Outcomes of endoscopic transnasal minimally invasive surgery through different approaches for pituitary tumors and their effects on nasal function

HE Yang

doi:10.13798/j.issn.1009-153X.2019.09.009

Abstract：To explore the clinical effects of endoscopic surgery through different approaches on the pituitary tumors. Methods The clinical data of 120 patients with pituitary tumors, of whom, 42 (nasal septum group) underwent endoscopic surgery through transnasal submucosal sphenoid sinus approach and 78 (nasal cavity group) through transnasal-sphenoidal approach were analyzed retrospectively. The ventilation function [nasal airway resistance (NAR)], olfaction [recognition threshold (RT)], quality of life [sino-nasal outcome test-20 (SNOT-20)] were determined before the operation and 1, 3 and 6 months before the operation. The treatment effects and complications were analyzed and compared between the two groups 1, 3 and 6 months after the operation. Results The levels of NAR, five taste olfactory liquid RT and SNOT-20 were significantly higher 1, 3 and 6 months after the operation than those before the operation in the two groups (P<0.05), and they were significantly lower in the nasal septum group than those in the nasal cavity group 1, 3 and 6 months after the operation (P<0.05). The basic perioperative indexes including the intraoperative bleeding volume, operative duration, rate of nasal concha fracture and postoperative hospital stay were significantly lower in the nasal septum group than those in the nasal cavity group (P<0.05). There was insignificant difference in the treatment effects between the two groups (P>0.05). The total incidence of the complications was significantly lower in the nasal septum group than that in the nasal cavity group (P<0.05). Conclusions The endoscope surgery through transnasal submucosal sphenoid sinus approach has less impact on nasal function and has higher safety compared to the surgery through transnasnal-sphenoidal approach, and it is worth clinical application.