Analyses and treatments of postoperative nasal complications after endonasal transsphenoidal resection of pituitary neoplasms

Medicine (Baltimore). 2017 Apr;96(15):e6614. doi: 10.1097/MD.0000000000006614.

Abstract

In this study, we analyze and discuss the treatments of postoperative nasal complications after endonasal transsphenoidal resection of pituitary neoplasms (PNs). We performed 129 endonasal transsphenoidal resections of PNs and analyzed and treated cases with nasal complications. After endonasal transsphenoidal resection of PNs, there were 26 cases of postoperative nasal complications (20.1%), including nasal hemorrhage (4.8%), cerebrospinal fluid rhinorrhea (6.9%), sphenoid sinusitis (2.3%), atrophic rhinitis (1.6%), olfactory disorder (1.6%), perforation of nasal septum (0.8%), and nasal adhesion (2.3%). All patients clinically recovered after therapy, which included treatment of the cavity through nasal endoscopy, intranasal corticosteroids, and nasal irrigation. We propose that regular nasal endoscopic review, specific nasal medications, and regular nasal irrigation can effectively clear nasal mucosal hyperemia-induced edema and nasal/nasoantral secretions, as well as promote regeneration of nasal mucosa, prevent nasal adhesion, maintain the sinus cavity drainage, and accelerate the recovery of the physiological function of the paranasal sinus. Timely treatment of patients with nasal complications after endonasal transsphenoidal resections of PNs could greatly relieve the clinical symptoms. Nasal cleaning is very beneficial to patients after surgery recovery.

MeSH terms

  • Adolescent
  • Adult
  • Aftercare / methods
  • Aged
  • Cerebrospinal Fluid Rhinorrhea / etiology
  • Cerebrospinal Fluid Rhinorrhea / therapy
  • Child
  • Epistaxis / etiology
  • Epistaxis / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasal Lavage / methods*
  • Nasal Mucosa / pathology
  • Nasal Septal Perforation / etiology
  • Nasal Septal Perforation / therapy
  • Nasal Surgical Procedures / methods
  • Natural Orifice Endoscopic Surgery / adverse effects*
  • Natural Orifice Endoscopic Surgery / methods
  • Nose / injuries
  • Nose / surgery
  • Nose Diseases / etiology
  • Nose Diseases / therapy*
  • Olfactory Nerve Diseases / etiology
  • Olfactory Nerve Diseases / therapy
  • Paranasal Sinuses / physiopathology
  • Pituitary Neoplasms / surgery*
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy*
  • Recovery of Function
  • Retrospective Studies
  • Rhinitis, Atrophic / etiology
  • Rhinitis, Atrophic / therapy
  • Sphenoid Sinus / surgery
  • Sphenoid Sinusitis / etiology
  • Sphenoid Sinusitis / therapy
  • Tissue Adhesions / etiology
  • Tissue Adhesions / therapy
  • Young Adult