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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
"When patients see what the surgeon sees": 3D imaging creates new understanding in preoperative counseling for
Jonas Kornmann1, Philipp Lorenz1,2, Paul Bonik1
1Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Mannheim, Medical Faculty of the Ruprecht-Karls-University of Heidelberg, Germany.
Background:
In functional endoscopic sinus surgery, the intricate anatomy and the use of minimally invasive endoscopic techniques may hinder comprehensive patient understanding in the informed consent process.
Aims/Objectives:
Evaluation of the impact of personalized 3D CT computed tomography (CT) imaging supplementing informed consent in sinus surgery.
Material And Methods:
In this prospective randomized study, patients scheduled for paranasal sinus surgery were allocated to standard informed consent using two-dimensional (2D) CT imaging or to counseling supplemented with individualized three-dimensional (3D) CT reconstructions. All patients received a questionnaire prior- and postsurgery to assess disease comprehension, perception of risks and benefits, and satisfaction with the informed consent process.
Results:
Twenty-two patients were included, with equal distribution between groups. The 3D group demonstrated significantly greater understanding of expected recovery and recurrence (p = 0.03) and improved knowledge transfer (p = 0.04). Postoperatively, the 3D group reported significantly higher understanding scores (4.50 vs. 2.73). The composite outcome-encompassing disease understanding, surgical comprehension, and overall satisfaction-was superior in the 3D group (16.00 vs. 11.64; p < 0.01).
Conclusions And Significance:
Patient-specific 3D CT reconstructions may enhance informed consent in sinus surgery, improving comprehension, shared decision-making, and satisfaction with preoperative counseling.
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