Wouter R van Furth1, Amir H Zamanipoor Najafabadi2,1, Merel van der Meulen3, Marco J T Verstegen1, Daniel J Lobatto1, Maarten C Kleijwegt4, Alberto M Pereira2, Nienke R Biermasz2. 1. Department of Neurosurgery, Haaglanden Medical Center and Haga Teaching Hospital, University Neurosurgical Center Holland, Leiden University Medical Center, Leiden and The Hague, The Netherlands. 2. Division of Endocrinology, Department of Medicine, Pituitary Center and Center for Endocrine Tumors, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. 3. Division of Endocrinology, Department of Medicine, Pituitary Center and Center for Endocrine Tumors, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. m.vandermeulen@lumc.nl. 4. Department of Ear Nose and Throat-Head and Neck Cancer, Leiden University Medical Center, Leiden, The Netherlands.
Abstract
PURPOSE: Endoscopic transsphenoidal surgery causes nasal morbidity and negatively affects health-related quality of life (HRQoL). Knowledge on actionable symptoms that could improve postoperative HRQoL is therefore important. This study assessed the impact of nasal symptoms on postoperative HRQoL. METHODS: This perioperative cohort study included 103 adult patients undergoing endoscopic pituitary adenoma resection (August 2016-December 2018), with measurements preoperatively, and 5 days, 6 weeks and 6 months after surgery. Nasal symptoms were measured with the Anterior Skull base nasal inventory-12, and HRQoL with the Short Form-36 (SF-36) physical (PCS) and mental component scores (MCS). Linear regression analysis was used to assess (1) determinants of postoperative nasal morbidity, (2) associations between number of symptoms or (3) individual symptoms and HRQoL, and (4) the percentage of variance of HRQoL explained by nasal symptoms. RESULTS: The number of nasal symptoms transiently increased after surgery. No significant treatment- or disease-related determinants of nasal morbidity were identified. The number of nasal symptoms was significantly associated with a lower PCS (β = - 1.0; 95%CI - 1.5, - 0.4), but not with MCS at 6 weeks. Similar results were observed at 6 months. Headaches (42.2%), problems with smell (42.0%), and taste (36.0%) were the most prevalent symptoms, while sense of smell and taste, and nasal discharge showed the strongest associations with HRQoL. CONCLUSIONS: Postoperative nasal symptoms, in particular problems with smell and taste, significantly affect pituitary patients' physical HRQoL. Monitoring of these symptoms may aid in determining which patients may benefit from intensified follow-up and treatment, aiming to optimize HRQoL.
PURPOSE: Endoscopic transsphenoidal surgery causes nasal morbidity and negatively affects health-related quality of life (HRQoL). Knowledge on actionable symptoms that could improve postoperative HRQoL is therefore important. This study assessed the impact of nasal symptoms on postoperative HRQoL. METHODS: This perioperative cohort study included 103 adult patients undergoing endoscopic pituitary adenoma resection (August 2016-December 2018), with measurements preoperatively, and 5 days, 6 weeks and 6 months after surgery. Nasal symptoms were measured with the Anterior Skull base nasal inventory-12, and HRQoL with the Short Form-36 (SF-36) physical (PCS) and mental component scores (MCS). Linear regression analysis was used to assess (1) determinants of postoperative nasal morbidity, (2) associations between number of symptoms or (3) individual symptoms and HRQoL, and (4) the percentage of variance of HRQoL explained by nasal symptoms. RESULTS: The number of nasal symptoms transiently increased after surgery. No significant treatment- or disease-related determinants of nasal morbidity were identified. The number of nasal symptoms was significantly associated with a lower PCS (β = - 1.0; 95%CI - 1.5, - 0.4), but not with MCS at 6 weeks. Similar results were observed at 6 months. Headaches (42.2%), problems with smell (42.0%), and taste (36.0%) were the most prevalent symptoms, while sense of smell and taste, and nasal discharge showed the strongest associations with HRQoL. CONCLUSIONS: Postoperative nasal symptoms, in particular problems with smell and taste, significantly affect pituitary patients' physical HRQoL. Monitoring of these symptoms may aid in determining which patients may benefit from intensified follow-up and treatment, aiming to optimize HRQoL.
Authors: Aldo Pereira-Neto; André Meireles Borba; Paulo Andrade de Mello; Luciana Ansanelli Naves; Antônio Santos e Araújo; Luis Augusto Casulari Journal: Arq Neuropsiquiatr Date: 2010-06 Impact factor: 1.420
Authors: Cornelie D Andela; Nicolasine D Niemeijer; Margreet Scharloo; Jitske Tiemensma; Shaaji Kanagasabapathy; Alberto M Pereira; Noëlle G A Kamminga; Ad A Kaptein; Nienke R Biermasz Journal: Pituitary Date: 2015-02 Impact factor: 4.107
Authors: Cornelie D Andela; Margreet Scharloo; Alberto M Pereira; Ad A Kaptein; Nienke R Biermasz Journal: Pituitary Date: 2015-10 Impact factor: 4.107
Authors: Amparo Wolf; Sandy Goncalves; Fateme Salehi; Jeff Bird; Paul Cooper; Stan Van Uum; Donald H Lee; Brian W Rotenberg; Neil Duggal Journal: J Neurosurg Date: 2015-10-23 Impact factor: 5.115