| Objectivewe analysed image data and smell test results, scale assessment of patientsundergoing transsphenoidal approach surgery, combined with intraoperative findings,to analyse clinical outcomes,lapse to and influencing factors of nasal symptoms, tostudy factors related to various aspects of the research and discuss clinical guidingsignificance.MethodsCollected patients undergoing transsphenoidal approach surgery, admitted toour hospital from March2012to January2013. All patients accepted MRIexaminations by3.0T Simence MR scanner in the preoperative and postoperative,used routine SE sequences T1, T2unenhanced and enhanced scanning. Recordexpansion nasal surgery time, observe tumor resection situation, invasive, consistency.Accepted video laryngoscope examinations by PENTAX-EPM-3500, nasal sinuscoronal/axial scanning by GE-256layer spiral CT after operation1week,4months.Assessed SF-36and SNOT-22before operation and after operation1week,1month,4months, accepted T&T smell tests before operation and after operation1week,4months;.and to analyze the clinical outcome and related factors of nasal symptoms bySPSS18.0software.. P<0.05was considered as statistical significance..ResultsCollected a total of53cases of patients,20males and33females, aged15to70years, mean44.8years old.①we find that between invasive and noninvasive group,tumor removal group and non-full-cut group, non-functional pituitary adenoma,functional pituitary adenoma and Rathke’s cyst, expanding nose time were nostatistically significant (P＞0.05).②SF-36assessment results showed that: Inaddition to mental health, the seven dimensions and dimensions scores weredecreased significantly compared with that before operation after operation1week; Inaddition to the physiological function,others are returned to preoperative levels afterfour months;③SNOT-22assessment results showed that: olfactory disorder,rhinobyon, headache and runny nose are the most common nasal symptoms, nasal symptoms after operation1month were significantly improved with that afteroperation1week; and sustained recovery after operation4months on the basis of thatafter operation1month, reaching preoperative levels. Between full cut group and notfull-cut group, invasive and non-invasive group, SNOT-22were not statisticallydifferent.④Olfactory examination showed: after operation one week, all patients hadvarying degrees of olfactory dysfunction. compared with one week after operation thesense of smell after operation4months had a significant recovery, but has not yetreached the preoperative level. By gender, invasiveness, full cut or not groupingcomparison, olfactory difference had no statistical significance (P <0.05).⑤Videolaryngoscope examinations and spiral CT find that: after operation one week, callus,mucous membrane, Sinus effusion,are the most common nasal signs, after operation4months all had a significant recovery.⑥General scale and special disease scale inthe postoperative results of various periods had certain correlation (P <0.01);Intraoperative extended nose surgery time and postoperative SNOT-22scores had acertain correlation score,(P <0.01). Regression analysis showed that preoperativenasal diseases and low educational level were high risk factors of preoperative QOLscore (preoperative SNOT-22entry score). Extended nose surgery time is a risk factorof that.affectd the postoperative QOL score (entry postoperative SNOT-22score)decreased levelsConclusions①SNOT-22, SF-36, T&T olfactometer tests combined with electroniclaryngoscope, sinus CT examination can better assess nasal symptoms.aftertranssphenoidal surgery.②The nasal symptoms are more able to get a good recovery,quality of life can be recovered to preoperative levels after operation4months.③Olfactory function after transsphenoidal surgery is severe disordered, and slowrecovery, and the level of4months after surgery has not yet reached that ofpreoperative.④Using nasal expansion time and SNOT-22have a correlation,SNOT-22and SF-36are correlated.⑤Nasal diseases, lower education level and thetime of using nasal expansion are risk factors affecting SNOT-22... |
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