Object: The endoscopic approach for pituitary tumors is a recent innovation and is said to reduce the nasal trauma associated with transnasal transsphenoidal surgery. The authors assessed the temporal changes in the rhinological symptoms following endoscopic transsphenoidal surgery for pituitary lesions, using the General Nasal Patient Inventory (GNPI). Methods: The GNPI was administered to 88 consecutive patients undergoing endoscopic transsphenoidal surgery at 3 time points (presurgery, 3-6 months postsurgery, and at final follow-up). The total GNPI score and the scores for the individual GNPI questions were calculated and differences between groups were assessed once before surgery, several months after surgery, and at final follow-up. Results: Of a maximum possible score of 135, the mean GNPI score at 3-6 months postsurgery was only 12.9 ± 12 and was not significantly different from the preoperative score (10.4 ± 13) or final follow-up score (10.3 ± 10). Patients with functioning tumors had higher GNPI scores than those with nonfunctioning tumors for each of these time points (p <0.05). Individually, a mild increase in symptom severity was seen for symptoms attributable to the nasal trauma of surgery, with partial recovery (nasal sores and bleeding) or complete recovery (nasal blockage, painful sinuses, and unpleasant nasal smell) by final follow-up (p <0.05). Progressive improvements in symptom severity were seen for symptoms more attributable to tumor mass preoperatively (for example, headaches and painkiller use [p <0.05]). In total, by final follow-up 8 patients (9%) required further treatment or advice for ongoing nasal symptoms. Conclusions: Endoscopic transsphenoidal surgery is a well-tolerated minimally invasive procedure for pituitary fossa lesions. Overall patient-assessed nasal symptoms do not change, but some individual symptoms may show a mild worsening or overall improvement.
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机译：目的：垂体瘤的内窥镜治疗是一项最新创新，据说可以减少经鼻经蝶窦手术所引起的鼻外伤。作者使用鼻总患者清单（GNPI）评估了经内镜经蝶窦手术治疗的垂体病变后的流变学症状随时间的变化。方法：GNPI在3个时间点（术前，术后3-6个月以及最终随访）连续接受88例接受内镜经蝶窦手术的患者。计算总GNPI分数和单个GNPI问题的分数，并在手术前，手术后几个月以及最后的随访中评估各组之间的差异。结果：在最高可能得分135中，术后3-6个月的GNPI平均得分仅为12.9±12，与术前得分（10.4±13）或最终随访得分（10.3±10）并无显着差异。 。在所有这些时间点上，具有正常功能的患者的GNPI评分均高于非正常功能的患者（p <0.05）。个别而言，由于最终的随访结果，可观察到由于鼻部手术创伤引起的症状轻度增加，部分恢复（鼻疮和出血）或完全恢复（鼻塞，鼻窦疼痛和鼻臭）。 p ＜0.05）。对于更可归因于术前肿瘤肿块的症状（例如，头痛和止痛药的使用[p <0.05]），症状严重程度逐渐改善。通过最终的随访，总共有8名患者（9％）需要进一步的治疗或就持续的鼻部症状提出建议。结论：内镜经蝶窦手术是一种对垂体窝病变耐受良好的微创手术。由患者评估的总体鼻部症状没有改变，但某些个体症状可能显示轻度恶化或总体改善。
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