Endoscope-assisted microsurgery via the transsphenoidal approach to the clivus

Abstract

Objective To explore the microsurgical technique and clinical value of endoscope-assisted microsurgery via the transsphe-noidal approach to the clivus. Methods According to the results of microanatomy of endoscope-assisted via the transsphenoidal approach to sellar and clival area, the clinical data of 12 cases (8 with invasive pituitary adenoma, 3 with chordoma, 1 with chondroma) treated by transsphenoidal approach were studied retrospectively. All cases were followed-up 3 months to 6 years after operation. Results The tumor was totally removed in 8 patients, removed subtotally in 3 patients, and removed partially in 1 patient. 6 patients occurred transient diabetes insipidus, 2 patients with transient cerebrospinal rhinorrhoea. There were no death or intracranial infection. Postoperative follow-up was performed for 3 months to 6 years, No recurrence occurred except for enlargement of 1 chordoma. Conclusion Transsphenoidal approach satisfactorily and quickly reaches and helps remove the larger tumors in sellar and clival area without severe complication. It has the advantages of low incidence of surgical complication and high total removal rate. Endoscope-assisted may be helpful for this approach. Key words: Transsphenoidal approach; Neuroendoscope; Pituitary adenoma; Chordoma; Clivus