Transseptal, transsphenoidal surgery: a subjective and objective analysis of results

Transseptal, transsphenoidal surgery in British Columbia is performed as a joint procedure between otolaryngology and neurosurgery. We analysed the 84 procedures performed on 78 patients between 1978 and 1983 at St. Paul's Hospital in Vancouver. A questionnaire was completed by 66 patients (85%) which examined the patients' subjective assessment of the success of the surgery. A postoperative review demonstrated 18 postoperative nasal complications (21%) consisting of seven septal perforations (8%), 10 synechiae (12%) and one septal abscess (1%). The majority of these complications were asymptomatic. Subsequent modifications of the operative technique are discussed. Our assessment of the overall success of this surgery was confirmed by the fact that 97% of respondents stated that they would undergo the primary surgery again, 17% of these with some reservations. Only 3% would now refuse the primary surgery.