Frontiers in Oncology (Feb 2022)
A Modified Microscopic-Endoscopic Bilateral Transseptal Approach for Pituitary Adenomas: Comparisons of Nasal Outcome and Quality of Life Using the Microscopic Transnasal Approach
- Junjie Zhong,
- Junjie Zhong,
- Junjie Zhong,
- Junjie Zhong,
- Junjie Zhong,
- Yanfang Gu,
- Yanfang Gu,
- Yanfang Gu,
- Yanfang Gu,
- Yanfang Gu,
- Jie Zheng,
- Jie Zheng,
- Jie Zheng,
- Jie Zheng,
- Jie Zheng,
- Bojie Yang,
- Bojie Yang,
- Bojie Yang,
- Bojie Yang,
- Bojie Yang,
- Zengxin Qi,
- Zengxin Qi,
- Zengxin Qi,
- Zengxin Qi,
- Zengxin Qi,
- Tianwen Li,
- Tianwen Li,
- Tianwen Li,
- Tianwen Li,
- Tianwen Li,
- Chao Shen,
- Chao Shen,
- Chao Shen,
- Chao Shen,
- Chao Shen,
- Chao Shen,
- Zhifeng Shi,
- Zhifeng Shi,
- Zhifeng Shi,
- Zhifeng Shi,
- Zhifeng Shi,
- Zhifeng Shi
Affiliations
- Junjie Zhong
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Junjie Zhong
- Neurosurgical Institute of Fudan University, Shanghai, China
- Junjie Zhong
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Junjie Zhong
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Junjie Zhong
- National Center for Neurological Disorders, Shanghai, China
- Yanfang Gu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Yanfang Gu
- Neurosurgical Institute of Fudan University, Shanghai, China
- Yanfang Gu
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Yanfang Gu
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Yanfang Gu
- National Center for Neurological Disorders, Shanghai, China
- Jie Zheng
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Jie Zheng
- Neurosurgical Institute of Fudan University, Shanghai, China
- Jie Zheng
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Jie Zheng
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Jie Zheng
- National Center for Neurological Disorders, Shanghai, China
- Bojie Yang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Bojie Yang
- Neurosurgical Institute of Fudan University, Shanghai, China
- Bojie Yang
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Bojie Yang
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Bojie Yang
- National Center for Neurological Disorders, Shanghai, China
- Zengxin Qi
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Zengxin Qi
- Neurosurgical Institute of Fudan University, Shanghai, China
- Zengxin Qi
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Zengxin Qi
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Zengxin Qi
- National Center for Neurological Disorders, Shanghai, China
- Tianwen Li
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Tianwen Li
- Neurosurgical Institute of Fudan University, Shanghai, China
- Tianwen Li
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Tianwen Li
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Tianwen Li
- National Center for Neurological Disorders, Shanghai, China
- Chao Shen
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Chao Shen
- Neurosurgical Institute of Fudan University, Shanghai, China
- Chao Shen
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Chao Shen
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Chao Shen
- National Center for Neurological Disorders, Shanghai, China
- Chao Shen
- Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery (2018RU008), Chinese Academy of Medical Sciences, Shanghai, China
- Zhifeng Shi
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Zhifeng Shi
- Neurosurgical Institute of Fudan University, Shanghai, China
- Zhifeng Shi
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Zhifeng Shi
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Zhifeng Shi
- National Center for Neurological Disorders, Shanghai, China
- Zhifeng Shi
- Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery (2018RU008), Chinese Academy of Medical Sciences, Shanghai, China
- DOI
- https://doi.org/10.3389/fonc.2022.778704
- Journal volume & issue
-
Vol. 12
Abstract
ObjectivesIn this study, we introduced a novel modified microscopic-endoscopic bilateral transseptal approach for pituitary adenoma resection to minimize surgery-related nasal injury. We also retrospectively compared comprehensive nasal outcomes and quality of life between the microscopic transnasal approaches.MethodsPatients with pituitary adenomas who underwent modified microscopic-endoscopic bilateral transseptal or microscopic transnasal approaches were assessed for olfactory function and quality of life using the Sniffin’ Sticks test, the Sino-Nasal Outcome Test-22 (SNOT-22), the SF-36, the anterior skull base (ASK) nasal inventory, and the subjective visual analog scale (VAS) before and 1 and 3 months after surgery. A nasal endoscopy procedure was also performed to evaluate structure abnormalities at 1 and 3 months after surgery.ResultsFifty-eight patients who underwent either modified microscopic-endoscopic bilateral transseptal (35 patients) or microscopic transnasal (23 patients) surgery were consecutively enrolled. Patients who underwent either transnasal approach experienced similar surgical complications, except for intraoperative cerebrospinal fluid leakage (43.5% vs 14.3% for modified microscopic-endoscopic bilateral transseptal or microscopic transnasal approach, respectively; p = 0.013). Patients who underwent the two approaches fully recovered according to the SF-36, SNOT-22, VAS, and Sniffin’ Sticks surveys, but not ASK scores, 3 months post-operatively. There was no significant difference in nasal endoscopy outcome at 3 months follow-up between the two approaches.ConclusionsThe modified microscopic-endoscopic bilateral transseptal approach showed largely similar nasal mucosa protective outcomes to those of the microscopic transnasal approach for pituitary adenoma surgery. After pituitary adenoma resection using the modified approach, patients’ postoperative olfactory function, nasal structure, and quality of life can be restored to preoperative status within 3 months.
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