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DOI: 10.1055/s-0041-1730322
A Prospective Evaluation of Quality of Life in Patients Undergoing Extended Endoscopic Endonasal Surgery for Benign Pituitary Gland Lesion
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Abstract
Introduction Endoscopic endonasal surgery (EES) has become the preferred approach for pituitary tumor resection. Nevertheless, research on quality of life related to pituitary adenoma surgery is scarce.
Objective The aim of the study is to evaluate short-term quality of life in patients after endoscopic endonasal resection of pituitary tumors and to find predictors for poor quality of life (QOL) outcome.
Materials and Methods A prospective cohort study was conducted, including all patients who underwent EES for pituitary tumors in a tertiary medical referral center. Recruited patients completed the Anterior Skull Base Disease-Specific QOL (ASBS-Q) questionnaire and the Sinonasal Outcome Test 22 (SNOT-22) questionnaire before surgery, 2 and 4 to 6 months after surgery. Demographic and clinical data was collected.
Results Our study included 49 patients. The overall ASBS-Q scores significantly improved 4 to 6 months after surgery (4.46 vs. 4.2, p < 0.05). We found a significant improvement in QOL related to emotional state 2 months post surgery (4.41 vs. 3.87, p < 0.05), which became borderline significant 4 to 6 months post surgery. There was a significant improvement in pain (4.5 vs. 4.08, p < 0.05) and vitality (4.43 vs. 4.16, p < 0.05) domains 4 to 6 months post surgery. SNOT-22 scores did not change significantly postoperatively. Factors such as secreting and non-secreting tumors, tumor size, intraoperative cerebrospinal fluid leak, gross tumor resection, endocrine remission, and the use of nasoseptal flap reconstruction did not have a significant effect on QOL.
Conclusion We found that patients after EES reported improved QOL 4 to 6 months post surgery. Specific improvement was noted in the QOL related to pain and vitality.
Publication History
Received: 03 November 2020
Accepted: 21 March 2021
Article published online:
29 May 2021
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References
- 1 Crespo I, Santos A, Resmini E, Valassi E, Martínez-Momblán MA, Webb SM. Improving quality of life in patients with pituitary tumours. Eur Endocrinol 2013; 9 (01) 32-36
- 2 Mohsenipour I, Deusch E, Gabl M, Hofer M, Twerdy K. Quality of life in patients after meningioma resection. Acta Neurochir (Wien) 2001; 143 (06) 547-553
- 3 Kelleher MO, Fernandes MF, Sim DW, O'Sullivan MG. Health-related quality of life in patients with skull base tumours. Br J Neurosurg 2002; 16 (01) 16-20
- 4 Abergel A, Fliss DM, Margalit N, Gil Z. A prospective evaluation of short-term health-related quality of life in patients undergoing anterior skull base surgery. Skull Base 2010; 20 (01) 27-33
- 5 Amit M, Abergel A, Fliss DM, Gil Z. The clinical importance of quality-of-life scores in patients with skull base tumors: a meta-analysis and review of the literature. Curr Oncol Rep 2012; 14 (02) 175-181
- 6 Gil Z, Abergel A, Spektor S. et al. Quality of life following surgery for anterior skull base tumors. Arch Otolaryngol Head Neck Surg 2003; 129 (12) 1303-1309
- 7 Cavel O, Abergel A, Margalit N, Fliss DM, Gil Z. Quality of life following endoscopic resection of skull base tumors. J Neurol Surg B Skull Base 2012; 73 (02) 112-116
- 8 Gil Z, Abergel A, Spektor S, Khafif A, Fliss DM. Patient, caregiver, and surgeon perceptions of quality of life following anterior skull base surgery. Arch Otolaryngol Head Neck Surg 2004; 130 (11) 1276-1281
- 9 Heald AH, Ghosh S, Bray S. et al. Long-term negative impact on quality of life in patients with successfully treated Cushing's disease. Clin Endocrinol (Oxf) 2004; 61 (04) 458-465
