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'The columellotomy modification' of transseptal hypophysectomy
Cem Bilgen1, Kazim Oner, Izzet Ovül
1ENT Department, Ege University, Talatpasa Bulvari No: 35/5, Alsancak, Izmir 35220, Turkey. cembilgen@hotmail.com
Auris, Nasus, Larynx
|May 20, 2003
Summary
A modified surgical approach using columellotomy provides better access to the pituitary gland for tumor resection in patients with narrow nostrils. This technique offers a wider, faster surgical field without cosmetic drawbacks.
Area of Science:
- Neurosurgery
- Otorhinolaryngology
Background:
- Transseptal approach is standard for pituitary tumor resection but unsuitable for narrow nostrils.
- Narrow nostrils limit neurosurgical speculum placement, hindering tumor resection.
Purpose of the Study:
- Introduce and evaluate 'the columellotomy modification' of the transseptal approach.
- Address limitations of the standard transseptal approach in patients with narrow nostrils.
Main Methods:
- Measured speculum blade spread in five patients using hemitransfixion vs. columellotomy incisions.
- Statistically compared the increase in speculum spread relative to nostril width.
- Assessed postoperative patient complaints and cosmetic outcomes.
Main Results:
- Columellotomy significantly increased speculum spread compared to hemitransfixion (P=0.011).
- Three patients reported temporary columellar skin numbness.
- Cosmetic results were satisfactory in all patients.
Conclusions:
- The columellotomy modification provides a wide, direct, and rapid surgical exposure of the sella turcica.
- This technique is advantageous for pituitary tumor resection in patients with narrow nostrils.
- The approach offers satisfactory cosmetic outcomes without significant disadvantages.