Authors (including presenting author) :
Tam SM(1), Lam MW(1), Chan YM(1), Chan KH(1)
Affiliation :
(1) Department of Neurosurgery, Princess Margaret Hospital
Introduction :
Endoscopic transsphenoidal surgery is a common surgical approach to remove pituitary adenomas. However, patents often report nasal symptoms such as nasal discharge, congestion, bleeding, crusting, pain and loss of smell afterwards. A number of literatures show the ability to smell would decrease 1 month after surgery and become normal after 2 to 3 months.
Objectives :
-To provide nasal douching education to patient who undergoes endonasal transsphenoidal surgery -To relieve sino-nasal symptoms after nasal douching performed
Methodology :
Nasal douching education program is introduced to nursing staff. Patients are advised to have nasal douching to clear nasal secretions, clots and infective debris from the nasal cavity to improve nasal symptoms and thus better quality of life post-operatively. Doctor’s prescription is required to confirm there is no risk of cerebrospinal fluid leakage before commencing of nasal douching. Patients are required to have returned demonstration of nasal douching after watching a video-taped illustration under nurse’s supervision. Leaflet is given on discharge. Patients were asked about the nasal morbidity to measure the frequency and severity on telephone by nurses. Questions on frequency of nasal douching, improvement of nasal crusting, nasal discharge, and loss of smell and pain were included in numeric scale before nasal douching and 2 weeks after nasal douching. Mean score for each items were calculated.
Result & Outcome :
- Questions on frequency of nasal douching, improvement of nasal crusting, nasal discharge, and loss of smell and pain were included in numeric scale before nasal douching and 2 weeks after nasal douching. - There will be 50% of sino-nasal improvement on nasal crusting and discharge, loss of smell, and pain after nasal douching performed after education.
38 nursing staff were educated for the nasal douching education program. There were 18 eligible patients recruited in the program from September 2019 to August 2020. Telephone interview was done 2 weeks after discharge. Among the 18 patients, 2 patients did not perform nasal douching after discharge since they did not feel nasal discomfort. 13 patients performed nasal douching for a week and stopped after improvement of nasal symptom. 3 patients continued to do nasal douching twice a day at the time of phone-interview. Nasal crusting and nasal discharge was improved by 81.1% (from 3.0 to 3.7). The loss of smell was improved by 76% (from 3.2 to 4.2) while the pain was also improved by 48% (from 4.8 to 3.7).
