MRI evaluation of the sphenoid sinus after transsphenoidal approach to the pituitary

The transsphenoidal approach to the pituitary (TSA) is currently the most common approach used to treat pituitary tumors. The surgical technique necessitates an incomplete stripping of sphenoid sinus mucosa. Long-term postoperative magnetic resonance imaging (MRI) evaluation of the sphenoid sinus has not been reported. A retrospective review of patients undergoing a TSA at the University of Washington Hospitals was performed. Preoperative scans were compared with postoperative scans done during three time intervals. Group 1 had scans at 1 to 12 weeks postoperatively; 10 of 10 patients had sinus effusions. Group 2 had scans at 6 to 18 months post-operatively; 22 of 31 had mucosal abnormalities. Group 3 had scans at 2 to 3 years; 7 of 9 were abnormal. MRI evaluation indicates that a majority of patients have both acute and chronic sphenoid sinus abnormalities after TSA.