Prediction Model for Postoperative Headache After Transsphenoidal Pituitary Surgery

Primary Objective: This observational study aims to construct a predictive model for short-term headache following endonasal pituitary adenoma surgery and to identify risk factors associated with postoperative headache after endonasal surgery. Secondary Objectives: First, to investigate the relationship between the severity of short-term postoperative headache and long-term life burden (at 1 and 3 months postoperatively), as well as its correlation with quality of life. Second, to elucidate the clinical characteristics and evolutionary patterns of short-term postoperative headache. Third, to explore key aspects of perioperative management, including changes in nasal cavity status and postoperative mobilization, which may optimize the management of short-term postoperative headache. Primary outcome measure1: VAS scale（0-10） Primary outcome measure2: feature of postoperative headache including (location, type, length, accompany symptom, and factors that elevate or sharpen headache, analgesics usage, analgesics frequency, analgesics effect) Secondary outcome measure 1: HIT-6 test Secondary outcome measure 2: Postoperative Olfaction Secondary outcome measure 3: Postoperative Massive Epistaxis Participants will undergo daily assessments postoperatively, which include evaluations of headache, nasal cavity status, and analgesic drug usage. These assessments will continue until two consecutive Visual Analog Scale (VAS) scores are less than 4. Additionally, participants will complete questionnaires, including the Headache Impact (HIT-6) test at 4 weeks and 12 weeks postoperatively.

Sex

All

Minimum age

18 Years

Maximum age

100 Years

Inclusion Criteria:

1. Age ≥ 18 years old.
2. Preoperatively diagnosed with pituitary adenoma by clinical and radiological (MRI) evaluation, and scheduled to undergo primary or recurrent neuroendoscopic transsphenoidal surgery in the Tumor Ward 7 of the Department of Neurosurgery at Beijing Tiantan Hospital.
3. Fully conscious with adequate cognitive and comprehension abilities to complete pain assessment scales (VAS) and questionnaires (HIT-6, psychological scales, etc.).
4. Willing to participate in this study and provide written informed consent.

Exclusion Criteria:

1. Presence of other intracranial tumors, or undergoing transsphenoidal surgery due to other diseases (such as aneurysms, Rathke's cysts, meningiomas, etc.).
2. History of chronic headache (such as migraines, tension headaches) with a frequency of \>4 times per month, or long-term dependence on analgesic medications.
3. Presence of severe nasal or sinus diseases preoperatively (such as chronic sinusitis requiring surgical intervention, nasal polyps) or a history of nasal surgery within the recent 3 months.
4. History of severe psychiatric or psychological disorders, or presence of cognitive impairment or language communication barriers that prevent participation in study assessments.
5. Pregnant or breastfeeding women.
6. Conversion to craniotomy during surgery due to various reasons (such as uncontrollable bleeding, change in tumor nature).