Jalessi Maryam, Jahanbakhshi Amin, Amini Elahe, Kamrava Seyyed Kamran, Farhadi Mohammad
Endoscopic Skull Base Surgery Unit, ENT-Head and Neck Surgery Center, Iran University of Medical Sciences, Tehran, Iran.
Hazrat Rasoul Akram Hospital, Niayesh st., Sattarkhan Ave., 1445613131, Tehran, Iran.
Eur Arch Otorhinolaryngol. 2016 May;273(5):1199-205. doi: 10.1007/s00405-015-3729-z. Epub 2015 Jul 29.
To evaluate the impact of nasoseptal flap (NSF) elevation on sinonasal quality of life (QOL) in patients with pituitary adenomas who underwent endoscopic endonasal trans-sphenoidal approach (EETSA), the data of 106 eligible patients were included from February 2011 to December 2014. The scores of Sinonasal Outcome Test (SNOT-22) Questionnaire were assessed in case (that received reconstruction with NSF) and control groups preoperatively as well as 1, 3, 6, and more than 12 months postoperatively. Nine most related sinonasal questions were evaluated separately (9Q). There were no significant inter-group differences in the mean SNOT-22, 9Q, and sense of taste/smell scores in preoperative and all postoperative assessments. Within each group, a significant improvement of SNOT-22 and 9Q scores were noted after 12 months of surgery compared to preoperative data. In the NSF group, comparison of the pre- and first postoperative evaluation revealed a significant deterioration in 9Q score (p = 0.007) and "sense of taste/smell" (p < 0.001) which both returned to baseline in the 3rd month. Patients who used nasal paper mask for more than 100 "hour-days" showed a better SNOT-22 scores at 1st (p = 0.04) and 3rd (p < 0.001) months after surgery. Patients with adrenocorticotropic hormone (ACTH) secretory adenomas showed significantly higher scores of SNOT-22 in all postoperative assessments compared to the others. Although nasal symptoms deteriorated at first postoperative month (compare to preoperative data) in the NSF group, no negative impacts on the sinonasal QOL was showed comparing to the control group. ACTH-secreting adenomas could be assumed as a risk factor for poorer sinonasal QOL in EETSA.
为评估鼻中隔瓣（NSF）掀起对接受内镜鼻内经蝶窦入路（EETSA）的垂体腺瘤患者鼻窦生活质量（QOL）的影响，纳入了2011年2月至2014年12月期间106例符合条件患者的数据。在病例组（接受NSF重建）和对照组中，于术前以及术后1、3、6和超过12个月时评估鼻窦结局测试（SNOT-22）问卷的得分。分别对9个最相关的鼻窦问题进行评估（9Q）。术前和所有术后评估中，两组间SNOT-22、9Q以及味觉/嗅觉得分的均值无显著差异。在每组中，与术前数据相比，术后12个月时SNOT-22和9Q得分有显著改善。在NSF组中，术前与首次术后评估相比，9Q得分（p = 0.007）和“味觉/嗅觉”（p < 0.001）显著恶化，两者均在第3个月恢复至基线水平。使用鼻纸面罩超过100“小时 - 天”的患者在术后第1个月（p = 0.04）和第3个月（p < 0.001）时SNOT-22得分更好。与其他患者相比，促肾上腺皮质激素（ACTH）分泌性腺瘤患者在所有术后评估中SNOT-22得分显著更高。尽管NSF组术后第一个月鼻窦症状恶化（与术前数据相比），但与对照组相比，对鼻窦QOL未显示出负面影响。可认为ACTH分泌性腺瘤是EETSA中鼻窦QOL较差的一个危险因素。
