Late Postoperative Rhinological Complications After Microscopic Transnasal Hypophysectomy

Area of Science:

• Otorhinolaryngology
• Neurosurgery
• Endocrinology

Background:

• Major complications of microscopic transnasal hypophyseal surgery (MTHS) are rare, but late-occurring rhinological issues can be overlooked.
• Pituitary adenoma treatment via MTHS necessitates a thorough understanding of potential post-operative nasal complications.

Purpose of the Study:

• To investigate the incidence and types of late rhinological complications following MTHS for pituitary adenoma.
• To highlight the importance of addressing less common, yet significant, post-surgical nasal issues.

Main Methods:

• Retrospective analysis of 31 patients who underwent MTHS for pituitary adenoma between January 2007 and January 2014.
• Preoperative nasal examinations were recorded, and detailed postoperative rhinological examinations were performed.

Main Results:

• A high incidence of rhinological complications was observed: 38.7% septal perforation and 42% nasal synechiae.
• Other complications included anosmia (9.7%), hyposmia (6.5%), nasal tip deflection, and saddle nose deformity (3.2%).
• No cases of perinasal sense loss, oronasal fistula, or purulent nasal discharge were reported.

Conclusions:

• Gentle manipulation of nasal structures, especially the nasal septum mucosa, is essential during MTHS.
• Collaboration with an otolaryngologist is recommended for the nasal stages of MTHS until sufficient surgical experience is attained.