World Journal of Endocrine Surgery

Register      Login

VOLUME 13 , ISSUE 3 ( September-December, 2021 ) > List of Articles

Original Article

Endoscopic Transsphenoidal Pituitary Surgery: Local Experience

Mohammad Natheer, Haitham Alnori

Keywords : Complications, Endoscopic pituitary surgery, Pituitary adenoma, Transsphenoidal

Citation Information : Natheer M, Alnori H. Endoscopic Transsphenoidal Pituitary Surgery: Local Experience. World J Endoc Surg 2021; 13 (3):92-96.

DOI: 10.5005/jp-journals-10002-1419

License: CC BY-NC 4.0

Published Online: 19-05-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Background: The endoscopic transsphenoidal approach to pituitary tumors has become popular and accepted, with minimal postoperative morbidity. Aim: To document the efficacy and the patients’ safety of endoscopic transsphenoid surgery. Patients and methods: Summary of 55 consecutive patients with pituitary tumors who underwent endoscopic transsphenoidal surgery at the Department of Neurosurgery, Ibn Sina Teaching Hospital from March 2018 to February 2021. Follow-up is between 6 months and 2 years. Results: Females represent 52.7% and males 47.3% of the patients. Non-functioning tumors represent 32.7%, while hormones-secreting tumors are 67.7%. In 29 patients (52.7%), the tumors were completely excised. Subtotal excision was performed in seven patients (12.8%), while partial removal was done in 19 patients (34.5%). Conclusion: Endoscopic transsphenoidal pituitary surgery is a safe approach to pituitary adenomas, avoiding external scars with minimal postoperative morbidity.


