Modification of a nasal speculum for transsphenoidal surgery. Technical note

Area of Science:

• Neurosurgery
• Otolaryngology
• Surgical Instrumentation

Background:

• Transsphenoidal surgery is a minimally invasive approach for accessing the pituitary gland and surrounding structures.
• Traditional surgical instruments and speculums can present challenges in visualization and maneuverability within the surgical field.
• Improving access and instrument handling is crucial for optimizing outcomes in transsphenoidal procedures.

Purpose of the Study:

• To modify the Hardy nasal speculum to enhance surgical field access and instrument manipulation during transsphenoidal surgery.
• To evaluate the efficacy of the modified speculum in a clinical setting, specifically for pituitary adenoma resection.

Main Methods:

• Modification of the Hardy nasal speculum involved removing a section from the inferior edge and reducing the tip thickness.
• Speculum length was customized based on patient anatomy, specifically the distance between the sphenoid sinus and gingiva.
• The modified speculum was utilized during transsphenoidal surgery for pituitary adenoma removal.

Main Results:

• The modified nasal speculum significantly reduced protrusion above the gingiva.
• Instrument handling was facilitated, particularly for instruments inserted through the inferior portion of the speculum orifice.
• The surgical field became shallower and wider, reducing the need for conventionally long surgical instruments.

Conclusions:

• The modified Hardy nasal speculum offers significant advantages for transsphenoidal surgery.
• Improved visualization and instrument maneuverability can lead to a more efficient and potentially safer surgical procedure.
• This modification represents a practical advancement in surgical instrumentation for pituitary surgery.