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Updated: Apr 27, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Endoscopic transsphenoidal approach for resection of malignant pituitary blastoma in an 18-month-old infant: a
Malik Zaben1, Mohsin Zafar, Shafqat Bukhari
1*Department of Neurosurgery, University Hospital of Wales, Cardiff, United Kingdom; ‡Aintree University Hospital, Liverpool, United Kingdom; §Department of Neurosurgery, Royal Manchester Children's Hospital, Manchester, United Kingdom.
Insights
Endoscopic endonasal transsphenoidal surgery successfully resected a pituitary blastoma in an infant. This minimally invasive technique offers a safe and effective option for treating this rare pediatric sellar tumor.
Area of Science:
- Pediatric Neurosurgery
- Endoscopic Skull Base Surgery
Background:
- Sella and suprasellar tumors are typically managed with endoscopic transsphenoidal surgery.
- Infantile endoscopic surgery for these tumors remains largely unreported.
- Pituitary blastoma, a rare malignant sellar tumor, predominantly affects infants and requires surgical cytoreduction followed by adjuvant therapy.
Observation:
- This study details the endoscopic endonasal transsphenoidal approach for pituitary blastoma resection in an 18-month-old infant.
- The surgical technique involved minimally invasive resection of the malignant sellar tumor.
- Skull base reconstruction was performed using a nasoseptal flap.
Findings:
- Near-total resection of the pituitary blastoma was achieved.
- The procedure was completed without cerebrospinal fluid leak or intraoperative complications.
- Postoperative recovery was uneventful, with complete tumor resolution observed at one-year follow-up.
Implications:
- The endoscopic endonasal transsphenoidal approach is a safe and innovative technique for infant pituitary blastoma resection.
- This minimally invasive method provides a viable alternative for managing pediatric sellar malignancies.
- The use of a nasoseptal flap ensures effective skull base reconstruction in infant endoscopic surgery.
Background:
Sella and suprasellar tumors are increasingly managed via an endoscopic transsphenoidal approach, but infant endoscopic surgery has not been reported. Pituitary blastoma is a rare sellar malignant tumor that primarily occurs in infants and is managed by surgical resection (cytoreduction) followed by adjuvant therapy.
Objective:
To describe the technique and feasibility of resection of a pituitary blastoma via endoscopic endonasal transsphenoidal approach in an 18-month-old infant.
Methods:
Endoscopic endonasal transsphenoidal approach for resection of a pituitary malignant tumor in an infant.
Results:
Near-total tumor resection was achieved. The skull base was reconstructed by using a nasoseptal flap with no cerebrospinal fluid leak or any other intraoperative complications. The postoperative course was uneventful. One-year follow-up showed complete resolution of the tumor.
Conclusion:
The endoscopic endonasal transsphenoidal approach with nasoseptal flap reconstruction could be used as a safe, yet minimally invasive and innovative technique for the resection of pituitary blastoma in infants.
