Quality of Life Changes after Endoscopic Pituitary Surgery

Abstract

Objective: Given that the transnasal endoscopic approach to the sella involves resection of nasal cavity and sinus anatomy, the effect of surgery on sinonasal quality of life was tested.

Method: Case series with planned data collection at a single tertiary care institution. Adults with a pituitary mass scheduled for transnasal endoscopic resection underwent preoperative testing using the Sinonasal Outcome Test-22 (SNOT-22). Repeat testing was performed 1 and 3 months postoperatively. Paired Student t tests and confidence intervals compared pre- and postoperative scores.

Results: Thirty-nine consecutive patients were enrolled. Thirty-seven patients (19 males, 18 females) completed testing at 1 month. Thirty-four (17 males, 17 females) completed a 3-month evaluation. The average score (out of 120) was 23.9 preoperatively, 27.5 at 1 month, and 15.3 at 3 months. A significant improvement was found between preoperative and 3-month scores (P = .03), but no change was found at 1 month (P = .4). Emotional well-being questions such as sadness, frustration, concentration, productivity, and fatigue significantly improved 3 months after surgery (P < .05). Physiological questions such as olfaction, obstruction, and postnasal drainage decreased at 1 month (<.05) and normalized at 3 months.

Conclusion: No difference was found between total preoperative and 1 month SNOT-22 scores. At 3 months clinically significant improvement was seen in SNOT-22 scores. Analysis of individual SNOT-22 questions shows marked improvement in emotional well-being and temporary physiologic changes after endoscopic pituitary surgery.