scholarly journals Sinonasal quality of life in patients after an endoscopic endonasal surgery of a sellar tumour

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vlastimil Novák ◽  
L. Hrabálek ◽  
J. Hoza ◽  
C.Hučko ◽  
D. Pohlodek ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nasal Congestion ◽  
Cranial Base ◽  
Fascia Lata ◽  
Endoscopic Endonasal Approach ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Snot 22

AbstractEndoscopic endonasal approach uses the nasal cavity and paranasal sinuses to access the cranial base and may be a source of post-surgical morbidity in many patients with a sellar tumour. The objective of the presented study was to evaluate sinonasal quality of life and assess the effect of chosen reconstruction of the cranial base on the final condition. 65 patients, 33 male and 32 female who underwent an endoscopic endonasal surgery due to sellar expansion, were included into this prospective study. Sinonasal quality of life was evaluated using the Sinonasal Outcome Test-22 (SNOT-22) questionnaire before the surgery and six months after the surgery. Sinonasal quality of life was evaluated for the total cohort of patients and for patients after reconstruction (fascia lata, muscle) and without reconstruction. The minimum follow-up period was one year. There was no significant difference between the score (SNOT-22) before the surgery (average 14.4 points) and after the surgery (average 17.5 points), p = 0.067 in the whole cohort. Statistically significant differences were found in the following items—the need to blow nose, nasal congestion, loss of smell and taste, and thick discharge from the nose. The comparison of subgroups with and without the reconstruction yielded statistically significant differences in favour of patients with reconstruction in the following items—lack of high-quality sleep and feeling exhaustion. The endoscopic endonasal approach in patients with a sellar tumour is a gentle method with minimal effects on sinonasal quality of life over a period longer than six months. The most common complaints are the need to blow nose, nasal congestion, loss of smell and taste, and thick discharge from the nose. Cranial base reconstruction using the muscle and fascia lata seems to be a potential factor positively influencing sinonasal quality of life.

A Prospective Evaluation of Quality of Life in Patients Undergoing Extended Endoscopic Endonasal Surgery for Benign Pituitary Gland Lesion

2021 ◽  
Author(s):  
Narin Nard Carmel Neiderman ◽  
Anat Wengier ◽  
Omri Dominsky ◽  
Barak Ringel ◽  
Anton Warshavsky ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Tumor Resection ◽  
Pituitary Tumors ◽  
Cerebrospinal Fluid Leak ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Post Surgery ◽  
Snot 22

Abstract Introduction Endoscopic endonasal surgery (EES) has become the preferred approach for pituitary tumor resection. Nevertheless, research on quality of life related to pituitary adenoma surgery is scarce. Objective The aim of the study is to evaluate short-term quality of life in patients after endoscopic endonasal resection of pituitary tumors and to find predictors for poor quality of life (QOL) outcome. Materials and Methods A prospective cohort study was conducted, including all patients who underwent EES for pituitary tumors in a tertiary medical referral center. Recruited patients completed the Anterior Skull Base Disease-Specific QOL (ASBS-Q) questionnaire and the Sinonasal Outcome Test 22 (SNOT-22) questionnaire before surgery, 2 and 4 to 6 months after surgery. Demographic and clinical data was collected. Results Our study included 49 patients. The overall ASBS-Q scores significantly improved 4 to 6 months after surgery (4.46 vs. 4.2, p < 0.05). We found a significant improvement in QOL related to emotional state 2 months post surgery (4.41 vs. 3.87, p < 0.05), which became borderline significant 4 to 6 months post surgery. There was a significant improvement in pain (4.5 vs. 4.08, p < 0.05) and vitality (4.43 vs. 4.16, p < 0.05) domains 4 to 6 months post surgery. SNOT-22 scores did not change significantly postoperatively. Factors such as secreting and non-secreting tumors, tumor size, intraoperative cerebrospinal fluid leak, gross tumor resection, endocrine remission, and the use of nasoseptal flap reconstruction did not have a significant effect on QOL. Conclusion We found that patients after EES reported improved QOL 4 to 6 months post surgery. Specific improvement was noted in the QOL related to pain and vitality.

scholarly journals Sinonasal Quality of Life Outcomes After Extended Endonasal Approaches to the Skull Base

2018 ◽  
Vol 80 (04) ◽  
pp. 416-423 ◽  
Author(s):  
Kevin J. Choi ◽  
Feras Y. Ackall ◽  
Tracy Truong ◽  
Tracy Z. Cheng ◽  
Maragatha Kuchibhatla ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Linear Regression ◽  
Regression Model ◽  
Skull Base ◽  
Clinical History ◽  
Linear Regression Models ◽  
Endoscopic Endonasal ◽  
Significant Change ◽  
Snot 22

