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Quality of life after transsphenoidal pituitary surgery: a qualitative study

  • Experimental Research
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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.

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Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada

    Shelly Lwu, Idara Edem, Beverly Banton, Mark Bernstein, Fred Gentili & Gelareh Zadeh

  2. Department of Otolaryngology Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada

    Allan Vescan

  3. Toronto Western Hospital, 399 Bathurst Street, 4 W, Toronto, ON, M5V 1A8, Canada

    Idara Edem

Authors
  1. Shelly Lwu
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  2. Idara Edem
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  3. Beverly Banton
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  4. Mark Bernstein
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  5. Allan Vescan
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  6. Fred Gentili
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  7. Gelareh Zadeh
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Corresponding author

Correspondence to Idara Edem.

Appendix

Appendix

Interview Guide

Open microscopic

  1. 1.

    When was your surgery?

  2. 2.

    About how long were you in the hospital after surgery?

  3. 3.

    Were there any complications? (CSF leak, endocrine dysfunction)

  4. 4.

    What was your level of pain/discomfort? How long did this last? Did you require pain medication in the hospital or at home?

  5. 5.

    Did you experience any alterations to your smell or taste? Any numbness to your lips/mouth/nose? Any persistent drainage from the nose? Any nasal crusting? Anything else you experienced during your recovery period?

  6. 6.

    How long was it before you felt like you were back to your normal self?

  7. 7.

    How long was it before you were back to work or your normal activities?

  8. 8.

    Were there any long-standing side effects as a result of surgery?

  9. 9.

    Anything else you wish to add with regard to your experience (positive or negative)?

Endoscopic

  1. 1.

    When was your surgery?

  2. 2.

    About how long were you in hospital after surgery?

  3. 3.

    Were there complications? (CSF leak, endocrine dysfunction)

  4. 4.

    What was your level of pain/discomfort? How long did this last? Did you require pain medication in the hospital or at home?

  5. 5.

    Did you experience any alterations to your smell or taste? Any numbness to your lips/mouth/nose? Any persistent drainage from the nose? Anything else you experienced during your recovery period?

  6. 6.

    How long was it before you felt like you were back to your normal self?

  7. 7.

    How long was it before you were back to work or your normal activities?

  8. 8.

    Were there any long-standing side effects as a result of surgery?

  9. 9.

    Anything else you wish to add with regard to your experience (positive or negative)?

Comparison

  1. 1.

    Please compare the two surgeries with regard to your experiences during the recovery period and beyond, including pain, discomfort, etc.

  2. 2.

    Did you see any advantages or disadvantages with each procedure?

  3. 3.

    Was there a procedure that you preferred?

  4. 4.

    If you were to require further surgery, which procedure would you prefer?

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Lwu, S., Edem, I., Banton, B. et al. Quality of life after transsphenoidal pituitary surgery: a qualitative study. Acta Neurochir 154, 1917–1922 (2012). https://doi.org/10.1007/s00701-012-1455-5

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  • DOI: https://doi.org/10.1007/s00701-012-1455-5

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