The influence of radiological tumor growth pattern on sino‑nasal health in pituitary adenomas

Walbrodt,Sebastian; Wrede,Karsten H.; Chmielewski,Witold X.; Dinger,Thiemo Florin; Schüβler,Maximilian; Deuschl,Cornelius; Chihi,Mehdi; Gull,Hanah Hadice; Jabbarli,Ramazan; Oppong,Marvin Darkwah; Lenkeit,Annika; Uerschels,Anne-Kathrin; Gembruch,Oliver; Kreitschmann‑Andermahr,Ilonka; Scheffler,Björn; Sure,Ulrich; Ahmadipour,Yahya

doi:10.3892/ol.2024.14258

The influence of radiological tumor growth pattern on sino‑nasal health in pituitary adenomas

Authors:
- Sebastian Walbrodt
- Karsten H. Wrede
- Witold X. Chmielewski
- Thiemo Florin Dinger
- Maximilian Schüβler
- Cornelius Deuschl
- Mehdi Chihi
- Hanah Hadice Gull
- Ramazan Jabbarli
- Marvin Darkwah Oppong
- Annika Lenkeit
- Anne-Kathrin Uerschels
- Oliver Gembruch
- Ilonka Kreitschmann‑Andermahr
- Björn Scheffler
- Ulrich Sure
- Yahya Ahmadipour
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Affiliations: Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg‑Essen, D‑45147 Essen, Germany, Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg‑Essen, D‑45147 Essen, Germany, Center for Translational Neuro‑ and Behavioral Sciences, University of Duisburg‑Essen, D‑45147 Essen, Germany
Published online on: January 26, 2024 https://doi.org/10.3892/ol.2024.14258
Article Number: 125
Copyright: © Walbrodt et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Pituitary adenomas are one of the most common mass lesions of the brain and are associated with a reduced quality of life. While transnasal and transsphenoidal endoscopic approaches are considered to deliver similar recovery rates for sino‑nasal health (SNH), the impact of radiological tumor growth patterns on SNH has not been evaluated. In the present study, the influence of radiological tumor growth on SNH was examined before and after endoscopic transsphenoidal tumor resection. Patient data were prospectively collected between August 1, 2016 and August 31, 2022. The Knosp and Hardy classifications were used to dichotomize pituitary adenoma lesions into low‑ and high‑graded lesions. SNH was assessed shortly before surgery and at follow‑up examinations 3‑6 months after operation using the Sino‑Nasal Outcome Test for Neurosurgery (SNOT‑NC) questionnaire. Fully completed SNOT‑NC questionnaires were collected before and after surgery from a total of 101 patients. Independent t‑tests showed significantly higher rates of deterioration after surgery in patients with Knosp low‑graded lesions compared with those with high‑graded tumors for the SNOT‑NC total score P=0.048, nasal discomfort P=0.034, sleep problems P=0.024 and visual impairment P=0.042. Pre‑ and post-operative comparisons for the Knosp low‑graded tumor cohort showed an increase of nasal discomfort (P=0.004), while the Knosp high‑graded tumor cohort reported decreased visual impairment (P=0.016) after surgery. Assessing the Hardy classification, increased nasal discomfort was reported in patients with high‑graded infrasellar tumors after surgery (P=0.046). Growth characteristics of pituitary adenomas based on Knosp and Hardy classifications may influence SNH. Patients with less invasive lesions were revealed to be more prone to experiencing a decrease in SNH, which went beyond the assumed deterioration of 1‑3 months. These findings indicate the importance of detailed information regarding SNH as part of every pre‑operative patient briefing.

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