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Updated: Mar 18, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Development of minimally invasive surgery for sinonasal malignancy
A Moya-Plana1, D Bresson2, S Temam1
1Département de cancérologie cervico-faciale, Institut Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
Abstract:
Sinonasal malignancies are rare and histologically heterogeneous. Treatment is complicated by tumor aggressiveness and location near critical anatomic structures (orbita, skull base, etc.). This low incidence and histologic diversity make prospective studies unfeasible, and thus therapeutic guidelines difficult to establish. The gold standard for surgery is a transfacial approach, with craniofacial resection in case of skull-base involvement. However, these techniques are associated with non-negligible perioperative morbidity. In the past two decades, endoscopic surgery has made major progress, extending its indications: initially developed for functional sinus surgery, it is now applied in benign skull-base pathologies (CSF leakage, meningocele, etc.) and, more recently, in sinonasal malignancy. Literature analysis shows a significant decrease in morbidity and improved quality of life associated with endoscopic endonasal surgery, with oncologic safety and efficacy in well-selected cases, although dependent on operator experience. Additional studies with longer follow-up and comparison between histologic subtypes will be needed.
Insights
Endoscopic endonasal surgery offers reduced morbidity and improved quality of life for sinonasal malignancies. This minimally invasive approach shows oncologic safety and efficacy in select cases, though operator experience is key.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Sinonasal malignancies are rare, histologically diverse, and challenging to treat due to tumor aggressiveness and proximity to critical structures.
- Current surgical standards, such as transfacial approaches and craniofacial resections, carry significant perioperative risks.
Purpose of the Study:
- To evaluate the role and outcomes of endoscopic endonasal surgery (EES) for sinonasal malignancies.
- To compare EES with traditional surgical approaches regarding morbidity and quality of life.
Main Methods:
- A literature analysis was conducted to review studies on endoscopic endonasal surgery for sinonasal malignancy.
- Outcomes assessed included perioperative morbidity, oncologic safety, efficacy, and patient quality of life.
Main Results:
- Endoscopic endonasal surgery demonstrates a significant decrease in morbidity and improved quality of life compared to traditional methods.
- Oncologic safety and efficacy are achievable with EES in well-selected sinonasal malignancy cases.
- Outcomes are notably dependent on the surgeon's experience and expertise.
Conclusions:
- Endoscopic endonasal surgery is a viable and less morbid alternative for treating select sinonasal malignancies.
- Further research with longer follow-up and comparative analyses across histologic subtypes is warranted to refine treatment guidelines.
