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Related Experiment Video

Updated: Apr 5, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

20.1K

Extended transsphenoidal approach for pituitary adenomas invading the cavernous sinus using multiple complementary

Xinjie Bao1, Kan Deng1, Xiaohai Liu1

  • 1Department of Neurosurgery, Pituitary Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Pituitary
|August 13, 2015
PubMed
Summary

Extended transsphenoidal surgery effectively resects pituitary adenomas invading the cavernous sinus. Initial surgeries and lower tumor grades yield better outcomes with fewer complications.

Keywords:
Cavernous sinusEndoscopeExtended transsphenoidal approachNeuronavigationPituitary adenoma

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Area of Science:

  • Neurosurgery
  • Endocrinology
  • Oncology

Background:

  • Transsphenoidal surgery is standard for pituitary adenomas (PA).
  • Standard approaches struggle with PAs invading the cavernous sinus (CS).
  • Limited exposure hinders radical resection of CS-invading PAs.

Purpose of the Study:

  • Analyze extended transsphenoidal surgery for PAs invading the CS.
  • Identify factors influencing tumor resection extent.
  • Determine factors affecting complication rates.

Main Methods:

  • Retrospective analysis of 52 patients with CS-invading PAs.
  • Utilized extended transsphenoidal approach with microscopy, endoscopy, neuronavigation, and intraoperative Doppler ultrasonography.
  • Evaluated gross-total resection (GTR) rates and complications.

Main Results:

  • Achieved GTR in 63.5% of patients.
  • Higher GTR rates for Knosp Grade 3 vs. Grade 4 (92.3% vs. 53.8%).
  • Higher GTR rates for initial surgery vs. reoperation (77.1% vs. 35.3%).
  • Complications were higher after reoperation; transient cranial nerve palsy in 2.9% of initial surgeries.

Conclusions:

  • Extended transsphenoidal surgery with multiple techniques is effective for CS-invading PAs.
  • Low complication rates observed, particularly in initial surgeries and Knosp Grade 3 tumors.
  • Complete resection remains challenging for reoperations and firm tumors.