title: Impact of nasoseptal flap elevation on sinonasal quality of life in endoscopic endonasal approach to pituitary adenomas.
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.
authors.affiliation: Endoscopic Skull Base Surgery Unit, ENT-Head and Neck Surgery Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Jalessi
authors.affiliation: Endoscopic Skull Base Surgery Unit, ENT-Head and Neck Surgery Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Amin
authors.initials: A
authors.lastname: Jahanbakhshi
authors.affiliation: Endoscopic Skull Base Surgery Unit, ENT-Head and Neck Surgery Center, Iran University of Medical Sciences, Tehran, Iran. elaheaminimd@gmail.com.|Hazrat Rasoul Akram Hospital, Niayesh st., Sattarkhan Ave., 1445613131, Tehran, Iran. elaheaminimd@gmail.com.
authors.forename: Elahe
authors.initials: E
authors.lastname: Amini
authors.affiliation: Endoscopic Skull Base Surgery Unit, ENT-Head and Neck Surgery Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyyed Kamran
authors.initials: SK
authors.lastname: Kamrava
authors.affiliation: Endoscopic Skull Base Surgery Unit, ENT-Head and Neck Surgery Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Farhadi
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery*; D057605:Natural Orifice Endoscopic Surgery; D010911:Pituitary Neoplasms / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D012903:Smell; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D013649:Taste; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adrenocorticotropic; Nasoseptal flap; Pituitary adenoma; Quality of life; Skull base