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Impact of nasoseptal flap elevation on sinonasal quality of life in endoscopic endonasal approach to pituitary adenomas

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

To evaluate the impact of nasoseptal flap (NSF) elevation on sinonasal quality of life (QOL) in patients with pituitary adenomas who underwent endoscopic endonasal trans-sphenoidal approach (EETSA), the data of 106 eligible patients were included from February 2011 to December 2014. The scores of Sinonasal Outcome Test (SNOT-22) Questionnaire were assessed in case (that received reconstruction with NSF) and control groups preoperatively as well as 1, 3, 6, and more than 12 months postoperatively. Nine most related sinonasal questions were evaluated separately (9Q). There were no significant inter-group differences in the mean SNOT-22, 9Q, and sense of taste/smell scores in preoperative and all postoperative assessments. Within each group, a significant improvement of SNOT-22 and 9Q scores were noted after 12 months of surgery compared to preoperative data. In the NSF group, comparison of the pre- and first postoperative evaluation revealed a significant deterioration in 9Q score (p = 0.007) and “sense of taste/smell” (p < 0.001) which both returned to baseline in the 3rd month. Patients who used nasal paper mask for more than 100 “hour-days” showed a better SNOT-22 scores at 1st (p = 0.04) and 3rd (p < 0.001) months after surgery. Patients with adrenocorticotropic hormone (ACTH) secretory adenomas showed significantly higher scores of SNOT-22 in all postoperative assessments compared to the others. Although nasal symptoms deteriorated at first postoperative month (compare to preoperative data) in the NSF group, no negative impacts on the sinonasal QOL was showed comparing to the control group. ACTH-secreting adenomas could be assumed as a risk factor for poorer sinonasal QOL in EETSA.

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References

  1. Awad AJ, Mohyeldin A, El-Sayed IH, Aghi MK (2015) Sinonasal morbidity following endoscopic endonasal skull base surgery. Clin Neurol Neurosurg 130:162–167

    Article  PubMed  Google Scholar 

  2. Balaker AE, Bergsneider M, Martin NA, Wang MB (2010) Evolution of sinonasal symptoms following endoscopic anterior skull base surgery. Skull Base 20(4):245–251

    Article  PubMed  PubMed Central  Google Scholar 

  3. de Almeida JR, Snyderman CH, Gardner PA, Carrau RL, Vescan AD (2011) Nasal morbidity following endoscopic skull base surgery: a prospective cohort study. Head Neck 33(4):547–551

    Article  PubMed  Google Scholar 

  4. Strychowsky J, Nayan S, Reddy K, Farrokhyar F, Sommer D (2011) Purely endoscopic transsphenoidal surgery versus traditional microsurgery for resection of pituitary adenomas: systematic review. J Otolaryngol Head Neck Surg 40(2):175–185

    PubMed  Google Scholar 

  5. Pant H, Bhatki AM, Snyderman CH, Vescan AD, Carrau RL, Gardner P, Prevedello D, Kassam AB (2010) Quality of life following endonasal skull base surgery. Skull Base 20(1):35–40

    Article  PubMed  PubMed Central  Google Scholar 

  6. McCoul ED, Anand VK, Schwartz TH (2012) Improvements in site-specific quality of life 6 months after endoscopic anterior skull base surgery: a prospective study. J Neurosurg 117(3):498–506

    Article  PubMed  Google Scholar 

  7. Hadad G, Bassagasteguy L, Carrau RL, Mataza JC, Kassam A, Snyderman CH, Mintz A (2006) A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 116(10):1882–1886

    Article  PubMed  Google Scholar 

  8. Snyderman CH, Kassam AB, Carrau R, Mintz A (2007) Endoscopic reconstruction of cranial base defects following endonasal skull base surgery. Skull Base 17(1):73–78

    Article  PubMed  PubMed Central  Google Scholar 

  9. Patel MR, Stadler ME, Snyderman CH, Carrau RL, Kassam AB, Germanwala AV, Gardner P, Zanation AM (2010) How to choose? Endoscopic skull base reconstructive options and limitations. Skull Base 20(6):397–404

    Article  PubMed  PubMed Central  Google Scholar 

  10. Granados EC, Carrau R, Kassam A, Snyderman CH, Prevedello D, Miranda JF, Gardner P (2011) In response to pedicled nasoseptal flap is not the standard of care for skull base defects. Laryngoscope 121(4):898

