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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Pituitary apoplexy following endoscopic sinus surgery

Georgios Fyrmpas1, J Constantinidis, N Foroglou

  • 1Department of Otolaryngology Head and Neck Surgery, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. drfirbas@hotmail.com

The Journal of Laryngology and Otology
|November 26, 2009
PubMed
Abstract

Insights

Pituitary apoplexy, a rare complication, can occur after sinus surgery in patients with pituitary adenomas. Prompt endoscopic surgery by specialists can effectively manage this condition.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Endocrinology

Background:

  • Functional endoscopic sinus surgery (FESS) is often a prerequisite for pituitary fossa access.
  • Pituitary adenomas are tumors of the pituitary gland.
  • Pituitary apoplexy is a clinical syndrome characterized by sudden onset of severe headache, visual impairment, and ophthalmoplegia.

Observation:

  • A 67-year-old male with a pituitary macroadenoma experienced sudden headache, diplopia, and vision loss post-FESS.
  • MRI confirmed pituitary hemorrhage (apoplexy).
  • The patient underwent emergency endoscopic transsphenoidal surgery for tumor resection.

Findings:

  • The patient showed significant symptomatic improvement after surgery.
  • Persistent diabetes insipidus and mild ptosis were noted.
  • This is the first reported case of pituitary apoplexy following nasal surgery.

Implications:

  • Pituitary apoplexy is a rare but serious risk in patients with pituitary adenomas undergoing nasal procedures.
  • Multidisciplinary collaboration between rhinologists and neurosurgeons is crucial for management.
  • Endoscopic transsphenoidal surgery offers a safe and effective approach for acute pituitary apoplexy management.

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