Pituitary Tumour
Conditions
Keywords
Silastic Stenting, Trans-nasal Endoscopic Surgery, Post-operative Intra-nasal Re-mucosalization
Brief summary
Endoscopic skull base surgery is a relatively new procedure that is now a standard of care for surgeries at the base of the skull; however there are no studies that examine the healing process of the nasal lining with the use of silastic (silicone) stents (or splints) that might be placed at the time of surgery. While there is some evidence to suggest that the use of stents improves wound healing, the decision to use a stent or not is currently up to the preference of the surgeon. To investigate the impact of stents on post-surgical healing, the investigators at Vancouver General Hospital will compare patients undergoing trans-sphenoidal pituitary surgeries with septal flap reconstruction with the use of silastic stents to line the septal donor site, and compare their recovery to those who did not receive stents. The investigators hypothesize that the use of silastic stents in endonasal surgery increases the rate of mucosal healing, and better quality mucosal regeneration, and with no effect on the patients experience after surgery. In this randomized control trial the investigators aim to recruit 26 (13 in each arm) study participants. The primary outcome is to determine the effect of silastic stunting on healing of the naso-septal flap donor site. This objective will be achieved by assessment of endoscopic photographs of healing tissue and histologic assessment of healing tissues. The secondary outcome involves questionnaires that measure the patient's subjective nasal symptoms prior to and following endoscopic skull based surgery. Total time commitment for the study participant is about 4 months across 4 study visits (all of which are part of standard of care): the assessment visit, surgery, 4 weeks post-operative follow up visit and 12 week post-operative follow up visit.
Interventions
DEVICESilastic Stent
The silastic stent is a splint made of silicone.
Sponsors
University of British Columbia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
Histology of the healing tissues will be examined by a pathologist who is blinded to whether the patient received or did not receive stenting.
Intervention model description
Participants will be randomly assigned in one of two groups (stent vs no stent).
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* patients undergoing trans-sphenoidal endoscopic pituitary surgery at their first post-operative appointment
Exclusion criteria
* patients with inflammatory sinus conditions * patients having undergone extensive skull base reconstructions * patients having received previous radiotherapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Determining the effect of silastic stunting on gross level healing of the naso-septal flap donor sites in two aspects gross level healing and microscopic level of healing. | Total time approx. 4 months (pre-operative assessment; surgery; 4 and 12 weeks post-operative follow up appointments) | Visual assessment of endoscopic photographs of healing tissue. |
| Determining the effect of silastic stunting on microscopic level healing of the naso-septal flap donor sites in two aspects gross level healing and microscopic level of healing. | Total time approx. 4 months (pre-operative assessment; surgery; 4 and 12 weeks post-operative follow up appointments) | Histologic assessment of healing tissues. |
| Determining the effect of silastic stunting on nasa-septal flap donor sites on the patient's subjective nasal symptoms following endoscopic skull based surgery. | Total time approx. 4 months (pre-operative assessment; surgery; 4 and 12 weeks post-operative follow up appointments) | Participants will fill out a quality of life questionnaire called Sino-Nasal Outcome Test (SNOT-22). |
| Determining the effect of silastic stunting on nasa-septal flap donor sites on the patient's subjective post-operative outcomes following endoscopic skull based surgery. | Total time approx. 4 months (post-operative follow up at 4 and 12 weeks) | Participants will fill out a post-operative rating scale. |
| Physician's evaluation of the effect of silastic stunting on nasa-septal flap donor sites following endoscopic skull based surgery. | Total time approx. 4 months (surgery; post-operative follow up at 4 and 12 weeks) | Physician will fill out an outcome measures evaluation scale. |
Outcome results
None listed