Treatment of pituitary adenomas by simple neuroendoscopic surgery via endonasal transsphenoidal approach

Abstract

Objective To summarize our experience of simple neuroendoscopic endonasal transsphenoidal surgery for pituitary adenoma and discuss its advantages. Methods Forty-two patients with pituitary adenoma diagnosed by CT or MRI detection (diameters of the tumor: 3cm in 8) were treated by simple neuroendoscopic endonasal transsphenoidal surgery. During transsphenoidal approach, the nasal mucosa was not incised and the nasal septum and median nasal conchae were not dissected. Under neuroendoscopic assistance, the anterior wall of the sphenoidal sinus and sellae base was opened directly and adenoma resection was performed. Results All the patients were followed up for 1-12 months. By postoperative MRI detection, adenomas were resected completely in 38 patients, subtotally in 4 cases. Rapid improvement of vision was noted postoperatively. The increased hormonal level in 18 of 22 patients was decreased to normal postoperatively and another 4 cases improved clinically in serum hormone levels during follow-up. Postoperative transient CSF leakage occurred in 6 cases and transient diabetes insipidus in 23 cases. Conclusions The simple neuroendoscopic endonasal transsphenoidal surgery for pituitary adanoma is safe, time-saving and without severe complications, provides a satisfactory deep illumination and a panoramic operative field. The injury to the patient and postoperative complications are less. The clinical application of the neuroendoscopy for pituitary adenoma is worthy of recommending. Key words: Neuroendoscopy; Trausnasal-sphenoidal approach; Pituitary adenoma