title: Impact of endoscopic endonasal pituitary surgery on nasal airway patency.
abstract: BACKGROUND
  Nose is used as a corridor in endoscopic endonasal transsphenoidal approach (EETSA) for pituitary adenoma. Thus, it may affect the nasal airway patency, function and sinonasal-related quality of life. The aim of this study is to objectively and subjectively evaluate these effects.
  
  
  METHODS
  In this prospective study, 43 patients with pituitary adenoma who were candidates for EETSA from March 2012 to October 2013 were enrolled. The patients were evaluated preoperatively using acoustic rhinometry and rhinomanometry (with/without the use of decongestant drops) and asked to complete the 22-Item Sinonasal Outcome Test (SNOT-22) questionnaire. The tests were repeated at one and three months postoperatively. The preoperative data were compared with the first and second postoperative ones using paired-sample t-test.
  
  
  RESULTS
  Without the use of decongestant drops, the total airway resistance increased significantly (p=0.016), and the nasal airflow decreased significantly (p=0.031) in the first postoperative evaluation. However, in the 3rd postoperative month, the difference was not significant. With the use of decongestant drops, the objective parameters showed no significant changes compared to preoperative data even at the first evaluation. The SNOT- 22 scores also did not differ significantly in 1st and 3rd postoperative months. The first postoperative SNOT-22 showed a strong correlation with the second minimal cross-sectional area on simultaneous evaluation, and with the preoperative total airway resistance.
  
  
  CONCLUSIONS
  EETSA has a transient adverse effect on the nasal patency that quickly improves, making it a safe approach for the sinonasal system. Rhinomanometry is the most sensitive test for detecting these nasal functional changes objectively.
authors: MD, Associate Professor of Otolaryngology- Head and Neck Surgery, Skull Base Research Center, ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. jalessimd@gmail.com.
authors: Maryam
authors: M
authors: Jalessi
authors: MD, Professor of Otolaryngology- Head and Neck Surgery, ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. farhadi28@gmail.com.
authors: Mohammad
authors: M
authors: Farhadi
authors: MD, Associate Professor of Otolaryngology- Head and Neck Surgery, ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. dramasghari@gmail.com.
authors: Alimohamad
authors: A
authors: Asghari
authors: MD, Research Assistant, ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran. sbresearchcenter@gmail.com.
authors: Maryam
authors: M
authors: Hosseini
authors: MD, Research Assistant, Skull Base Research Center, ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran. elaheaminimd@gmail.com.
authors: Elahe
authors: E
authors: Amini
authors: MD, Associate Professor of Otolaryngology- Head and Neck Surgery, ENT and Head & Neck Research Center and Department, Hazrat Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. sb_pousti@yahoo.ca.
authors: Seyyed Behzad
authors: SB
authors: Pousti
keywords: Acoustic rhinometry; Endoscopy; Pituitary adenoma; Rhinomanometry; Skull base