Cheng You, Xue Fei, Wang Tian-You, Ji Jun-Feng, Chen Wei, Wang Zhi-Yi, Xu Li, Hang Chun-Hua, Liu Xin-Feng
Department of Otolaryngology-Head and Neck Surgery Department of Neurosurgery Department of Neurology, Jinling Hospital, Nanjing, Jiangsu, China.
Medicine (Baltimore). 2017 Apr;96(15):e6614. doi: 10.1097/MD.0000000000006614.
In this study, we analyze and discuss the treatments of postoperative nasal complications after endonasal transsphenoidal resection of pituitary neoplasms (PNs). We performed 129 endonasal transsphenoidal resections of PNs and analyzed and treated cases with nasal complications. After endonasal transsphenoidal resection of PNs, there were 26 cases of postoperative nasal complications (20.1%), including nasal hemorrhage (4.8%), cerebrospinal fluid rhinorrhea (6.9%), sphenoid sinusitis (2.3%), atrophic rhinitis (1.6%), olfactory disorder (1.6%), perforation of nasal septum (0.8%), and nasal adhesion (2.3%). All patients clinically recovered after therapy, which included treatment of the cavity through nasal endoscopy, intranasal corticosteroids, and nasal irrigation. We propose that regular nasal endoscopic review, specific nasal medications, and regular nasal irrigation can effectively clear nasal mucosal hyperemia-induced edema and nasal/nasoantral secretions, as well as promote regeneration of nasal mucosa, prevent nasal adhesion, maintain the sinus cavity drainage, and accelerate the recovery of the physiological function of the paranasal sinus. Timely treatment of patients with nasal complications after endonasal transsphenoidal resections of PNs could greatly relieve the clinical symptoms. Nasal cleaning is very beneficial to patients after surgery recovery.
在本研究中，我们分析并讨论了经鼻蝶窦垂体肿瘤（PNs）切除术后鼻腔并发症的治疗方法。我们对129例PNs进行了经鼻蝶窦切除术，并对出现鼻腔并发症的病例进行了分析和治疗。PNs经鼻蝶窦切除术后，有26例出现术后鼻腔并发症（20.1%），包括鼻出血（4.8%）、脑脊液鼻漏（6.9%）、蝶窦炎（2.3%）、萎缩性鼻炎（1.6%）、嗅觉障碍（1.6%）、鼻中隔穿孔（0.8%）和鼻腔粘连（2.3%）。所有患者经治疗后临床均康复，治疗方法包括鼻内镜下鼻腔清理、鼻内使用糖皮质激素和鼻腔冲洗。我们建议定期进行鼻内镜检查、使用特定的鼻腔药物以及定期进行鼻腔冲洗，可有效清除鼻黏膜充血引起的水肿和鼻/鼻窦分泌物，促进鼻黏膜再生，防止鼻腔粘连，保持鼻窦引流，并加速鼻窦生理功能的恢复。对PNs经鼻蝶窦切除术后出现鼻腔并发症的患者及时治疗可极大缓解临床症状。鼻腔清理对术后患者的恢复非常有益。
