Anatomic Changes Caused by Endoscopic Endonasal Transsphenoidal Surgery and Their Effects on Nasal Functions

Kim, Do Hyun; Hong, Yong-Kil; Jeun, Sin‐Soo; Park, Yong Jin; Kim, Soo Whan; Cho, Jin Hee; Kim, Boo Young; Han, Sun Wook; Jung, Young Hoon; Lee, Yong Joo; Kim, Sung Won

doi:10.1177/0194599816630726

Cited by 17 publications

(3 citation statements)

References 28 publications

(56 reference statements)

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“…Access to the pituitary gland must compromise between creating sufficient space for tumor extraction and preserving nasal anatomical structures. Disruption of the normal nasal anatomy can lead to the postoperative deterioration of the nasal functions, especially the sense of smell [10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Transnasal Endoscopic Pituitary Surgery—The Role of a CT Scan in Individual Tailoring of Posterior Septum Size Resection

Lubojacký,

Čábalová,

Mladoňová

et al. 2023

Tomography

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Objective: This study was designed to evaluate the possibility of predicting the minimum size of septal resection for safe tumor extraction in transnasal paraseptal pituitary adenoma resection from preoperative computed tomography scans. Methods: A retrospective CT scan analysis was performed on 20 patients who underwent endoscopic pituitary surgery at the University Hospital in Ostrava. Virtual insertion of the straight instrument into the sphenoid cavity was simulated using a CT scan. The minimum septal resection size was predicted and compared to various diameters in the nasal cavity. The results were then compared with cadaveric dissections, in which septal resections were performed at 1 cm and 2 cm distances from the anterior sphenoid wall. The association between cadaver dissections and CT scan results was studied. Results: A total of 20 patients who underwent endoscopic transnasal surgery for pituitary adenoma between the years 2020 and 2021 were enrolled in the study. The mean virtual posterior septal size resection needed to reach the medial edge of the ICA with the straight instrument, without infracturing the nasal septum, was 13.2 mm. In cadavers with a 1 cm posterior septal resection, the medial edge of the ICA was reached with the straight instrument. In 2 cm resections, it was possible to reach beyond the lateral edge of the ICA. Conclusion: There is no significant correlation between the minimum septal size resection and measured diameters in the nasal cavity. According to our study, a 1 cm resection is sufficient for a non-extended pituitary tumor extraction. More extensive septal resections allow for better maneuverability and overview in the surgical field.

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Section: Discussionmentioning

confidence: 99%

Transnasal Endoscopic Pituitary Surgery—The Role of a CT Scan in Individual Tailoring of Posterior Septum Size Resection

Lubojacký,

Čábalová,

Mladoňová

et al. 2023

Tomography

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“…With regard to the sample‐size calculation, Kim et al 17,18 have reported that ILST‐induced intranasal volume changes do not correlate with objective olfactory changes after binostril EETS, suggesting that the overall impact of ILST on olfaction is minimal. In an earlier study of endoscopic sinus surgery (ESS), the incidence of objective olfactory decline after PRST was 12% in patients with chronic rhinosinusitis 19 .…”

Section: Methodsmentioning

confidence: 99%

Superior turbinate management and olfactory outcome after endoscopic endonasal transsphenoidal surgery for pituitary adenoma: a propensity score‒matched cohort study

Luo

Zhang

et al. 2020

Int Forum Allergy Rhinol

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Background Surgical management of the superior turbinate ST is required to access the sella in endoscopic endonasal transsphenoidal surgery EETS for pituitary adenoma Two common ST management techniques include partial resection of the ST PRST and intentional lateralization of the ST ILST Given the concentrated distribution of the olfactory nerve fibers on the medial surface of the ST in this study we aimed to ascertain whether PRST worsens the objective olfactory outcome when compared with ILST Methods A retrospective propensity score-matched cohort study was performed at a tertiary referral center A total of adult patients undergoing EETS for pituitary adenoma were analyzed The threshold test STT and the-item identification test SIT-from "Sniffin' Sticks" were administered for separate nostrils preoperatively and months postoperatively Results Of patients had right-sided PRST and received right-sided ILST Propensity score matchingcontrolling for olfactory-related confounding factors including gender age medical comorbidities surgical technique and preoperative olfaction-resulted in matched pairs When comparing the-month postoperative olfactory performance of the right nostril the STT score was significantly lower in the PRST group than the ILST group p = η for effect size estimate = but the SIT-scores were similar in the groups p = Overall the olfactory outcomes for the right nostril did not qualitatively differ between the PRST and ILST groups p = Conclusion Despite its association with threshold impairment PRST in EETS does not seem to carry an additional risk of postoperative olfactory dysfunction

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“…-Changes in the volume (mm 3 ) of both nasal cavities on acoustic rhinometry between postoperative 3 months and current status. -Changes in cross-sectional area of nasal cavity [at the ostiomeatal unit (OMU) level; mm 2 ] on coronal view CT images [11] between postoperative 3 months and current status.…”

Section: Secondary Outcomesmentioning

confidence: 99%

Long-term efficacy and safety of 3D printed implant in patients with nasal septal deformities

Kim

Lee

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose To investigate the long-term safety and efficacy of a 3D-printed bioresorbable polycaprolactone (PCL) nasal implant for nasal septal deformity reconstruction. Methods Fourteen patients who had undergone nasal septum reconstruction surgery using 3D-printed PCL nasal septal implants were enrolled. The primary outcome was the change in total Nasal Obstruction Symptom Evaluation (NOSE) scale scores between postoperative 3 months and current status (3.59 ± 0.51 years). The secondary outcomes were changes in the minimum cross-sectional area (MCA) and volume of both nasal cavities based on acoustic rhinometry, the cross-sectional area of the ostiomeatal unit, and the nasal septum angle of the paranasal sinus (PNS) in computed tomography (CT) images, and a visual analog scale (VAS) of the patients' subjective satisfaction. ResultsThe results showed no significant changes in the MCAs (Cohen's d:0.09; p = 0.711) or nasal volume (Cohen's d:0.26; p = 0.356), the area of the ostiomeatal unit (Cohen's d:0.49; p = 0.064), septum angles (Cohen's d:0.18; p = 0.831), the NOSE scale (Cohen's d:0.14; p = 0.621), or patients' subjective satisfaction (Cohen's d:0.52; p = 0.076) during the follow-up period. Conclusions This homogeneous composite microporous PCL nasal septal implant demonstrated long-term clinical efficacy and safety in human tissues that required maintenance of mechanical strength. Therefore, the indications for this implant could extend to various other craniofacial reconstructions in the future.

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Anatomic Changes Caused by Endoscopic Endonasal Transsphenoidal Surgery and Their Effects on Nasal Functions

Cited by 17 publications

References 28 publications

Transnasal Endoscopic Pituitary Surgery—The Role of a CT Scan in Individual Tailoring of Posterior Septum Size Resection

Transnasal Endoscopic Pituitary Surgery—The Role of a CT Scan in Individual Tailoring of Posterior Septum Size Resection

Superior turbinate management and olfactory outcome after endoscopic endonasal transsphenoidal surgery for pituitary adenoma: a propensity score‒matched cohort study

Long-term efficacy and safety of 3D printed implant in patients with nasal septal deformities

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