PDF Share
  1. Jane JA, Han J, Prevedello DM, et al. Perspectives on endoscopic transsphenoidal surgery. Neurosurg Focus 2005;19(6):1–10. DOI: 10.3171/foc.2005.19.6.3
  2. Liu JK, Das K, Weiss MH, et al. The history and evolution of transsphenoidal surgery. J Neurosurg 2001;95(6):1083–1096. DOI: 10.3171/jns.2001.95.6.1083
  3. Jho HD. Endoscopic transsphenoidal surgery. J Neurooncol 2001;54(2):187–195. DOI: 10.3171/jns.1997.87.1.0044
  4. Zhang Y, Wang Z, Liu Y, et al. Endoscopic transsphenoidal treatment of pituitary adenomas. Neurol Res 2008;30(6):581–586. DOI: 10.1179/174313208X298110
  5. Honegger J, Grimm F. The experience with transsphenoidal surgery and its importance to outcomes. Pituitary 2018;21(5):545–555. DOI: 10.1007/s11102-018-0904-4
  6. Cappabianca P, Cavallo LM, Colao A, et al. Endoscopic endonasal transsphenoidal approach: outcome analysis of 100 consecutive procedures. Minim Invasive Neurosurg 2002;45(4):193–200. DOI: 10.1055/s-2002-36197
  7. Dusick JR, Esposito F, Mattozo CA, et al. Endonasal transsphenoidal surgery: the patient's perspective - survey results from 259 patients. Surg Neurol 2006;65(4):332–341. DOI: 10.1016/j.surneu.2005.12.010
  8. Eördögh M, Briner HR, Simmen D, et al. Endoscopic unilateral transethmoid- paraseptal approach to the central skull base. Laryngoscope Investig Otolaryngol 2017;2(5):281–287. DOI: 10.1002/lio2.82
  9. Ammirati M, Wei L, Ciric I. Short-term outcome of endoscopic versus microscopic pituitary adenoma surgery: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 2013;84(8):843–849. DOI: 10.1136/jnnp-2012-303194
  10. Tumul C, Hemanshu P, Parmod K B, et al. Immediate postoperative complications in transsphenoidal pituitary surgery: a prospective study. Saudi J Anaesth 2014;8(3):335–341. DOI: 10.4103/1658-354X.136424
  11. Ivan C, Ann R, Craig B, et al. Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery 1997;40(2):225–237. DOI: 10.1097/00006123-199702000-00001
  12. Friedman M, Caldarelli DD, Venkatesan TK, et al. Endoscopic sinus surgery with partial middle turbinate resection: effects on olfaction. Laryngoscope 1996;106(8):977–981. DOI: 10.1097/00005537-199608000-00012
  13. Rice DH, Kern EB, Marple BF, et al. The turbinates in nasal and sinus surgery: a consensus statement. Ear, Nose Throat J 2003;82(2):82–84. DOI: 10.1177/014556130308200202
  14. Swanson PB, Lanza DC, Vining EM, et al. The effect of middle turbinate resection upon the frontal sinus. Am J Rhinol 1995;9(4):191–196.
  15. Eseonu CI, ReFaey K, Pamias-Portalatin E, et al. Three-hand endoscopic endonasal transsphenoidal surgery: experience with an anatomy-preserving mononostril approach technique. Oper Neurosurg 2018;14(2):158–165. DOI: 10.1093/ons/opx110
  16. HIRSCH O. Successful closure of cerebrospinal fluid rhinorrhea by endonasal surgery. AMA Arch Otolaryngol 1952;56(1):1–12. DOI: 10.1001/archotol.1952.00710020018001
  17. Hadad G, Bassagasteguy L, Carrau RL, et al. A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope 2006;116(10): 1882–1886. DOI: 10.1097/01.mlg.0000234933.37779.e4
  18. Kassam AB, Thomas A, Carrau RL, et al. Endoscopic reconstruction of the cranial base using a pedicled nasoseptal flap. Oper Neurosurg 2008;63(suppl_1):ONS44–ONS53. DOI: 10.1227/01.neu.0000297074.13423.f5
  19. Eloy JA, Choudhry OJ, Shukla PA, et al. Nasoseptal flap repair after endoscopic transsellar versus expanded endonasal approaches: is there an increased risk of postoperative cerebrospinal fluid leak? Laryngoscope 2012;122(6):1219–1225. DOI: 10.1002/lary.23285
  20. Zanation AM, Carrau RL, Snyderman CH, et al. Nasoseptal flap reconstruction of high flow intraoperative cerebral spinal fluid leaks during endoscopic skull base surgery. Am J Rhinol Allergy 2009;23(5):518–521. DOI: 10.2500/ajra.2009.23.3378
  21. Charalampaki P, Ayyad A, Kockro RA, et al. Surgical complications after endoscopic transsphenoidal pituitary surgery. J Clin Neurosci 2009;16(6):786–789. DOI: 10.1016/j.jocn.2008.09.002
  22. Wang F, Zhou T, Wei S, et al. Endoscopic endonasal transsphenoidal surgery of 1,166 pituitary adenomas. Surg Endosc 2015;29(6):1270–1280. DOI: 10.1007/s00464-014-3815-0
  23. Zhan R, Ma Z, Wang D, et al. Pure endoscopic endonasal transsphenoidal approach for nonfunctioning pituitary adenomas in the elderly: surgical outcomes and complications in 158 patients. World Neurosurg 2015;84(6):1572–1578. DOI: 10.1016/j.wneu.2015.08.035
  24. Dallapiazza RF, Grober Y, Starke RM, et al. Long-term results of endonasal endoscopic transsphenoidal resection of nonfunctioning pituitary macroadenomas. Neurosurgery 2015;76(1):42–53. DOI: 10.1227/neu.0000000000000563
  25. Banu MA, Szentirmai O, Mascarenhas L, et al. Pneumocephalus patterns following endonasal endoscopic skull base surgery as predictors of postoperative CSF leaks. J Neurosurg 2014;121(4):961–975. DOI: 10.3171/2014.5.JNS132028
  26. Li W, Liu Q, Lu H, et al. Tension pneumocephalus from endoscopic endonasal surgery: a case series and literature review. Ther Clin Risk Manag 2020;16:531–538. DOI: 10.2147/TCRM.S258890
  27. Hannon MJ, Finucane FM, Sherlock M, et al. Disorders of water homeostasis in neurosurgical patients. J Clin Endocrinol 2012;97(5):1423–1433. DOI: 10.1210/jc.2011-3201
  28. Mamelak AN, Carmichael J, Bonert VH, et al. Single-surgeon fully endoscopic endonasal transsphenoidal surgery: outcomes in three-hundred consecutive cases. Pituitary 2013;16(3):393–401. DOI: 10.1007/s11102-012-0437-1
  29. Qari FA, AbuDaood EA, Nasser TA. Diabetes insipidus following neurosurgery at a university hospital in Western Saudi Arabia. Saudi Med J 2016;37(2):156. DOI: 10.15537/smj.2016.2.12848
  30. Sudhakar N, Ray A, Vafidis JA. Complications after trans-sphenoidal surgery: our experience and a review of the literature. Br J Neurosurg 2004;18(5):507–512. DOI: 10.1080/02688690400012459a
  31. Baban MIA, Battaglia P, Mohammed MH, et al. How to preserve the olfaction in harvesting the nasoseptal flap in endoscopic skull base surgery. Oper Tech Otolaryngol-Head Neck Surg 2020;31(2):e7–e12. DOI: 10.1016/j.otot.2020.03.001
  32. Tam S, Duggal N, Rotenberg BW. Olfactory outcomes following endoscopic pituitary surgery with or without septal flap reconstruction: a randomized controlled trial. Int Forum Allergy Rhinol 2013;3(1):62–65. DOI: 10.1002/alr.21069
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.