Transsphenoidal resection of pituitary adenoma accompanied by conchal or pre-sellar sphenoid sinus

Abstract

Objective To investigate the method and characteristics of transsphenoidal resection of pituitary adenoma accompanied by conchal or pre-sellar sphenoid sinus. Methods The clinical data of 32 cases of pituitary adenoma accompanied by conchal or pre-sellar sphenoid sinus treated by transsphenoidal surgery between June 2004 and June 2009 were retrospectively analyzed. Preoperative CT multiplanar reconstruction, CT virtual endoscopy and MRI were performed to study the detail anatomic informations of sphenoid sinus and adenoma, and to guide the intraoperative seller floor exploration and tumor resection. Five patients with conchal sphenoid sinus and 27 with presellar sphenoid sinus were confirmed by preoperative image data. Results The seller floor exploration and tumor resection could be accomplished successfully with microdrill, microscope or endoscope, and the average operating time was about 86 minutes. Postoperative MRI within 3 d indicated that total resection, subtotal resection and resection of bulk were achieved in 25, 6 and 1 patient, respectively, and no serious complications occurred. Conclusion Pituitary adenoma accompanied by conchal and presellar sphenoid sinus can be surgically treated by transsphenoidal approach with the detailed preoperative CT and MR imaging and intraoperative use of microdrill, microscope or endoscope. Key words: Pituitary adenoma; Sphenoid sinus; Transsphenoidal approach; Microsurgery