{"title":"Impact of nasal septal deviation on surgical outcomes in endoscopic transsphenoidal surgery: a population-based study.","authors":"Chia-En Wong, Da-Wei Huang, Yu Chang, Heng-Jui Hsu, Liang-Chao Wang, Po-Hsuan Lee, Hao-Hsiang Hsu, Pang-Shuo Perng, Chih-Hao Tien, Jung-Shun Lee","doi":"10.1007/s11102-025-01531-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Nasal septal deviation (NSD) is a prevalent condition that may affect the surgical outcome of endoscopic transsphenoidal approach surgery (ETA) for pituitary adenomas (PA). This study aims to evaluate the effect of NSD on perioperative and neuroendocrine outcomes in patients undergoing ETA for PAs.</p><p><strong>Methods: </strong>This study is a retrospective analysis utilized the TriNetX database to evaluate the effect of NSD on perioperative and neuroendocrine outcomes in patients undergoing ETA for PAs. Propensity score matching (PSM) was performed to balance baseline characteristics between NSD and non-NSD cohorts. Outcomes were presented as odds ratios (ORs) with 95% confidence intervals (CIs), calculated using the TriNetX platform. Primary outcomes include perioperative complications and postoperative endocrinological functions.</p><p><strong>Results: </strong>A total of 9,896 patients were included in the initial cohort. After matching, 2,002 patients were included in each group. The mean age at surgery was 53.1 ± 15.8 years for the NSD group and 53.0 ± 16.0 years for the non-NSD groups (SMD: 0.006, p = 0.842). Patients in the NSD group demonstrated a higher risk of postoperative cerebrospinal fluid (CSF) leakage (OR: 2.04; 95% CI: 1.63-2.54; p < 0.001), postoperative diabetes insipidus (DI) (OR: 1.36; 95% CI: 1.18-1.57; p < 0.001), desmopressin use (OR: 1.26; 95% CI: 1.06-1.51; p = 0.009), hypopituitarism (OR:1.63; 95% CI: 1.40-1.89; p < 0.001), and steroid use (OR: 1.43; 95% CI: 1.25-1.62; p < 0.001) as compared to the non-NSD group. Sensitivity analyses confirmed consistent results across different matching models.</p><p><strong>Conclusions: </strong>These findings indicate that patients with NSD undertaking ETA for PAs had higher risks of postoperative complications, including postoperative CSF leakage, DI, desmopressin use, hypopituitarism, and steroid use.</p>","PeriodicalId":20202,"journal":{"name":"Pituitary","volume":"28 3","pages":"61"},"PeriodicalIF":3.3000,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pituitary","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11102-025-01531-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Nasal septal deviation (NSD) is a prevalent condition that may affect the surgical outcome of endoscopic transsphenoidal approach surgery (ETA) for pituitary adenomas (PA). This study aims to evaluate the effect of NSD on perioperative and neuroendocrine outcomes in patients undergoing ETA for PAs.
Methods: This study is a retrospective analysis utilized the TriNetX database to evaluate the effect of NSD on perioperative and neuroendocrine outcomes in patients undergoing ETA for PAs. Propensity score matching (PSM) was performed to balance baseline characteristics between NSD and non-NSD cohorts. Outcomes were presented as odds ratios (ORs) with 95% confidence intervals (CIs), calculated using the TriNetX platform. Primary outcomes include perioperative complications and postoperative endocrinological functions.
Results: A total of 9,896 patients were included in the initial cohort. After matching, 2,002 patients were included in each group. The mean age at surgery was 53.1 ± 15.8 years for the NSD group and 53.0 ± 16.0 years for the non-NSD groups (SMD: 0.006, p = 0.842). Patients in the NSD group demonstrated a higher risk of postoperative cerebrospinal fluid (CSF) leakage (OR: 2.04; 95% CI: 1.63-2.54; p < 0.001), postoperative diabetes insipidus (DI) (OR: 1.36; 95% CI: 1.18-1.57; p < 0.001), desmopressin use (OR: 1.26; 95% CI: 1.06-1.51; p = 0.009), hypopituitarism (OR:1.63; 95% CI: 1.40-1.89; p < 0.001), and steroid use (OR: 1.43; 95% CI: 1.25-1.62; p < 0.001) as compared to the non-NSD group. Sensitivity analyses confirmed consistent results across different matching models.
Conclusions: These findings indicate that patients with NSD undertaking ETA for PAs had higher risks of postoperative complications, including postoperative CSF leakage, DI, desmopressin use, hypopituitarism, and steroid use.
期刊介绍:
Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease.
The journal considers:
Biology of Pituitary Tumors
Mechanisms of Pituitary Hormone Secretion
Regulation of Pituitary Function
Prospective Clinical Studies of Pituitary Disease
Critical Basic and Clinical Reviews
Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.