Extracranial complications of endoscopic transsphenoidal sellar surgery

The endoscopic transsphenoidal approach for the resection of sellar tumours has rapidly increased in popularity. However, few studies report on the extracranial complications of this procedure. To be able to critically evaluate all of the outcomes from this approach, the occurrence of any extracranial complications that result from its performance needs to be established.

To examine specifically what extracranial complications are associated with this surgical approach to sellar lesions.

A retrospective analysis of a consecutive case series was performed to identify the extracranial complications for primary sellar lesions operated on using an endoscopic transsphenoidal approach performed during the years 2003 to 2006. Patients had a minimal postoperative follow-up of 6 months.

A total of 135 patients were eligible for analysis, of whom 82% underwent an isolated endoscopic transsellar approach to the sellar tumour. Extracranial complications occurred in 29.6% of the operated cases. The most common complications were prolonged nasal crusting (10.4%), synechia formation (8.8%), and septal deviation (3.7%). The use of a combined transplanum and transsellar approach was not associated with a significant increase in complications (p = .354).

It is important that the outcomes, including the complications that can arise from the endoscopic transsphenoidal approach to sellar lesions, be established if meaningful comparisons are to be drawn between it and classic microscopic approaches to the sella turcica. From this study, although considered minor, up to one-third of patients may be expected to experience an extracranial complication from this surgery.