Quality of life after transsphenoidal pituitary surgery: a qualitative study

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.

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.

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.

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.