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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Endoscopic transsphenoidal approach versus microscopic approach in children
Mario Rigante1, Luca Massimi, Claudio Parrilla
1Institute of Otolaryngology, A. Gemelli University Hospital, Catholic University of Sacred Heart, Rome 00168, Italy. m_rigante@hotmail.com
International Journal of Pediatric Otorhinolaryngology
|July 19, 2011
Summary
The endoscopic endonasal transsphenoidal (ETS) approach is effective and safe for treating pediatric sellar and parasellar lesions. This minimally invasive technique offers improved outcomes compared to the conventional microscopic transsphenoidal approach (CTS).
Area of Science:
- Pediatric Neurosurgery
- Endoscopic Surgery
- Transsphenoidal Surgery
Background:
- Sellar and parasellar lesions in children require effective and safe treatment.
- Conventional microscopic transsphenoidal approach (CTS) has been the standard, but minimally invasive options are sought.
Purpose of the Study:
- To compare the efficacy and safety of the endoscopic endonasal transsphenoidal (ETS) approach versus the conventional microscopic transsphenoidal approach (CTS) for pediatric sellar/parasellar lesions.
Main Methods:
- Retrospective chart review of 21 children with sellar/parasellar lesions.
- Group A (n=11): CTS (1995-2005).
- Group B (n=10): ETS (2006-2009).
Main Results:
- Gross total excision rates were similar (81.2% CTS vs. 80% ETS).
- ETS group showed significantly shorter hospitalization (4.1 vs. 5.8 days), less blood transfusion, lower pain scores, and no PICU requirement.
- No permanent morbidity in the ETS group versus 1/11 in the CTS group; CSF fistula occurred in 2/10 ETS patients.
Conclusions:
- The endoscopic endonasal transsphenoidal (ETS) approach is a reliable and effective minimally invasive option for pediatric sellar/parasellar lesions.
- ETS is ideal for preserving hypothalamic-pituitary axis and naso-facial structures, crucial for child development.
- ETS demonstrates superior outcomes in terms of recovery and patient comfort compared to CTS in pediatric cases.
