Sinonasal outcome after endoscopic mononostril transsphenoidal surgery: A single center cohort study

Linsler, Stefan; Prokein, Benjamin; Hendrix, Philipp; Oertel, Joachim

doi:10.1016/j.jocn.2018.04.011

Cited by 14 publications

(13 citation statements)

References 47 publications

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“…The rate of developing an episode of post‐TSH acute rhinosinusitis that required treatment in this retrospective study was 14% (within 3 months) and 6% (after 3 months). The rate of rhinosinusitis following TSH varies widely in the literature . Linsler et al., using a patient‐reported survey of sinonasal outcomes following a mono‐nostril TSH technique using a speculum and endoscope, reported a rate of postoperative recurrent acute rhinosinusitis of 25% at 1 year and 11.4% of patients requiring additional nasal surgery for nasal obstruction or rhinosinusitis.…”

Section: Discussionmentioning

confidence: 99%

“…The rate of rhinosinusitis following TSH varies widely in the literature. [7][8][9][10][11][12] Linsler et al, 7 using a patient-reported survey of sinonasal outcomes following a mono-nostril TSH technique using a speculum and endoscope, reported a rate of postoperative recurrent acute rhinosinusitis of 25% at 1 year and 11.4% of patients requiring additional nasal surgery for nasal obstruction or rhinosinusitis. Batra et al 8 reported a 7.5% rate of sphenoid sinusitis following TSH, whereas Gondim et al 11 showed a 1.66% rate of sphenoid sinusitis in 301 patients undergoing TSH.…”

Section: Discussionmentioning

confidence: 99%

“…The rate of rhinosinusitis following endoscopic TSH varies widely in the literature. Studies can be difficult to compare because of differences in technique, sample size, and patient comorbidities . Aggressive turbinate resections, ethmoidectomies, and extensive sphenoidotomies are unnecessary for TSH approach in otherwise nondiseased sinuses.…”

mentioning

confidence: 99%

“…Studies can be difficult to compare because of differences in technique, sample size, and patient comorbidities. [7][8][9][10][11][12] Aggressive turbinate resections, ethmoidectomies, and extensive sphenoidotomies are unnecessary for TSH approach in otherwise nondiseased sinuses. It has been argued that this approach may result in more adhesions, obstruction, and rhinosinusitis.…”

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confidence: 99%

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Rate of rhinosinusitis and sinus surgery following a minimally destructive approach to endoscopic transsphenoidal hypophysectomy

Rimmer

Vimawala

Chitguppi

et al. 2019

Int Forum Allergy Rhinol

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Background There remains considerable variation in the extent of sinonasal preservation during the approach for endoscopic transsphenoidal hypophysectomy (TSH). We advocate for a minimally destructive approach utilizing turbinate lateralization, small posterior septectomy, no ethmoidectomy, and preservation of nasoseptal flap (NSF) pedicles bilaterally. Due to these factors, this approach may affect the rates of postoperative rhinosinusitis. The objective of this study is to define the rates of postoperative rhinosinusitis in patients undergoing this approach. Methods Single institution, retrospective chart review of patients undergoing TSH from 2005 to 2018. Results A total of 415 patients were identified and 14% developed an episode of postoperative rhinosinusitis within 3 months. These patients were significantly more likely to have had a history of recurrent acute or chronic rhinosinusitis. Most cases were sphenoethmoidal sinusitis managed with 1 to 2 courses of antibiotics. Of patients with postoperative rhinosinusitis, most did not undergo NSF. Average follow‐up was 38 months. Six patients (1.4%) underwent post‐TSH functional endoscopic sinus surgery (FESS). Average time from TSH to FESS was 26.3 months. Two of these patients had a history of prior chronic rhinosinusitis without polyposis. Two patients underwent revision TSH for recurrent tumor as the primary indication for surgery at time of FESS. Twenty‐two–item Sino‐Nasal Outcome Test (SNOT‐22) scores generally increased immediately postoperatively, but frequently decreased below preoperative level by the time of last follow‐up, regardless of whether patients developed rhinosinusitis. Conclusion Sinonasal preservation during TSH is associated with a low rate of postoperative rhinosinusitis requiring FESS and excellent long‐term patient reported outcomes. We continue to advocate for sinonasal preservation during pituitary surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Rate of rhinosinusitis and sinus surgery following a minimally destructive approach to endoscopic transsphenoidal hypophysectomy

Rimmer

Vimawala

Chitguppi

et al. 2019

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

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“…However, many of these studies are retrospective studies. 16,30,34,40,47,[51][52][53] Our study is a prospective study. Also, most of the studies are focused on the bi-nostril technique.…”

Section: Unique Features Of Present Studymentioning

confidence: 99%

Comparison of Sinonasal Outcomes in Patients Undergoing Uni-nostril and Bi-nostril Endoscopic Trans-sphenoidal Excision of Pituitary Adenomas: A Prospective Study

Vupputuri,

D'Souza,

Ralte

et al. 2023

J Neurol Surg B Skull Base

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Background Prospective studies comparing quality-of-life and olfaction in patients undergoing endoscopic uni-nostril versus bi-nostril trans-sphenoidal pituitary surgery have not been published. Methods We prospectively compared olfaction and quality-of-life at baseline and at 3 to 6 months follow-up using the Anterior Skull Base Nasal Inventory-12 (ASK-12) questionnaire, composite olfaction score, and Lund–Kennedy Endoscopic Score (LKES) in 43 patients who underwent endoscopic excision of pituitary adenoma with either a uni-nostril (24 patients) or a bi-nostril (19 patients) approach. Results Baseline data for both groups were comparable. In the uni-nostril group, ASK-12 and LKES scores were not significantly different at follow-up when compared with the preoperative scores. In the bi-nostril group, there was a significant postoperative worsening of ASK-12 scores (mean: 3.2 vs. 5.3; p = 0.04) and the LKES (mean: 2.9 vs. 6.6; p = 0.01). Composite olfaction score was not significantly affected postoperatively with either approach. Nasal complications were also more in the bi-nostril group (5/18, 27.8% vs. 1/23, 4.3%) but this was not statistically significant (p = 0.07). Conclusion Both approaches preserve olfactory function but the uni-nostril approach is associated with better postoperative quality-of-life and endoscopic scores and subjective olfaction outcomes. At least in short term, the postoperative morbidity is higher in the bi-nostril approach compared with the uni-nostril approach. Although preference for a particular approach is related to a surgeon's preference, preoperative counselling of the patients regarding sinonasal morbidity is important.

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Surgical complications of endoscopic approach to skull base: analysis of 584 consecutive patients

Fallah

Sadaghiani

Sadrhosseini

et al. 2022

Eur Arch Otorhinolaryngol

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Sinonasal outcome after endoscopic mononostril transsphenoidal surgery: A single center cohort study

Cited by 14 publications

References 47 publications

Rate of rhinosinusitis and sinus surgery following a minimally destructive approach to endoscopic transsphenoidal hypophysectomy

Rate of rhinosinusitis and sinus surgery following a minimally destructive approach to endoscopic transsphenoidal hypophysectomy

Comparison of Sinonasal Outcomes in Patients Undergoing Uni-nostril and Bi-nostril Endoscopic Trans-sphenoidal Excision of Pituitary Adenomas: A Prospective Study

Surgical complications of endoscopic approach to skull base: analysis of 584 consecutive patients

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