  11. Soudry E, Psaltis AJ, Lee KH, Vaezafshar R, Nayak JV, Hwang PH (2015) Complications associated with the pedicled nasoseptal flap for skull base reconstruction. Laryngoscope 125(1):80–85

    Article  PubMed  Google Scholar 

  12. Morley AD, Sharp HR (2006) A review of sinonasal outcome scoring systems—which is best? Clin Otolaryngol 31(2):103–109

    Article  CAS  PubMed  Google Scholar 

  13. Ransom ER, Doghramji L, Palmer JN, Chiu AG (2012) Global and disease-specific health-related quality of life after complete endoscopic resection of anterior skull base neoplasms. Am J Rhinol Allergy 26(1):76–79

    Article  PubMed  Google Scholar 

  14. Jalessi M, Farhadi M, Kamrava SK, Amintehran E, Asghari A, RezaeiHemami M, Mobasseri A, Masroorchehr M (2013) The reliability and validity of the persian version of sinonasal outcome test 22 (Snot 22) questionnaires. Iran Red Crescent Med J 15(5):404–408

    Article  PubMed  PubMed Central  Google Scholar 

  15. Jalessi M, Sharifi G, MirfallahLayalestani MR, Amintehran E, Yazdanifard P, Rezaee Mirghaed O, Farhadi M (2013) Sellar reconstruction algorithm in endoscopic transsphenoidal pituitary surgery: experience with 240 cases. Med J Islam Repub Iran 27(4):186–194

    PubMed  PubMed Central  Google Scholar 

  16. Kimple AJ, Leight WD, Wheless SA, Zanation AM (2012) Reducing nasal morbidity after skull base reconstruction with the nasoseptal flap: free middle turbinate mucosal grafts. Laryngoscope 122(9):1920–1924

    Article  PubMed  PubMed Central  Google Scholar 

  17. Caicedo-Granados E, Carrau R, Snyderman CH, Prevedello D, Fernandez-Miranda J, Gardner P, Kassam A (2010) Reverse rotation flap for reconstruction of donor site after vascular pedicled nasoseptal flap in skull base surgery. Laryngoscope 120(8):1550–1552

    Article  PubMed  Google Scholar 

  18. Junker JP, Kamel RA, Caterson EJ, Eriksson E (2013) Clinical Impact Upon Wound Healing and Inflammation in Moist, Wet, and Dry Environments. Adv Wound Care (New Rochelle) 2(7):348–356

    Article  Google Scholar 

  19. Brown CL, Graham SM (2004) Nasal irrigations: good or bad? Curr Opin Otolaryngol Head Neck Surg 12(1):9–13

    Article  PubMed  Google Scholar 

  20. Ural A, Oktemer TK, Kizil Y, Ileri F, Uslu S (2009) Impact of isotonic and hypertonic saline solutions on mucociliary activity in various nasal pathologies: clinical study. J Laryngol Otol 123(5):517–521

    Article  CAS  PubMed  Google Scholar 

  21. Georgitis JW (1994) Nasal hyperthermia and simple irrigation for perennial rhinitis. Changes in inflammatory mediators. Chest 106(5):1487–1492

    Article  CAS  PubMed  Google Scholar 

  22. Wang AS, Armstrong EJ, Armstrong AW (2013) Corticosteroids and wound healing: clinical considerations in the perioperative period. Am J Surg 206(3):410–417

    Article  CAS  PubMed  Google Scholar 

  23. Semple PL, Laws ER Jr (1999) Complications in a contemporary series of patients who underwent transsphenoidal surgery for Cushing’s disease. J Neurosurg 91(2):175–179

    Article  CAS  PubMed  Google Scholar 

  24. Johnson MD, Woodburn CJ, Vance ML (2003) Quality of life in patients with a pituitary adenoma. Pituitary 6(2):81–87

    Article  PubMed  Google Scholar 

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Correspondence to Elahe Amini.

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The authors declare that they have no conflict of interest.

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It is a retrospective study. For this type of study Ethical approval is not required but informed consent had been obtained from the patients.

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Jalessi, M., Jahanbakhshi, A., Amini, E. et al. Impact of nasoseptal flap elevation on sinonasal quality of life in endoscopic endonasal approach to pituitary adenomas. Eur Arch Otorhinolaryngol 273, 1199–1205 (2016). https://doi.org/10.1007/s00405-015-3729-z

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  • DOI: https://doi.org/10.1007/s00405-015-3729-z

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