title: Nasal symptoms following endoscopic transsphenoidal pituitary surgery: assessment using the General Nasal Patient Inventory.
abstract: OBJECTIVE
  The endoscopic approach for pituitary tumors is a recent innovation and is said to reduce the nasal trauma associated with transnasal transsphenoidal surgery. The authors assessed the temporal changes in the rhinological symptoms following endoscopic transsphenoidal surgery for pituitary lesions, using the General Nasal Patient Inventory (GNPI).
  
  
  METHODS
  The GNPI was administered to 88 consecutive patients undergoing endoscopic transsphenoidal surgery at 3 time points (presurgery, 3-6 months postsurgery, and at final follow-up). The total GNPI score and the scores for the individual GNPI questions were calculated and differences between groups were assessed once before surgery, several months after surgery, and at final follow-up.
  
  
  RESULTS
  Of a maximum possible score of 135, the mean GNPI score at 3-6 months postsurgery was only 12.9 ± 12 and was not significantly different from the preoperative score (10.4 ± 13) or final follow-up score (10.3 ± 10). Patients with functioning tumors had higher GNPI scores than those with nonfunctioning tumors for each of these time points (p < 0.05). Individually, a mild increase in symptom severity was seen for symptoms attributable to the nasal trauma of surgery, with partial recovery (nasal sores and bleeding) or complete recovery (nasal blockage, painful sinuses, and unpleasant nasal smell) by final follow-up (p < 0.05). Progressive improvements in symptom severity were seen for symptoms more attributable to tumor mass preoperatively (for example, headaches and painkiller use [p < 0.05]). In total, by final follow-up 8 patients (9%) required further treatment or advice for ongoing nasal symptoms.
  
  
  CONCLUSIONS
  Endoscopic transsphenoidal surgery is a well-tolerated minimally invasive procedure for pituitary fossa lesions. Overall patient-assessed nasal symptoms do not change, but some individual symptoms may show a mild worsening or overall improvement.
authors: Department of Neurosurgery, Greater Manchester Neuroscience Centre, Salford Royal Foundation Trust, Salford, United Kingdom. yiyuen.wang@svhm.org.au
authors: Yi Yuen
authors: YY
authors: Wang
authors: Vinothan
authors: V
authors: Srirathan
authors: Erica
authors: E
authors: Tirr
authors: Tara
authors: T
authors: Kearney
authors: Kanna K
authors: KK
authors: Gnanalingham
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D009668:Nose Diseases / Q000175:diagnosis* / Q000209:etiology*; D010911:Pituitary Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000503:physiopathology*; D012720:Severity of Illness Index; D013100:Sphenoid Bone / Q000601:surgery; D055815:Young Adult