scholarly journals Transient Exacerbation of Nasal Symptoms following Endoscopic Transsphenoidal Surgery for Pituitary Tumors: A Prospective Study

2016 ◽  
Vol 77 (S 02) ◽  
Author(s):  
Kanna Gnanalingham ◽  
Benjamin Davies ◽  
Erica Tirr ◽  
Yi Wang
Keyword(s):  
Prospective Study ◽  
Transsphenoidal Surgery ◽  
Pituitary Tumors ◽  
Endoscopic Transsphenoidal Surgery ◽  
Nasal Symptoms ◽  
A Prospective Study

scholarly journals Transient Exacerbation of Nasal Symptoms following Endoscopic Transsphenoidal Surgery for Pituitary Tumors: A Prospective Study

2017 ◽  
Vol 38 (03) ◽  
pp. 266-272 ◽  
Author(s):  
Benjamin Davies ◽  
Erica Tirr ◽  
Yi Wang ◽  
Kanna Gnanalingham
Keyword(s):  
Transsphenoidal Surgery ◽  
Temporal Evolution ◽  
Pituitary Tumors ◽  
Pituitary Surgery ◽  
Endoscopic Transsphenoidal Surgery ◽  
Rapid Reduction ◽  
Nasal Symptoms ◽  
Transsphenoidal Pituitary Surgery ◽  
A Prospective Study

Object Endoscopic transsphenoidal surgery is the commonest approach to pituitary tumors. One disadvantage of this approach is the development of early postoperative nasal symptoms. Our aim was to clarify the peak onset of these symptoms and their temporal evolution. Methods The General Nasal Patient Inventory (GNPI) was administered to 56 patients undergoing endoscopic transsphenoidal surgery for pituitary tumors preoperatively and at 1 day, 3 days, 2 weeks, 3 months, and 6 to 12 months postoperatively. Most patients underwent surgery for pituitary adenomas (N = 49; 88%) and through a uninostril approach (N = 55; 98%). Total GNPI (0–135) and scores for the 45 individual components were compared. Results GNPI scores peaked at 1 to 3 days postoperatively, with rapid reduction to baseline by 2 weeks and below baseline by 6 to 12 months postsurgery (p < 0.01). Of the 45 individual symptoms on the GNPI scale, 19 (42%) worsened transiently after surgery (p < 0.05). Functioning tumors had a higher GNPI scores at postoperative day 1 and 3 than nonfunctioning tumors, although their temporal evolution was the same (p < 0.05). Conclusions Nasal morbidity following endoscopic transsphenoidal pituitary surgery is common, but transient, more so in the functioning subgroup. Nasal symptoms improve below baseline by 6 to 12 months, without the need for specific long-term postoperative interventions in the vast majority of patients.

scholarly journals Nasal symptoms following endoscopic transsphenoidal pituitary surgery: assessment using the General Nasal Patient Inventory

2011 ◽  
Vol 30 (4) ◽  
pp. E12 ◽  
Author(s):  
Yi Yuen Wang ◽  
Vinothan Srirathan ◽  
Erica Tirr ◽  
Tara Kearney ◽  
Kanna K. Gnanalingham
Keyword(s):  
Symptom Severity ◽  
Transsphenoidal Surgery ◽  
Invasive Procedure ◽  
Partial Recovery ◽  
Endoscopic Transsphenoidal Surgery ◽  
Pituitary Fossa ◽  
Time Points ◽  
Nasal Symptoms ◽  
Nasal Trauma

Object The endoscopic approach for pituitary tumors is a recent innovation and is said to reduce the nasal trauma associated with transnasal transsphenoidal surgery. The authors assessed the temporal changes in the rhinological symptoms following endoscopic transsphenoidal surgery for pituitary lesions, using the General Nasal Patient Inventory (GNPI). Methods The GNPI was administered to 88 consecutive patients undergoing endoscopic transsphenoidal surgery at 3 time points (presurgery, 3–6 months postsurgery, and at final follow-up). The total GNPI score and the scores for the individual GNPI questions were calculated and differences between groups were assessed once before surgery, several months after surgery, and at final follow-up. Results Of a maximum possible score of 135, the mean GNPI score at 3–6 months postsurgery was only 12.9 ± 12 and was not significantly different from the preoperative score (10.4 ± 13) or final follow-up score (10.3 ± 10). Patients with functioning tumors had higher GNPI scores than those with nonfunctioning tumors for each of these time points (p < 0.05). Individually, a mild increase in symptom severity was seen for symptoms attributable to the nasal trauma of surgery, with partial recovery (nasal sores and bleeding) or complete recovery (nasal blockage, painful sinuses, and unpleasant nasal smell) by final follow-up (p < 0.05). Progressive improvements in symptom severity were seen for symptoms more attributable to tumor mass preoperatively (for example, headaches and painkiller use [p < 0.05]). In total, by final follow-up 8 patients (9%) required further treatment or advice for ongoing nasal symptoms. Conclusions Endoscopic transsphenoidal surgery is a well-tolerated minimally invasive procedure for pituitary fossa lesions. Overall patient-assessed nasal symptoms do not change, but some individual symptoms may show a mild worsening or overall improvement.

Headache Before and After Endoscopic Transsphenoidal Pituitary Tumor Surgery: A Prospective Study

2021 ◽  
Author(s):  
Agnes Andersson ◽  
Tobias Hallén ◽  
Daniel S. Olsson ◽  
Dan Farahmand ◽  
Ann-Charlotte Olofsson ◽  
...  
Keyword(s):  
Prospective Study ◽  
Pituitary Tumors ◽  
Common Symptom ◽  
Tertiary Referral Hospital ◽  
Younger Age ◽  
Before And After ◽  
Observational Cohort ◽  
Midas Questionnaire ◽  
A Prospective Study ◽  
Postoperative Improvement

Abstract Objective Headache is a common symptom among patients with pituitary tumors, as it is in the general population. The aim of the study was to investigate headache as a symptom in patients with pituitary tumors before and 6 months after endoscopic transsphenoidal surgery (TSS). Design This is a prospective observational cohort study. Setting This study was conducted at university tertiary referral hospital. Participants A total of 110 adult patients underwent endoscopic TSS for pituitary tumors. Main Outcome Measures The Migraine Disability Assessment (MIDAS) questionnaire was used before and 6 months after surgery for the assessment of headache. Clinical variables with potential influence on headache were analyzed. Results Sixty-eight (62%) patients experienced headaches at least once during the 3 months before surgery. Thirty (27%) patients reported disabling headache before surgery, with younger age being an independent associated factor (p < 0.001). In patients with disabling headache before surgery, the median (interquartile range) MIDAS score improved from 78 (27–168) to 16 (2–145; p = 0.049), headache frequency decreased from 45 (20–81) to 14 (4–35) days (p = 0.009), and headache intensity decreased from 6 (5–8) to 5 (4–7) (p = 0.011) after surgery. In total, 16 of the 30 (53%) patients reported a clinically relevant improvement and five (17%) a clinically relevant worsening. Four (5%) patients developed new disabling headache. No predictor for postoperative improvement of headache was identified. Conclusion In this prospective study, the results show that disabling headache improves following endoscopic TSS in a subset of patients with pituitary tumors. However, no predictive factors for improvement could be identified.

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