OTHER-15 ENDOSCOPIC SURGERY FOR PATHOLOGIES OF SKULL BASE: ABOUT A SERIES OF CASES

Abstract

Abstract INTRODUCTION Transsphenoidal endoscopic surgery (TS) is currently the reference method for the treatment of pathologies affecting the sellar region. It is a relatively safe technique, with low per and postoperative morbidity. We report through this retrospective study the experience of the neurosurgery department of the HSR in this field. PATIENTS AND METHODS We have collected the records of 176 patients operated endoscopically (TS), since the advent of the technique in the service in January 2016 until March 2022. Epidemiological, radiological and endocrine clinical data were analyzed by jamovi software version 1.6. RESULTS Over 6 years, 176 interventions were performed endoscopically transsphenoidal, these were 66 men and 110 women sex ratio = 1.66. The average age at surgery was estimated at 42 years. Several pathologies were treated by TS route, namely: pituitary adenoma (80%), and the other pathologies were divided between meningiomas; craniopharyngiomas; chordomas; pituitary abscess and OMB. Symptoms were dominated by: intracranial hypertension syndrome, optochiasmatic syndrome, endocrine syndrome. The diagnosis was based on imaging all our patients benefited from an injected brain MRI, as well as the anatomo-pathological examination the endocrine balance was disrupted in 9 patients (5.3%) Postoperative follow-up was favorable in 128 patients (75%),15 patients required revision surgery, 8 patients developed transient or prolonged diabetes Insipidus (4%), 5 cases of rhinorrhea (2%), 11 patients had meningitis (6%), new pituitary deficiency constituted 3.20%, hemorrhages and Epistaxis found in 6% of patients, no cases of ophthalmic complication were reported, deploring the death of 2 patients postoperatively. CONCLUSION The usage of Endoscopic Surgery (TS) in our department is the result of several efforts developed by different generations of neurosurgeons. Currently we operate about thirty patients per year by adopting this technique, with a significant reduction in hospitalization days as well as complications.