Preoperative HRQoL predicts postoperative olfactory performance in patients undergoing endoscopic transsphenoidal surgery for pituitary adenoma

Objectives: The relation of objective measures of olfactory function and health-related quality of life (HRQoL) in patients with pituitary adenoma after endoscopic transsphenoidal surgery is not well investigated yet. We examined HRQoL of pituitary adenoma patients pre- and postsurgery, in addition to olfactory performance as an objective measure of sinonasal health. Methods: Thirty patients with pituitary adenoma were included in this prospective observational study. They completed the Sniffin’ Sticks test as well as measures of HRQoL before and after bi-nostril endoscopic transsphenoidal surgery. Results: Olfactory performance and HRQoL were correlated in the physical (r_s=0.462, p=0.010) but not in the psychological HRQoL domain. While psychological HRQoL tended to ameliorate after surgery (Z=−1.94, p=0.052), physical HRQoL did not. Preoperative physical HRQoL predicted olfactory performance after surgery with an explained variance of 24.9 %, representing a moderate to strong effect; age did not significantly add to the explained variance. Conclusions: In our study, physical HRQoL before surgery of pituitary adenomas as a subjective measure of well-being was highly relevant for objective sinonasal outcome. This finding reinforces the value of preoperative HRQoL assessment as a predictor of postoperative patient health, adding to the benefits of minimally invasive surgical techniques.