Preservation of multidimensional quality of life after endoscopic pituitary XXXX resection.

@entity1 @entity227 @entity5 @entity977 @entity652
UNASSIGNED: OBJECT @entity977 are well suited to resection by a minimal-access endoscopic technique. Validation of this approach requires prospective outcome studies to determine the impact on quality of life (QOL). This study aims to assess the effect of endoscopic pituitary @entity652 resection on site-specific and sinonasal-related QOL before and after endoscopic surgery using validated instruments. METHODS Consecutive adult @entity1 undergoing endoscopic endonasal resection of pituitary @entity652 were prospectively enrolled from a single tertiary care center. All @entity1 completed the Anterior Skull Base Questionnaire (ASBQ) and the 22-Item Sino-Nasal Outcome Test (SNOT-22) preoperatively and then at regular intervals after surgery to assess their perceived QOL with regard to hormonal, surgical, and anatomical factors. RESULTS Eighty-one of 114 @entity1 were eligible for study; median follow-up was 16 months. This cohort included 24 (29.6%) nonsecreting macroadenomas and 57 (70.4%) hypersecreting @entity5 . There was significant improvement in the mean ASBQ score at 12 weeks, 6 months, and 1 year after surgery (p < 0.05), while postoperative SNOT-22 scores, at the same time points, showed no significant difference from preoperative scores. Both ASBQ and SNOT-22 scores showed transient worsening at 3 weeks postoperatively. Subtotal resection correlated with worse QOL, both overall and among @entity1 with hypersecreting @entity5 (p < 0.05). Extrasellar @entity5 extension, intraoperative CSF leakage, and a reconstruction technique during surgery did not impact postoperative QOL. @entity227 did not significantly alter QOL. There were no postoperative CSF leaks in this series. CONCLUSIONS Endoscopic resection of pituitary @entity652 is associated with long-term improvements in site-specific QOL and stability in sinonasal QOL when assessed pre- and postoperatively with validated instruments. Subtotal resection was the only factor that negatively impacted postoperative QOL. Therefore, gross-total resection should be attempted for all @entity1 to optimize QOL after surgery.
