Validation of Simultaneous Endoscopic Sinus Surgery and Transsphenoidal Surgery in Patients with Chronic Rhinosinusitis and Pituitary Tumors
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Background and Objectives Transsphenoidal (TS) surgery for removal of pituitary lesionshas become popular with improvements in diagnostic and treatment modalities, as well as endonasaland endoscopic methods, resulting in reduced complications. Rhinosinusitis (RS) isconsidered a risk factor for postoperative intracranial infections. Previously, we showed thatconcurrent TS surgery and endoscopic sinus surgery (ESS) yielded a favorable outcome incases with pituitary lesions and RS. However, there seems to be a lack of consensus in performingsimultaneous TS and ESS for patients with a pituitary lesion and RS. We would liketo validate the feasibility of performing two operations concurrently. Subjects and Method We reviewed the medical records of 13 patients who underwent simultaneousTS surgery and ESS between 2007 and 2016. One patient underwent concurrent TS surgeryand ESS twice due to the regrowth of pituitary macroadenoma and recurrence of RS. Results There were only four minor nasal complications during the postoperative period,which were controlled with conservative treatment. Only one patient exhibited postoperativecerebrospinal fluid leakage and no patients experienced intracranial complications. Conclusion This study shows that it might be better to treat patients with pituitary lesionand RS simultaneously. Also, further studies with large cases would be necessary to managethese patients without intracranial complications.
Abstract
Background and Objectives Transsphenoidal (TS) surgery for removal of pituitary lesionshas become popular with improvements in diagnostic and treatment modalities, as well as endonasaland endoscopic methods, resulting in reduced complications. Rhinosinusitis (RS) isconsidered a risk factor for postoperative intracranial infections. Previously, we showed thatconcurrent TS surgery and endoscopic sinus surgery (ESS) yielded a favorable outcome incases with pituitary lesions and RS. However, there seems to be a lack of consensus in performingsimultaneous TS and ESS for patients with a pituitary lesion and RS. We would liketo validate the feasibility of performing two operations concurrently. Subjects and Method We reviewed the medical records of 13 patients who underwent simultaneousTS surgery and ESS between 2007 and 2016. One patient underwent concurrent TS surgeryand ESS twice due to the regrowth of pituitary macroadenoma and recurrence of RS. Results There were only four minor nasal complications during the postoperative period,which were controlled with conservative treatment. Only one patient exhibited postoperativecerebrospinal fluid leakage and no patients experienced intracranial complications. Conclusion This study shows that it might be better to treat patients with pituitary lesionand RS simultaneously. Also, further studies with large cases would be necessary to managethese patients without intracranial complications.
참고문헌 (32)
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