Introduction Endoscopic endonasal skull base surgery (EESBS) leads to significant alterations in sinonasal anatomy and physiology. However, there is limited data available on quality of life (QOL) outcomes following EESBS. Methods A retrospective review of patients undergoing EESBS from January 2014 to April 2017 was performed. Records were reviewed for clinical history, operative details, and 22-item Sinonasal Outcomes Test (SNOT-22) scores. Unadjusted and adjusted linear regression models were utilized to compare change in SNOT-22 scores from baseline in patients who underwent a simple sella approach (SA) or an extended beyond sella approach (BSA). Results A total of 108 patients were in the SA group, while 61 patients were in the BSA group. SNOT-22 scores were available at baseline and 3 months for 84 patients, while 6-month scores were available for 49 patients. SNOT-22 scores for all patients were not significantly different at 3 months (p = 0.40) or at 6 months (p = 0.58). Unadjusted linear regression model did not show an association between the type of approach and change in SNOT-22 score at 3 months (p = 0.07) and 6 months (p = 0.28). Adjusted regression model showed a significant decrease in SNOT-22 scores at 3 months (p = 0.04) for the BSA group, but there was no significant change in SNOT-22 score at 6 months (p = 0.22). Conclusion Patients undergoing EESBS had no significant change in outcomes at 3 and 6 months. A more extensive BSA was not associated with worse QOL outcomes as measured by SNOT-22.

scholarly journals A Case of Fibrolipoma of the Nasal Septum

2020 ◽  
Vol 63 (10) ◽  
pp. 475-478
Author(s):  
Yeong Wook Jeong ◽  
Joo Yeon Kim ◽  
Dong Young Kim ◽  
Jae Hwan Kwon
Keyword(s):  
Nasal Septum ◽  
Histopathological Examination ◽  
Nasal Congestion ◽  
English Literature ◽  
Benign Neoplasm ◽  
University Hospital ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Oropharyngeal Cavity

Lipoma is the most common benign neoplasm in adults. While it is commonly found in the neck, trunk, and extremities, it is extremely rare in the nasal cavity, paranasal sinus, or nasal septum. To our knowledge, there have been only a few cases of septal lipomas reported in the English literature. A 32-year-old woman visited Kosin University Hospital complaining of left nasal congestion and throat discomfort. Upon nasal endoscopy examination and CT, we found a polypoid mass of 2.7×1.5 cm with an elongated neck occupying a region left of the nasopharyngeal to the oropharyngeal cavity. The mass was completely removed via endoscopic endonasal surgery under general anesthesia and was identified as a fibrolipoma in the histopathological examination. We report a case of a successfully treated fibrolipoma originating from the posterior margin of the nasal septum.

Endoscopic Endonasal Surgery for Cranial Base Chondrosarcomas: Comparison to Open Approaches

2014 ◽  
Vol 75 (S 01) ◽  
Author(s):  
Francisco Vaz-Guimaraes Filho ◽  
Maria Koutourousiou ◽  
Eric Wang ◽  
Juan Fernandez-Miranda ◽  
Carl Snydermean ◽  
...  
Keyword(s):  
Cranial Base ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal

Endoscopic Endonasal Surgery (EES) for Resection of Cranial Base Epidermoid and Dermoid Cysts: Advantages and Limitations

2014 ◽  
Vol 75 (S 02) ◽  
Author(s):  
Paul Gardner ◽  
F. Vaz-Guimaraes ◽  
J. De Almeida ◽  
M. Koutourousiou ◽  
E. Wang ◽  
...  
Keyword(s):  
Cranial Base ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal

Endoscopic Endonasal Approach to the Optic Canal: Anatomic Considerations and Surgical Relevance

2015 ◽  
Vol 11 (3) ◽  
pp. 431-446 ◽  
Author(s):  
Kumar Abhinav ◽  
Yancy Acosta ◽  
Wei-Hsin Wang ◽  
Luis R Bonilla ◽  
Maria Koutourousiou ◽  
...  
Keyword(s):  
Ophthalmic Artery ◽  
Human Head ◽  
Optic Canal ◽  
Falciform Ligament ◽  
Endoscopic Endonasal Approach ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Dural Opening ◽  
Anatomic Relationship

Abstract BACKGROUND Increasing use of endoscopic endonasal surgery for suprasellar lesions with extension into the optic canal (OC) has necessitated a better endonasal description of the OC. OBJECTIVE To identify the osseous OC transcranially and then investigate its anatomic relationship to the key endonasal intrasphenoidal landmarks. We also aimed to determine and describe the technical nuances for safely opening the falciform ligament and intracanalicular dura (surrounding the optic nerve [ON]) endonasally. METHODS Ten fresh human head silicon-injected specimens underwent an endoscopic transtuberculum/transplanum approach followed by 2-piece orbitozygomatic craniotomy to allow identification of 20 OCs. After completing up to 270° of endonasal bony decompression of the OC, a dural incision started at the sella and continued superiorly across the superior intercavernous sinus. Subsequently the dural opening was extended anterolaterally across the dura of the prechiasmatic sulcus, limbus sphenoidale, and planum. RESULTS Endonasally, the length of the osseous OC was approximately 6 mm and equivalent to the length of the lateral opticocarotid recess, as measured anteroposteriorly. The ophthalmic artery arose from the supraclinoidal carotid artery at approximately 2.5 mm from the medial osseous OC entrance. Transcranial correlation of the endonasal dural incision confirmed medial detachment of the falciform ligament and exposure of the preforaminal ON. CONCLUSION The lateral opticocarotid recess allows distinction of the preforaminal ON, roofed by the falciform ligament from the intracanalicular segment in the osseous OC. This facilitates the preoperative surgical strategy regarding the extent of OC decompression and dural opening. Extensive endonasal decompression of the OC and division of the falciform ligament is feasible.

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