Journal of Neurosurgery, Ahead of Print.
OBJECT Both endoscopic and microscopic transsphenoidal approaches are accepted techniques for the resection of pituitary adenomas. Although studies have explored patient outcomes for each technique individually, none have prospectively compared sinonasal and quality of life outcomes in a concurrent series of patients at the same institution, as has been done in the present study. METHODS Patients with nonfunctioning adenomas undergoing transsphenoidal surgery were assessed for sinonasal function, quality of life, and pain using the Sino-Nasal Outcome Test-20 (SNOT-20), the short form of the Nasal Obstruction Symptom Evaluation (NOSE) instrument, the SF-36, and a headache scale. Eighty-two patients undergoing either endoscopic (47 patients) or microscopic (35 patients) surgery were surveyed preoperatively and at 24–48 hours, 2 weeks, 4 weeks, 8 weeks, and 1 year after surgery. RESULTS Patients who underwent endoscopic and microscopic transsphenoidal surgery experienced a similar recovery pattern, showing an initial increase in symptoms during the first 2 weeks, followed by a return to baseline by 4 weeks and improvement beyond baseline functioning by 8 weeks. Patients who underwent endoscopic surgery experienced better sinonasal outcomes at 24–48 hours (SNOT total p = 0.015, SNOT rhinologic subscale [ssRhino] p < 0.001), 2 weeks (NOSE p = 0.013), and 8 weeks (SNOT total p = 0.032 and SNOT ssRhino p = 0.035). By 1 year after surgery, no significant differences in sinonasal outcomes were observed between the 2 groups. Headache scales at 1 year improved in all dimensions except duration for both groups (total result 73%, p = 0.004; severity 46%, p < 0.001; frequency 53%, p < 0.001), with 80% of either microscopic or endoscopic patients experiencing improvement or resolution of headache symptoms. Endoscopic and microscopic patients experienced reduced vitality preoperatively compared with US population norms and remained low postoperatively. By 8 weeks after surgery, both groups experienced significant improvements in mental health (13%, p = 0.005) and vitality (15%, p = 0.037). By 1 year after surgery, patients improved significantly in mental health (14%, p = 0.03), role physical (14%, p = 0.036), social functioning (16%, p = 0.009), vitality (22%, p = 0.002), and SF-36 total (10%, p = 0.024) as compared with preoperative measures. There were no significant differences at any time point between the 2 groups for the total SF-36 or for any of the 8 subscales. CONCLUSIONS Patients who underwent either an endoscopic or a microscopic approach experienced the greatest nasal symptoms at 2 weeks postoperatively and exhibited similar time courses of recovery in nasal, headache, and quality of life assessments. Although patients who underwent endoscopic surgery experienced significantly fewer nasal symptoms during the first 8 weeks, by 1 year after surgery, there were no significant differences between the 2 groups.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1Q9ZonN
via IFTTT
Αρχειοθήκη ιστολογίου
-
►
2020
(289)
- ► Φεβρουαρίου (28)
-
►
2019
(9071)
- ► Δεκεμβρίου (19)
- ► Σεπτεμβρίου (54)
- ► Φεβρουαρίου (3642)
- ► Ιανουαρίου (3200)
-
►
2018
(39872)
- ► Δεκεμβρίου (3318)
- ► Σεπτεμβρίου (3683)
- ► Φεβρουαρίου (2693)
- ► Ιανουαρίου (3198)
-
►
2017
(41099)
- ► Δεκεμβρίου (3127)
- ► Σεπτεμβρίου (2173)
-
►
2016
(13807)
- ► Δεκεμβρίου (700)
- ► Σεπτεμβρίου (600)
- ► Φεβρουαρίου (1350)
- ► Ιανουαρίου (1400)
-
▼
2015
(1500)
-
▼
Δεκεμβρίου
(1450)
-
▼
Δεκ 12
(50)
- Surgical management of bisphosphonate-related oste...
- Results of a Multicenter, Randomized, Double-Maske...
- Pharmacotherapy for Pediatric Generalized Anxiety ...
- Extracellular Toxoplasma gondii tachyzoites metabo...
- CD1a+ and CD83+ Langerhans cells are reduced in lo...
- mTOR pathway protein immunoexpression as a prognos...
- Intrathecal fentanyl abolishes the exaggerated blo...
- Endothelin regulates intermittent hypoxia-induced ...
- Increasing taurine intake and taurine synthesis im...
- Microglia modulate brainstem serotonergic expressi...
- Factors associated with having less than 20 natura...
- The Effect on Sodium/Iodide Symporter and Pendrin ...
- Transient spurious intrathecal immunoglobulin synt...
- Validation of the Chinese version of the FOUR scor...
- IJMS, Vol. 16, Pages 29772-29786: Microtubule-Asso...
- MMP2 and MMP7 at the invasive front of gastric can...
- Carcinosarcoma of the larynx consisting of squamou...
- Head and neck cancers: a clinico-pathological prof...
- The use of intraoperative triggered electromyograp...
- Scoliosis may increase the risk of recurrence of l...
- The role of obesity in the biomechanics and radiol...
- The rise and fall of the craniocervical junction r...
- Preoperative retrolisthesis as a risk factor of po...
- Economic value of treating lumbar disc herniation ...
- Letter to the Editor: Alternative approach in Type...
- Prevalence and type of cervical deformities among ...
- App-assisted external ventricular drain insertion
- Effectiveness of 2-methoxyestradiol in alleviating...
- Neuropsychological outcomes of subtemporal selecti...
- The safety of Pipeline flow diversion in fusiform ...
- Sonographic findings associated with stenosis prog...
- Origin of craniopharyngiomas: implications for gro...
- Identifying preoperative language tracts and predi...
- Dynamic telescopic craniotomy: a cadaveric study o...
- Prospective comparison of sinonasal outcomes after...
- Application of contrast-enhanced T1-weighted MRI-b...
- Treatment of ruptured complex and large/giant rupt...
- A cadaveric microanatomical study of the fascicula...
- EP24.15 as a potential regulator of Kisspeptin wit...
- Research-focused isolation of human islets from do...
- Activation of medulla-projecting perifornical neur...
- Nodal promotes functional luteolysis via downregul...
- Post stroke hemi-dystonia in children: a neglected...
- Salting-out-assisted liquid–liquid extraction as a...
- Downscaling the in vitro test of fungal bioremedia...
- Cervical Cancer Prevention in Malaysia: Knowledge ...
- Local cryosurgery and imiquimod: A successful comb...
- Blistering disease associated with diffuse large B...
- Spontaneous remission of aleukemic cutaneous myelo...
- Kissing tumors of sebaceous carcinoma on the eyeli...
-
▼
Δεκ 12
(50)
-
▼
Δεκεμβρίου
(1450)
Ετικέτες
Σάββατο 12 Δεκεμβρίου 2015
Prospective comparison of sinonasal outcomes after microscopic sublabial or endoscopic endonasal transsphenoidal surgery for nonfunctioning pituitary adenomas
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου