Endoscopic endonasal surgery for sellar tumour does not hurt QoL

For patients with a sellar tumour, an endoscopic endonasal surgery is a generally gentle method of intervention with minimal long-term impacts on sinonasal quality of life, a recent study has found.

The present prospective study included 65 patients (mean age 54.7 years, 33 men) who had undergone endoscopic endonasal surgery for sellar expansion. The Sinonasal Outcome Test-22 (SNOT-22) was used to assess sinonasal quality of life before vs 6 months after the procedure.

Average SNOT-22 scores worsened nominally from 14.4 points before surgery to 17.5 points after the procedure. The difference over time failed to reach significance (p=0.067).

However, there were significant deteriorations before vs after surgery in average sinonasal quality of life in the following domains: need to blow nose (0.57 to 1.23 points; p=0.0005), nasal congestion (0.71 to 1.18 points; p=0.013), loss of smell and taste (0.42 to 1.38 points; p=0.00001), and thick discharge from nose (0.23 to 0.65 points; p=0.004).

Subsequent subgroup analyses found that patients who had undergone cranial base reconstruction drove the above effects on SNOT-22 scores. That is, sinonasal quality of life in this subgroup dropped from before to after surgery in the following domains: need to blow nose (0.63 to 1.3 points; p=0.0008), nasal congestion (0.7 to 1.14 points; p=0.023), loss of smell and taste (0.46 to 1.39 points; p=0.00003), and thick discharge from nose (0.26 to 0.74 points; p=0.004).

In contrast, SNOT-22 scores did not change significantly in patients without cranial base reconstruction.