans-sphenoidal hypophysectomy of which 25 patients with complete medical and radiological data were include...

full text

Comprehensive review on endonasal endoscopic sinus surgery

Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases. Appropriate frame conditions provided, the respective procedures are safe and successful. These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery. The range of endonasal sinu...

full text

Management of Pituitary Adenomas: Mononostril Endoscopic Transsphenoidal Surgery

Introduction: The endoscopic transsphenoidal approach for pituitary adenomas and other sellar lesions is quickly becoming the procedure of choice in their surgical management. The most common approach is binostril three-hand technique which requires a large exposure and subjects both nasal cavities to potential trauma. To reduce nasal morbidity, we employ a mononostril two-hand technique with t...

full text

My Resources

Save resource for easier access later

Save to my library Already added to my library

{@ msg_add @}


Journal title

volume 30  issue 1

pages  551- 556

publication date 2016-01

By following a journal you will be notified via email when a new issue of this journal is published.

Keywords

Hosted on Doprax cloud platform doprax.com

copyright © 2015-2023