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J Neurol Surg B Skull Base 2022; 83(S 02): e160-e168
DOI: 10.1055/s-0041-1722929
Original Article

Sinonasal Symptoms and Self-Reported Health before and after Endoscopic Pituitary Surgery—A Prospective Study

Tobias Hallén
1   Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
2   Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Daniel S Olsson
3   Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
4   Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Dan Farahmand
1   Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
2   Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Daniela Esposito
3   Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
4   Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Ann-Charlotte Olofsson
3   Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
,
Sofie Jakobsson
5   Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Eva Jakobsson Ung
4   Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
5   Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Pernilla Sahlstrand-Johnson
6   Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Lund University, Ska°ne University Hospital, Malmö, Sweden
,
Gudmundur Johannsson
3   Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
4   Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Thomas Skoglund
1   Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden
2   Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
,
Henrik Bergquist
7   Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
8   Department of Otorhinolaryngology, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
› Author Affiliations Funding This study was supported by grants from the Swedish state under the agreement between the Swedish government and the County Councils, the ALF agreement (ALFGBG-719531 and ALFGBG-772591), by grants from the Health & Medical Care Committee of the Region Västra Götaland, Sweden (VGFOUREG-929693), and The Swedish Society of Medicine (SLS-884901).
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Abstract

Objectives Despite the limited invasiveness of endoscopic transsphenoidal surgery (ETSS), some degree of nasal structure destruction is unavoidable. Our objective was to evaluate sinonasal morbidity and self-reported health before and 6 months after ETSS for pituitary tumors, and to identify possible predictive factors for deterioration in sinonasal health.

Design Prospective observational cohort study.

Setting University tertiary referral hospital.

Participants Totally 109 consecutive adult patients undergoing ETSS for pituitary tumors between 2015 and 2019.

Main Outcome Measures Sinonasal symptoms and self-reported health before and 6 months after ETSS, assessed by the Sinonasal Outcome Test (SNOT-22) and the EQ-5D questionnaire. Predictive factors for postoperative deterioration in sinonasal symptoms.

Results The overall SNOT-22 score did not change, but the score of the rhinologic domain of SNOT-22 worsened from 6.0 ± 5.9 before to 8.0 ± 7.4 6 months after surgery (p = 0.011). The EQ-5D visual analog scale improved from 64.0 ± 22.9 before to 71.1 ± 18.7 6 months after surgery (p = 0.00088). Univariate and multivariable regression analyses showed that prior sinonasal surgery was associated with a significant worsening in rhinologic symptoms 6 months after surgery (p = 0.046 and p = 0.020, respectively).

Conclusions Although self-reported overall health improved, significant deterioration of rhinologic symptoms was seen 6 months after ETSS. This information is important for preoperative patient counselling. Further refinement of the surgical technique and follow-up strategies to reduce postoperative sinonasal morbidity could be of value, especially in patients who have undergone prior sinonasal surgery.

Keywords

endoscopic transsphenoidal surgery - pituitary tumors - sinonasal health - quality of life


Publication History

Received: 31 October 2020

Accepted: 02 December 2020

Article published online:
18 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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