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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
Summary
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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