Nasal Outcomes Using Saline Irrigations After Endonasal Pituitary Surgery

NCT ID: NCT05659524

Last Updated: 2024-04-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-18

Study Completion Date

2029-12-31

Brief Summary

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This is a prospective, single-blinded, multicenter study evaluating the benefit of sinonasal irrigations following endoscopic pituitary surgery. The goal of this study is to create practice changing guidelines with objective data highlighting the importance of irrigations on postoperative outcomes for pituitary surgery.

Detailed Description

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This prospective study, coupled with the results of the recent POET study evaluating the role of antibiotics in postoperative outcomes for pituitary surgery, will guide physicians in the optimal management of patients following endoscopic pituitary surgery.

The investigator group has an established record of completing multicenter studies (e.g., POET, TRANSPHER) that have influenced clinical practice guidelines, raised the profile of Barrow in the pituitary and skull base community, and resulted in numerous peer-reviewed publications and awards.

Conditions

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Pituitary Tumor

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Multicenter randomized single-blinded, intervention trial involving 70 patients from this site (140 treated patients total from all sites), undergoing endoscopic transsphenoidal surgery for pituitary lesions. The same cohort will simultaneously be used to evaluate the role of sinonasal irrigations in those patients who undergo nasoseptal flap reconstructive procedures as part of their treatment.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Caregivers
The study will be blinded to the Otolaryngologist involved in the study. The research team and the patient will not be blinded. The goal of blinding the Otolaryngologist is to minimize the bias in grading the Lund Kennedy endoscopic scores which are a subjective metric interpreted in the office setting.

Study Groups

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Nasal saline irrigation

Patients randomized to standard postoperative nasal care with twice a day saline sinonasal irrigations

Group Type ACTIVE_COMPARATOR

Nasal saline irrigation

Intervention Type OTHER

The following nasal care recommendations have been approved by the study protocol committee for patients randomized to the treatment arm with saline irrigations:

* Postoperative days 1 through 3: patients will administer saline spray (e.g., Ocean nasal spray) to both nostrils four times daily.
* Postoperative day 3 to week 12: patients will begin twice daily sinus irrigation rinse (e.g., NeilMed Sinus Rinse). They will perform 240 mL sinus rinses BID. After day 30, patients will perform sinus irrigation as needed. If a patient is unable to tolerate nasal rinses, saline spray can be used as an alternative.

No Intervention

Patients randomized to not performing saline sinonasal irrigations.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Nasal saline irrigation

The following nasal care recommendations have been approved by the study protocol committee for patients randomized to the treatment arm with saline irrigations:

* Postoperative days 1 through 3: patients will administer saline spray (e.g., Ocean nasal spray) to both nostrils four times daily.
* Postoperative day 3 to week 12: patients will begin twice daily sinus irrigation rinse (e.g., NeilMed Sinus Rinse). They will perform 240 mL sinus rinses BID. After day 30, patients will perform sinus irrigation as needed. If a patient is unable to tolerate nasal rinses, saline spray can be used as an alternative.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Adult patient undergoing endoscopic surgery for resection of pituitary tumors

* nonfunctioning adenoma
* acromegaly
* prolactinoma
* Rathke's cleft cyst
2. Adults \>18 and \<85 years of age
3. English speaking and able to understand the ASK Nasal-12 and SNOT-22 scales
4. Free of any physical, mental, or medical condition which, in the opinion of the investigator, makes study participation inadvisable
5. Planned binostril surgical approach
6. Either with or without septal flap reconstruction
7. Either with or without septoplasty

Exclusion Criteria

1. Active sinus infection
2. Allergic rhinitis
3. Asthma
4. Vascular or inflammatory disease
5. History of previous sinonasal surgery
6. Any subject who is unwilling or unable to sign informed consent for the study
7. Pregnancy
8. Incarcerated patients
9. Cushing's disease
10. History of chronic sinusitis
11. Extended approaches to the skull base
12. Active sinusitis
13. Nasal polyps
14. Concurrent antibiotics for another indication (i.e., urinary tract infection)
15. Immunodeficiency
16. History of radiation to the skull base
Minimum Eligible Age

19 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Barrow Brain and Spine

UNKNOWN

Sponsor Role collaborator

Lori Wood

OTHER

Sponsor Role lead

Responsible Party

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Lori Wood

Operations Manager of Neurosurgery Research

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Barrow Neurological Institute at St. Joseph's Hospital and Medical Center

Phoenix, Arizona, United States

Site Status RECRUITING

Cleveland Clinic

Cleveland, Ohio, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Val Calores

Role: CONTACT

602-406-8772

Malika Bhargava

Role: CONTACT

602-406-7121

Facility Contacts

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Val Calores

Role: primary

602-406-8772

Teresa Allison

Role: primary

216-444-6459

Other Identifiers

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PHX-20-500-189-30-12

Identifier Type: -

Identifier Source: org_study_id

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