In this study, we analyze and discuss the treatments of postoperative nasal complications after endonasal transsphenoidal resection of pituitary neoplasms (PNs). We performed 129 endonasal transsphenoidal resections of PNs and analyzed and treated cases with nasal complications. After endonasal transsphenoidal resection of PNs, there were 26 cases of postoperative nasal complications (20.1%), including nasal hemorrhage (4.8%), cerebrospinal fluid rhinorrhea (6.9%), sphenoid sinusitis (2.3%), atrophic rhinitis (1.6%), olfactory disorder (1.6%), perforation of nasal septum (0.8%), and nasal adhesion (2.3%). All patients clinically recovered after therapy, which included treatment of the cavity through nasal endoscopy, intranasal corticosteroids, and nasal irrigation. We propose that regular nasal endoscopic review, specific nasal medications, and regular nasal irrigation can effectively clear nasal mucosal hyperemia-induced edema and nasal/nasoantral secretions, as well as promote regeneration of nasal mucosa, prevent nasal adhesion, maintain the sinus cavity drainage, and accelerate the recovery of the physiological function of the paranasal sinus. Timely treatment of patients with nasal complications after endonasal transsphenoidal resections of PNs could greatly relieve the clinical symptoms. Nasal cleaning is very beneficial to patients after surgery recovery.

Background The expanding bilateral sphenoid sinus plasty is an essential technique in the treatment of refractory sphenoid sinusitis. The aim of the present study was to explore the application of expanding bilateral sphenoid sinus plasty in the treatment of refractory sphenoid sinusitis. Methods Retrospective medical record review in a tertiary-care university hospital of 15 patients treated with the expanding bilateral sphenoid sinus plasty between December 2012 and December 2020. A follow-up of the surgical effect and complications were conducted. Primary outcomes evaluated were overall and disease-free survival. The end points assessed were presence of positive surgical margins, development of local, and regional recurrences. Results The patients were followed up for 12–73 months, with an average follow-up time of 28.5 ± 9.6 months. 15 cases of refractory sphenoid sinusitis were cured with well opened sphenoid sinus orifice and clean cavity. Of all the 15 cases, the symptoms were relieved after operation except preoperative hyposmia in 2 and impaired vision in one with no obvious improvement. No complications such as nasal bleeding, olfactory hypofunction and perforation of nasal septum occurred. Follow up revealed a better mucosal epithelization in all the patients within an average time of 8.6 weeks. Endoscopic sinus reexamination showed that the sphenoid sinus orifice was well opened, and no case of sphenoid sinus orifice closure was observed. Conclusion This study is a case series of a long time follow-up of the expanding bilateral sphenoid sinus plasty application in the treatment of refractory sphenoid sinusitis. With the advantages of easily intraoperative positioning, clearly exposed surgical field, full opening of sinus cavity, high surgical safety, short epithelialization time and intuitionistic postoperative follow-up, the expanding bilateral sphenoid sinus plasty is an improved way of treating refractory sphenoid sinusitis. Implications: This technique is worth being explored by surgeons for better surgical outcome.