Summary
Inspired by an experience with endoscopie paranasal sinus surgery, an endoscope was applied in transsphenoidal pituitary surgery. This endoscopic transsphenoidal technique has been used in 45 cases of pituitary adenomas. Using a 4 mm rigid endoscope, the pituitary adenoma is removed through a nostril. A zero-degree endoscope is used for micro-adenomas. A combination of a 0-degree endoscope and a 30-degree endoscope is used for macro-adenomas that have extended to the suprasellar region. Although it is early in our experience with a small number of patients, the short-term surgical results have been encouraging with patients' short hospital stay and minimum morbidity. The endoscopic technique that has evolved with our experience is described with two cases of pituitary adenomas.
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References
Adams CBT, Burke CW (1993) Current modes of treatment of pituitary tumors. Br J Neurosurg 7: 123–128
Black PmcL, Zervas NT, Candia GL (1987) Incidence and management of complications of transsphenoidal operation for pituitary adenomas. Neurosurgery 20: 920–924
Cooke RS, Jones RAC (1994) Experience with the direct transnasal transsphenoidal approach to the pituitary fossa. Br J Neurosurg 8: 193–196
Gamea A, Fathi M, El-Guindy A (1994) The use of the rigid endoscope in trans-sphenoidal pituitary surgery. J Laryngol Otol 108: 19–22
Griffith HB, Veerapen R (1987) A direct transnasal approach to the sphenoid sinus. Technical note. J Neurosurg 66: 140–142
Guiot A (1973) Transsphenoidal approach in surgical treatment of pituitary adenomas. General principles and indications in nonfunctioning adenoma. In: Kohler PO, Ross GT (eds) Diagnosis and treatment of pituitary tumors. Excerpta Medica Amsterdam, International Congress Series No 303, pp 159–178
Hardy J (1969) Transsphenoidal microsurgery of the normal and pathological pituitary. Clin Neurosurg 16: 185–217
Hardy J (1985) Transsphenoidal approach to the pituitary gland. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 889–898
Jankowski R, Auque J, Simon C, Marchal JC, Hepner H, Wayoff M (1992) Endoscopic pituitary tumor surgery. Laryngoscope 102: 198–202
Liston SL, Siegel LG, Thienprasit P, Gregory R (1987) Nasal endoscopes in hypophysectomy (letter). J Neurosurg 66: 155
Papay FA, Benninger MS, Levine HL, Lavertu P (1989) Transnasal transseptal endoscopic repair of sphenoidal cerebral spinal fluid fistula. Otolaryngol Head Neck Surg 101: 595–597
Renn WH, Rhoton AL Jr (1975) Microsurgical anatomy of the sellar region. J Neurosurg 43: 288–298
Rosegay H (1981) Cushing's legacy to transsphenoidal surgery. J Neurosurg 54: 448–454
Stammberger H (1986) Endoscopic endonasal surgery — concepts in treatment of recurring rhinosinusitis. Part II. Surgical technique. Otolaryngol Head Neck Surg 94: 147–156
Stevens MH, Apfelbaum RI (1990) Transnasal pituitary tumor surgery. Laryngoscope 100: 427–429
Wilson WR, Khan A (1990) Transseptal approaches for pituitary surgery. Laryngoscope 100: 817–819
Wurster CF, Smith DE (1994) The endoscopic approach to the pituitary gland (letter). Arch Otolaryngol Head Neck Surg 120: 674
Zervas NT (1984) Surgical results in pituitary adenomas: results of international survey. In: Black PmcL, Zervas NT, Ridway EC Jr, Martin JB (eds) Secretory tumors of the pituitary gland. Raven, New York, pp 377–385
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Jho, H.D., Carrau, R.L. Endoscopy assisted transsphenoidal surgery for pituitary adenoma. Acta neurochir 138, 1416–1425 (1996). https://doi.org/10.1007/BF01411120
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DOI: https://doi.org/10.1007/BF01411120