Joustra, G.E. (2019) Endoscopic endonasal surgery has no long-term effects on the health-related quality of life of patients with pituitary adenomas. thesis, Medicine.
Full text available on request.Abstract
Introduction: Pituitary adenomas can be safely and effectively treated by endoscopic endonasal surgery (EES). The primary cause of morbidity following EES is altered nasal function. To assess a given treatment, the subjective health-related quality of life (HRQoL) is becoming increasingly important. This study aims to evaluate the impact of EES on the HRQoL of patients with a pituitary adenoma. Methods: Patient undergoing EES for pituitary adenomas were prospectively enrolled. All patients completed the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire preoperatively and postoperatively (two weeks, three months and one year). Wilcoxon signed rank tests were used to compare preoperative and postoperative domain scores. Generalized estimating equation analysis was performed to identify HRQoL changes on selected covariates during follow-up. Results: One-hundred one patients were included. There was a significant decrease in physical and social domain scores two weeks postoperatively (p < .01), while three months postoperatively no significant differences from the preoperative physical (p =. 68) and social (p = .62) domain scores were shown. Although the social domain score improved one year postoperatively (p = .06) to a level better than the preoperative score, patients experienced most inconveniences in social functioning one year postoperatively. The psychological domain score showed a significant improvement two weeks, three months and one year postoperatively (p < .05). Older age (> 60 years), male gender and no cerebrospinal fluid leak had a positive effect on the postoperative HRQoL trend. Conclusion: EES has no long-term effect on the HRQoL of patients with pituitary adenomas. All three HRQoL domains are recovered three months postoperatively. The psychological domain significantly improves directly postoperatively, nonetheless, social functioning warrants extra attention. These results emphasise the importance of multidimensional HRQoL assessment after EES.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Dam, drs. E ten and Feijen, dr. R.A. and Korsten-Meijer, dr. A.G.W. and Department of Otorhinolaryngology - Head and Neck Surgery Un |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:38 |
| Last Modified: | 25 Jun 2020 10:38 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/11 |
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