Quality of Life before and after Endoscopic Pituitary Surgery as Measured by the SF-36

Objectives/Hypotheses: As utilization of endoscopic, transnasal techniques have gained prominence in the management of anterior skull base pathologies, assessing quality of life (QOL) after these approaches is an active area of investigation. Previous research has focused on sinonasal outcomes, but no studies have examined QOL as assessed by the oft-utilized 36-item short form (SF-36) instrument.

Design: Retrospective review.

Setting: Tertiary academic medical center.

Participants: Patients who underwent endoscopic transnasal, transsphenoidal surgery for pituitary adenomas between January 1, 2007, and July 1, 2016, who completed preoperative and postoperative SF-36 surveys.

Main Outcome Measures: SF-36 survey data as measured by its eight domains (physical functioning, physical role functioning, emotional role functioning, energy/fatigue, emotional well-being, social functioning, pain, general health).

Results: There were 18 preoperative, 13 short-term (2 weeks or less after surgery) postoperative, and 14 long-term (> 2 weeks after surgery) postoperative surveys. There was no significant difference between preoperative and long-term postoperative SF-36 scores across all domains (p > 0.05). There was a trend toward decreased physical role functioning for the short-term postoperative group as compared with preoperative scores, but this was not significant (p = 0.06). Compared with standard U.S. general population summary data, these patients scored lower preoperatively in all domains except for emotional role functioning and pain (p < 0.05). Postoperatively, patients improved to baseline general population data scores with the exception of the physical role functioning domain (p < 0.0001).

Conclusion: Patients undergoing endoscopic transnasal, transsphenoidal surgery for pituitary adenomas have lower QOL in 6 of 8 domains preoperatively, but improved to baseline values on the long run after surgery in 7 of 8 domains. This suggests that minimally invasive pituitary surgery has a restorative role in general QOL as measured by the SF-36.