Background Prospective studies comparing quality-of-life and olfaction in patients undergoing endoscopic uni-nostril versus bi-nostril trans-sphenoidal pituitary surgery have not been published.

Methods We prospectively compared olfaction and quality-of-life at baseline and at 3 to 6 months follow-up using the Anterior Skull Base Nasal Inventory-12 (ASK-12) questionnaire, composite olfaction score, and Lund–Kennedy Endoscopic Score (LKES) in 43 patients who underwent endoscopic excision of pituitary adenoma with either a uni-nostril (24 patients) or a bi-nostril (19 patients) approach.

Results Baseline data for both groups were comparable. In the uni-nostril group, ASK-12 and LKES scores were not significantly different at follow-up when compared with the preoperative scores. In the bi-nostril group, there was a significant postoperative worsening of ASK-12 scores (mean: 3.2 vs. 5.3; p = 0.04) and the LKES (mean: 2.9 vs. 6.6; p = 0.01). Composite olfaction score was not significantly affected postoperatively with either approach. Nasal complications were also more in the bi-nostril group (5/18, 27.8% vs. 1/23, 4.3%) but this was not statistically significant (p = 0.07).

Conclusion Both approaches preserve olfactory function but the uni-nostril approach is associated with better postoperative quality-of-life and endoscopic scores and subjective olfaction outcomes. At least in short term, the postoperative morbidity is higher in the bi-nostril approach compared with the uni-nostril approach. Although preference for a particular approach is related to a surgeon's preference, preoperative counselling of the patients regarding sinonasal morbidity is important.

背景 比较接受内窥镜单鼻孔与双鼻孔经蝶垂体手术的患者的生活质量和嗅觉的前瞻性研究尚未发表。

方法 我们使用前颅底鼻量表 12 (ASK-12) 问卷、综合嗅觉评分和隆德-肯尼迪内窥镜评分 (LKES) 前瞻性比较基线和 3 至 6 个月随访时的嗅觉和生活质量）在 43 名接受单鼻孔（24 名患者）或双鼻孔（19 名患者）入路垂体腺瘤内窥镜切除术的患者中。

结果 两组的基线数据具有可比性。在单鼻孔组中，随访时的 ASK-12 和 LKES 评分与术前评分相比没有显着差异。在双鼻孔组中，术后 ASK-12 评分（平均值：3.2 vs. 5.3； p  = 0.04）和 LKES（平均值：2.9 vs. 6.6；p = 0.01）显着恶化 。两种方法术后综合嗅觉评分均未受到显着影响。双鼻孔组的鼻部并发症也较多（5/18，27.8% vs. 1/23，4.3%），但这没有统计学意义（p  = 0.07）。

结论 两种入路均保留嗅觉功能，但单鼻孔入路与更好的术后生活质量、内窥镜评分和主观嗅觉结果相关。至少在短期内，双鼻孔入路的术后发病率高于单鼻孔入路。尽管对特定方法的偏好与外科医生的偏好有关，但术前对患者进行有关鼻窦发病率的咨询很重要。