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Updated: Jul 14, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
[The diagnosis of non-pituitary space-occupied lesions in sphenoidal sinus and sellar area]
1Peking Union Medical College Hospital, Chinese Academy Medical Sciences, Beijing 100730.
Objective:
To improve the diagnostic accuracy of non-pituitary lesions in sphenoidal sinus and sellar area.
Methods:
Twenty-four cases with non-pituitary lesions in sphenoidal sinus and sellar area were analyzed. Eighteen cases were benign, including 7 sphenoidal sinus cyst, 6 craniopharyngioma, 2 chordoma, 1 nasal polyp extending into the sella, 1 neuronoma in sella, and 1 pinealoma. Six cases were malignant, including 2 malignant neuroendocrinoma in sphenoidal sinus, 1 adenoidocystic carcinoma, 1 sphenoidal sinus low differentiated carcinoma, 1 nasopharyngeal carcinoma extending into sella, 1 lung cancer metastasis to sphenoidal sinus. Clinical presentation, examination, imaging study, diagnosis and treatment were discussed.
Results:
Among 24 cases, 18 had headache, 17 had visual symptoms. In all cases the space-occupied lesions in sphenoidal sinus and sellar area were verified by CT scan.
Conclusions:
1. Headache at different levels was the commonest symptom for benign and malignant lesions. The visual loss was another common symptom. It is important to realize the relationship between visual symptom and space-occupied lesions in sphenoidal sinus and sellar area; 2. Imaging study is very important for the diagnosis of the lesions in sphenoidal sinus and sellar area; 3. It is helpful to do needle-aspirating biopsy under endoscopy to confirm the pathologic diagnosis. The benign lesions were operated on, and malignant lesions were treated by combined operation and radiation.
