Quality of life after transsphenoidal pituitary surgery: a qualitative study

Acta Neurochir (Wien). 2012 Oct;154(10):1917-22. doi: 10.1007/s00701-012-1455-5. Epub 2012 Aug 7.

Abstract

Background: Microscopic and endoscopic approaches are both utilized for transsphenoidal resection of sellar/parasellar lesions. The endoscopic approach has been gaining popularity over the past decade; however, quality-of-life studies comparing the microscopic and endoscopic approaches are lacking. We aimed to compare the patients' perceptions of their postoperative recovery periods following microscopic and endoscopic procedures.

Methods: Qualitative research methodology was used for this study. Each participant underwent a single semi-structured, open-ended interview based on an interview guide. Each participant had undergone at least one microscopic and one endoscopic transsphenoidal procedure for resection of a sellar/parasellar lesion. The interviews were audiotaped and transcribed. The transcripts were then analyzed for overarching themes. Demographic information was also collected.

Results: The following five overarching themes emerged from the data: (1) the endoscopic procedure was better tolerated than the microscopic procedure and was the preferred approach by 22 out of 27 patients should they require another surgery in the future; (2) most patients did not know that they had undergone two different surgical approaches; (3) other than an unpleasant malodorous smell, rhinologic complications (including drainage, crusting, and alterations in smell) following the endoscopic procedures were comparable to those following the microscopic procedures; (4) the patient's postoperative experience after the microscopic procedure had an impact on his/her expectations of the endoscopic procedure; (5) any significant pain or discomfort experienced from either procedure was mainly related to the nasal packing or fascia lata graft donor site.

Conclusions: The endoscopic procedure was the preferred approach over the microscopic approach by the majority of patients because of its better tolerability, despite comparable rhinologic complications.

MeSH terms

  • Adult
  • Aged
  • Endoscopy / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures / methods
  • Pituitary Diseases / pathology
  • Pituitary Diseases / surgery*
  • Postoperative Complications
  • Quality of Life*
  • Treatment Outcome