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Updated: May 13, 2026
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Endoscopic approaches to pituitary lesions: difficulties and challenges
Gonzalo de los Santos1, Claudio Fragola, Raúl Del Castillo
1Servicio de Otorrinolaringología, Hospital Universitario Ramón y Cajal, Madrid, España. gdlsantos@gmail.com
Acta Otorrinolaringologica Espanola
|March 20, 2013
Summary
This study reviews 40 endoscopic pituitary region surgeries, detailing complications like CSF leaks and diabetes insipidus. Findings suggest specific instruments and imaging improve outcomes for pituitary tumor surgery.
Area of Science:
- Neurosurgery
- Otolaryngology
- Endoscopic Skull Base Surgery
Background:
- Surgical approaches to the pituitary region are evolving, presenting new challenges for otolaryngologists.
- Endoscopic techniques offer patient benefits but require adaptation and understanding of potential difficulties.
Purpose of the Study:
- To present institutional experience with the endoscopic endonasal approach to the pituitary region.
- To assess complications and difficulties encountered during these procedures.
- To identify strategies for improving outcomes in endoscopic pituitary surgery.
Main Methods:
- Retrospective review of the first 40 endoscopic pituitary region approaches performed between 2008 and 2011.
- Collaborative surgical team including neurosurgeons and otolaryngologists.
- Analysis of pathologies, complications, and technical difficulties.
Main Results:
- 37 pituitary tumors and 3 cysts were operated on; 34 cases involved macroadenomas.
- Complications included 6 cerebrospinal fluid (CSF) leaks (3 with meningitis), 6 diabetes insipidus, 1 pulmonary embolism, 1 hydrocephalus, and 4 mild nasal complications.
- The frequency and type of complications were associated with surgical extent, patient age, tumor size, and suprasellar extension.
Conclusions:
- Complication rates in endoscopic pituitary surgery are influenced by surgical factors and patient/tumor characteristics.
- Use of specialized instruments, navigation systems, and thorough preoperative imaging can minimize complications.
- Careful implementation of new techniques, comprehensive knowledge of potential issues, and activity analysis are crucial for advancing skull base surgery.
