Endoscopic transsphenoidal resection of sellar tumors with conchal sphenoid sinus: A report of two cases.

Yexun Song,Jiangbo Chen,Guolin Tan,Tiansheng Wang

doi:10.3892/ol.2014.2732

Yexun Song, Jiangbo Chen + Show 2 more

Open Access

https://doi.org/10.3892/ol.2014.2732

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Abstract

A conchal non-pneumatized sphenoid sinus was previously considered to be a contraindication to the endoscopic transsphenoidal route to the sella due to its small sellar floor and poor anatomical landmarks, such as the optic nerve canal, opticocarotid recess and internal carotid arteries canal. The present study aimed to investigate the methodology and characteristics of the endoscopic transsphenoidal resection of sellar tumors with a conchal sphenoid sinus. Two patients with sellar tumor patients and non-pneumatized sphenoid sinuses received endoscopic transsphenoidal surgery. The two conchal sphenoid sinuses were accessed safely, total resection was achieved and no serious complications occurred. Therefore, the presence of a conchal non-pneumatized sphenoid is not an absolute contraindication for employing the endoscopic transsphenoidal route in the resection of sellar tumors; a positive outcome may be achieved, in particular when the surgery is performed by an experienced otolaryngologist.

Highlights

The endoscopic transsphenoidal route is considered the standard approach for the surgical resection of sellar tumors [1], which represent ~10% of all intracranial tumors, with a mortality rate of ~4.4% and a recurrence rate that varies between 6 and 21% [2]
The current study presents two cases of resection of sellar tumors with conchal sphenoid sinus via the endoscopic transsphenoidal route
Magnetic resonance imaging indicated the presence of a sellar tumor, which had extended into the suprasellar cistern and caused compression of the optic nerves and optic chiasma, as well as a non‐pneumatized sphenoid sinus (Fig. 1C)

Summary

Introduction

Magnetic resonance imaging indicated a sellar tumor extended into the left cavernous sinus and a non‐pneumatized sphenoid sinus (Fig. 1A). Magnetic resonance imaging indicated the presence of a sellar tumor, which had extended into the suprasellar cistern and caused compression of the optic nerves and optic chiasma, as well as a non‐pneumatized sphenoid sinus (Fig. 1C). Magnetic resonance imaging indicated that total resection of the tumor had been achieved, a hematoma was observed in the posterior pituitary fossa with no clinical symptoms (Fig. 1D). A conchal non‐pneumatized sphenoid does not appear to be an absolute contraindication for endoscopic transsphenoidal route in the resection of sellar tumors; endoscopic transsphenoidal surgery has a number of advantages when compared with other surgical approaches, including decreased morbidity, improved panoramic visualization and increased illumination and magnification.

Discussion

Kirnman J