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A randomized prospective comparative study on sinonasal morbidity and quality of life of transsphenoidal endoscopic surgery for pituitary adenomas: endonasal versus trans-septal approach

  • Rhinology
  • Published:
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A Letter to the Editor to this article was published on 01 March 2024

Abstract

Purpose

Endoscopic endonasal transsphenoidal approach (Endonasal approach) is commonly used to treat pituitary adenomas. The extent of dissection possibly changes the anatomy and the physiology of the nasal cavities and could give rise to post-operative morbidity and the quality of life (QoL). The purpose of this study was to investigate sinonasal morbidity and general QoL in patients who underwent surgery for treatment of pituitary adenoma, comparing Endonasal and endoscopic trans-septal transsphenoidal approach (Trans-septal approach).

Methods

A prospective observational study, recruiting 40 patients undergoing surgery for pituitary adenoma, 20 via Endonasal approach and 20 via Trans-septal approach at our institution. Surveys with Sinonasal Outcome Test-22 (SNOT-22), Chronic Sinusitis Survey (CSS), and Short Form Health Survey 36 version 2 (SF-36v2) were obtained to collect QoL data pre- and postoperatively.

Results

All the 40 patients completed the questionnaires. At 6 months postoperatively, the SNOT-22 and CSS score shows significant improvements both in Endonasal approach (p = 0.01) and in Trans-septal approach (p = 0.02). No significant difference in sinonasal morbidity is observed between the two groups for SNOT-22 (p = 0.13) and CSS scores, except for sinus headache (p = 0.49), with a better score in Endonasal approach. The mean SF-36v2 scores remain the same in pre- and post-operative periods, but an improvement in time is seen in general health (p = 0.027), and general health compared to one year ago (p < 0.001).

Conclusions

Endoscopic transsphenoidal surgery has negligible morbidity and does not negatively affect the nasal function in the long term. Endonasal approach and Trans-septal approach are comparable in terms of morbidity outcomes and general QoL, leaving the choice of the approach to the surgeon preference.

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Data availability

The datasets generated during the current study are available from the corresponding authors on reasonable request.

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Funding

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Authors and Affiliations

  1. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, Milan, Italy

    Fabio Ferreli, Chiara Lasagna, Luca Canali, Ali Baram, Beatrice C. Bono, Emanuela Morenghi, Giuseppe Mercante, Giuseppe Spriano & Giovanni Colombo

  2. Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy

    Fabio Ferreli, Chiara Lasagna, Luca Canali, Francesca Pirola, Giuseppe Mercante & Giuseppe Spriano

  3. Neurosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy

    Ali Baram, Beatrice C. Bono, Maria Pia Tropeano & Giovanni Lasio

  4. Biostatistics Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy

    Emanuela Morenghi

  5. Neurosurgery Department, Neurocenter of the Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland

    Davide Milani

  6. Department of Otorhinolaryngology, Ospedale Nuovo di Legnano, ASST Ovest Milanese, Milan, Italy

    Giovanni Colombo

  7. IRCCS Humanitas Research Hospital, Via Alessandro Manzoni, 56, 20089, Rozzano, Milan, Italy

    Fabio Ferreli

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  1. Fabio Ferreli
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  2. Chiara Lasagna
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Correspondence to Fabio Ferreli.

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Ferreli, F., Lasagna, C., Canali, L. et al. A randomized prospective comparative study on sinonasal morbidity and quality of life of transsphenoidal endoscopic surgery for pituitary adenomas: endonasal versus trans-septal approach. Eur Arch Otorhinolaryngol 281, 257–266 (2024). https://doi.org/10.1007/s00405-023-08216-1

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