Nasal Packing After Trans-Sphenoidal Surgery for Pituitary Tumor: A Pilot of a Randomized Controlled Trial

The goal of the study was to determine the feasibility of a larger trial to evaluate whether nasal packing after routine endoscopic endonasal resection of pituitary tumor negatively affects sinonasal quality of life (QOL) in the postoperative period and to evaluate the safety of not using nasal packing after routine endoscopic endonasal resection of pituitary tumor.

We conducted a parallel, nonblinded, randomized, pilot trial. A total of 60 patients were randomized to nasal packing (NP) (standard-of-care group) or no nasal packing (experimental group) after endoscopic endonasal trans-sphenoidal surgery (EETS) for the resection of a pituitary tumor. The primary outcome was sinonasal QOL measured using the Anterior Skull Base Nasal Inventory-12 questionnaire. Secondary outcomes included adverse events within 4 weeks of surgery, nasal pain, and health-related QOL using the EuroQol-5 dimension 5-level questionnaire tool.

Seventy-nine patients were approached to participate, and 60 patients were randomized to NP (n = 31) or no nasal packing (n = 29) after EETS. There were no patient withdrawals after randomization; one patient was excluded from analysis due to complications unrelated to the study. There was no significant difference between groups in sinonasal QOL (P > .05) nasal pain or frequency of adverse events (P > .05).

The proposed trial was effective and acceptable to patients. A definite larger trial is feasible with some modifications. Preliminary results show that the use of nonabsorbable NP after EETS does not significantly affect sinonasal QOL.

The study was registered with the ClinicalTrials.gov database (NCT03677713).