- 10 van Beek AP, van den Bergh ACM, van den Berg LM. et al. Radiotherapy is not associated with reduced quality of life and cognitive function in patients treated for nonfunctioning pituitary adenoma. Int J Radiat Oncol Biol Phys 2007; 68 (04) 986-991
- 11 Kuan EC, Yoo F, Chyu J, Oh A, Bergsneider M, Wang MB. Quality of Life before and after endoscopic pituitary surgery as measured by the Short-Form-36. J Neurol Surg B Skull Base 2018; 79 (03) 314-318
- 12 Weldring T, Smith SMS. Patient-Reported Outcomes (PROs) and Patient-Reported Outcome Measures (PROMs). Health Serv Insights 2013; 6: 61-68
- 13 Pant H, Bhatki AM, Snyderman CH. et al. Quality of life following endonasal skull base surgery. Skull Base 2010; 20 (01) 35-40
- 14 McCoul ED, Bedrosian JC, Akselrod O, Anand VK, Schwartz TH. Preservation of multidimensional quality of life after endoscopic pituitary adenoma resection. J Neurosurg 2015; 123 (03) 813-820
- 15 Alobid I, Enseñat J, Mariño-Sánchez F. et al. Expanded endonasal approach using vascularized septal flap reconstruction for skull base tumors has a negative impact on sinonasal symptoms and quality of life. Am J Rhinol Allergy 2013; 27 (05) 426-431
- 16 Shapira Galitz Y, Halperin D, Bavnik Y, Warman M. Sino-nasal outcome test-22: translation, cross-cultural adaptation, and validation in Hebrew-speaking patients. Otolaryngol Head Neck Surg 2016; 154 (05) 951-956
- 17 Wengier A, Ram Z, Warshavsky A, Margalit N, Fliss DM, Abergel A. Endoscopic skull base reconstruction with the nasoseptal flap: complications and risk factors. Eur Arch Otorhinolaryngol 2019; 276 (09) 2491-2498
- 18 Phillips KM, Hoehle LP, Caradonna DS, Gray ST, Sedaghat AR. Minimal clinically important difference for the 22-item Sinonasal Outcome Test in medically managed patients with chronic rhinosinusitis. Clin Otolaryngol 2018; 43 (05) 1328-1334
- 19 Levy MJ, Jäger HR, Powell M, Matharu MS, Meeran K, Goadsby PJ. Pituitary volume and headache: size is not everything. Arch Neurol 2004; 61 (05) 721-725
- 20 Gondim JA, de Almeida JP, de Albuquerque LA, Schops M, Gomes E, Ferraz T. Headache associated with pituitary tumors. J Headache Pain 2009; 10 (01) 15-20
- 21 Levy MJ, Matharu M, Goadsby PJ. Chronic headache and pituitary tumors. Curr Pain Headache Rep 2008; 12 (01) 74-78
- 22 Leopold DA, Hummel T, Schwob JE, Hong SC, Knecht M, Kobal G. Anterior distribution of human olfactory epithelium. Laryngoscope 2000; 110 (3 Pt 1): 417-421
- 23 Alam S, Li C, Bradburn KH, Zhao K, Lee TS. Impact of middle turbinectomy on airflow to the olfactory cleft: a computational fluid dynamics study. Am J Rhinol Allergy 2019; 33 (03) 263-268
- 24 Mariano FC, Hamerschmidt R, Soares CMC, Moreira AT. The middle turbinate resection and its repercussion in olfaction with the University of Pennsylvania Smell Identification Test (UPSIT). Int Arch Otorhinolaryngol 2018; 22 (03) 280-283
- 25 Akkoca Ö, Tüzüner A, Ünlü CE, Şimşek G, Kaytez SK, Uğurlu GA. Comparison of the effects of 2 surgical techniques used in the treatment of concha bullosa on olfactory functions. Ear Nose Throat J 2020; 99 (07) 437-441
- 26 Soler ZM, Hwang PH, Mace J, Smith TL. Outcomes after middle turbinate resection: revisiting a controversial topic. Laryngoscope 2010; 120 (04) 832-837
- 27 Delarestaghi MM, Rajaeih S, Firouzabadi FD. et al. Evaluation of the effect of endoscopic partial middle turbinectomy surgery on the quality of life of patients with chronic rhinosinusitis and nasal polyps. Rhinology 2020; 58 (03) 208-212
- 28 de Carvalho ACM, Dolci RLL, Rickli JCK. et al. Evaluation of olfactory function in patients undergoing endoscopic skull base surgery with nasoseptal flap. Braz J Otorhinolaryngol 2020; S1808-8694 (20): 30052-30055
- 29 Little AS, Kelly DF, Milligan J. et al. Comparison of sinonasal quality of life and health status in patients undergoing microscopic and endoscopic transsphenoidal surgery for pituitary lesions: a prospective cohort study. J Neurosurg 2015; 123 (03) 799-807