Turkish Neurosurgery 2017 , Vol 27 , Num 2
Late Postoperative Rhinological Complications After Microscopic Transnasal Hypophysectomy
Lutfi POSTALCI1,Ibrahim ERDIM2, Bulent DEMIRGIL1,Omur GUNALDI1,Murad ASILTURK1,Hakan DEMIRCI1,Hakan KINA1,Uzay ERDOGAN1,Mine YAZICI3,Erhan EMEL1
1Bakirkoy Research and Training Hospital for Neurology, Psychiatry and Neurosurgery, Neurosurgery Clinic, Istanbul, Turkey
2Erbaa State Hospital, Otorhinolaryngology Clinic, Tokat, Turkey
3Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Otorhinolaryngology Clinic, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.15754-15.1 AIM: Major complications of microscopic transnasal hypophyseal surgery (MTHS), such as cerebrospinal fluid rhinorrhea, carotid injury, and optic nerve injury, are very rare. However, late rhinological complications can be ignored because they are a minor cause of morbidity compared with major complications. In this study, we extensively examined postoperative rhinological complications in patients who underwent MTHS for pituitary adenoma.

MATERIAL and METHODS: Thirty-one patients diagnosed with pituitary adenoma, who underwent MTHS and whose preoperative nasal examinations were recorded between January 2007 and January 2014, were included in the study. A detailed rhinological examination of the patients was performed.

RESULTS: A total of 12 of 31 patients (38.7%) had a perforated nasal septum, and synechiae were detected in the nasal cavities of 13 patients (42%). Anosmia occurred in three patients, hyposmia in two, and a nasal tip deflection and saddle nose deformity were detected in one patient with a perforated nasal septum. No perinasal loss of sense, oronasal fistula, or purulent secretion in the nasal cavity was found in any patient.

CONCLUSION: The nasal structures, particularly the nasal septum mucosa, should be treated gently during MTHS. The nasal stages of the operation should be performed with the help of an otolaryngologist until adequate experience is gained. Keywords : Transsphenoidal surgery, Nasal synechiae, Perforation, Hyposmia, Complication