Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria.
Department of Neurosurgery, Medical University of Graz, Graz, Austria.
Eur Arch Otorhinolaryngol. 2024 Jan;281(1):245-256. doi: 10.1007/s00405-023-08203-6. Epub 2023 Aug 31.
The aim of this prospective longitudinal study was to assess both subjective quality of life using questionnaires and objective examination of nasal function with regard to olfaction, nasal air flow and mucociliary clearance in patients after minimally invasive, turbinate-preserving endoscopic transnasal trans-sphenoidal pituitary surgery.
Patients undergoing endoscopic transnasal pituitary surgery were recruited prospectively and examined during three study visits, preoperatively and 3 and 6 months postoperatively. We examined nasal function using sniffin' sticks test, rhinomanometry, saccharin transit time test, and endoscopic and radiological scores. In addition, the influence on subjective quality of life and mental health was recorded using the Sinonasal-Outcome-Test-20 (SNOT-20) and the Hospital-Anxiety-and-Depression-Scale (HADS).
20 patients undergoing endoscopic pituitary tumor resections were included. No significant changes in olfaction or mucociliary clearance were noted. Nasal air flow showed a tendency to increase in the postoperative course lacking significance. Both the endoscopy and the radiological scores showed a significant deterioration, especially after 3 months, with a trend towards improvement over time. However, neither the SNOT-20 nor the HADS showed significant changes compared to baseline.
Our concept of minimally invasive endoscopic tumor resections on the pituitary gland with preservation of nasal turbinates shows low morbidity for the patient. Despite objectifiable surgery-associated changes in the nose, nasal physiology in terms of smell, airflow and mucociliary clearance can be preserved and the subjective quality of life of our patients remains stable.
本前瞻性纵向研究旨在评估微创、保留鼻甲的经鼻内镜经蝶窦垂体手术患者术后嗅觉、鼻腔气流和黏液纤毛清除功能的主观生活质量（通过问卷调查）和客观检查。
前瞻性招募接受经鼻内镜垂体手术的患者，并在术前和术后 3 个月、6 个月进行 3 次研究访视。我们使用嗅觉测试棒测试、鼻阻力测试、糖精传递时间测试以及鼻内镜和放射学评分来检查鼻腔功能。此外，还使用鼻-鼻窦炎结局测试 20 项（SNOT-20）和医院焦虑和抑郁量表（HADS）记录对主观生活质量和心理健康的影响。
纳入 20 例行内镜垂体肿瘤切除术的患者。嗅觉或黏液纤毛清除功能无明显变化。术后鼻腔气流呈增加趋势，但无统计学意义。内镜和放射学评分均显著恶化，尤其是术后 3 个月，但随时间推移有改善趋势。然而，与基线相比，SNOT-20 和 HADS 均无显著变化。
我们微创、保留鼻甲的内镜垂体肿瘤切除术的概念显示出对患者低的发病率。尽管鼻部存在可客观评估的与手术相关的变化，但嗅觉、气流和黏液纤毛清除功能等鼻腔生理功能可以得到保留，并且我们患者的主观生活质量保持稳定。
