Effect of middle turbinate resection in endoscopic trans-sphenoid pituitary surgery, comparative study.

Younes, AbdelRahman; El Shazly, Mohamed; Abdallah, Ahmed Adel; Hassan, Osama

doi:10.21608/ejentas.2020.32229.1223

Effect of middle turbinate resection in endoscopic trans-sphenoid pituitary surgery, comparative study.

Articles in Press

Document Type : Original Article

Authors

¹ Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt.

² otorhinolaryngology department kasr al ainy Cairo university

³ otorhinolaryngology department kasr al ainy, cairo university

10.21608/ejentas.2020.32229.1223

Abstract

Objective: This study aimed to evaluate the effect of middle turbinate resection in endoscopic trans-sphenoid pituitary surgery. Methods: This prospective study included 208 patients who presented for endoscopic trans-sphenoid pituitary surgery to Kasr Al Ainy Medical Hospital, Cairo University, from February 2016 to October 2019. The University of Pennsylvania Smell Identification Test (SIT) was used to assess olfaction. Sinonasal symptoms were evaluated using the Sino-nasal Outcome Test (SNOT-22) and the modified Lund‐Kennedy Endoscopic Score (LKES). Endoscopic debridement of crustations was done until complete resolution. Imaging studies were done on the third postoperative month to assess the development of frontal sinusitis. Patients were divided into two groups according to the intraoperative management of the middle turbinate, whether to be preserved (A) or resected (B). Results: We found a significant change in SIT, SNOT-22, and LKES scores in the first postoperative month. Scores nearly returned to the preoperative baseline in the 6th postoperative month. There was no significant difference between both groups in the early and late postoperative months. There was a significant difference between both groups regarding the resolution of crustations and the development of postoperative frontal sinusitis. Conclusion: Middle turbinate should be preserved in endoscopic trans sphenoid surgery as long as it does not compromise safe and total tumor excision as it has less postoperative morbidity regarding the development of postoperative crustations and frontal sinusitis. In the late postoperative period, there are no significant impacts on olfaction and sinonasal outcomes either with middle turbinate preservation or resection.

Keywords