Quality of Life after Transsphenoidal Pituitary Surgery: A Qualitative Study

Background: Microscopic and endoscopic approaches are both used for transsphenoidal resection of sellar and parasellar lesions. The endoscopic approach has been gaining in popularity over the past decade; however, quality of life studies comparing the microscopic and endoscopic approaches are lacking in the literature.

Objective: We aim to compare the patients' perceptions of their postoperative recovery periods following microscopic and endoscopic procedures.

Methods: Qualitative research methodology was used for this retrospective study. Twenty-seven patients participated in the study. Each participant underwent a single semistructured, open-ended interview based on an interview guide. Each participant has undergone at least one microscopic and one endoscopic transsphenoidal procedure for resection of sellar and parasellar lesions. The interviews were audiotaped and transcribed. The transcripts were then analyzed for overarching themes. Demographic information was also collected.

Results: The following six overarching themes emerged from the data: (1) the endoscopic procedure was better tolerated than the microscopic procedure; (2) the endoscopic procedure was the preferred approach by 22 out of 27 patients and also the approach they would choose should they require another surgery in the future; (3) most patients did not know that they underwent two different surgical approaches; (4) other than foul odor, rhinologic complications (including drainage, crusting, changes in smell) following the endoscopic procedures were comparable to those following the microscopic procedures; (5) a patient's postoperative experience from the microscopic procedure had an impact on his or her expectations of the endoscopic procedure; and (6) any significant pain or discomfort experienced from either procedure was mainly related to nasal packing or fascia lata graft donor site.

Conclusions: The endoscopic procedure was the preferred approach by the majority of patients when compared with the microscopic approach. It was better tolerated and was associated with less quality of life disturbances. Rhinologic complications, which are generally perceived to be more of an issue in the endoscopic approach, were in fact the same as the microscopic approach.