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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Double nasoseptal flap technique for endonasal pituitary surgery
Sercan Gode1, Huseyin Biceroglu2, Goksel Turhal3
1Otolaryngology Department, Ege University School of Medicine, 35100, Bornova, Izmir, Turkey.
Summary
The double nasoseptal flap technique enhances endoscopic pituitary surgery by preserving nasal structures. This method offers improved surgical exposure and better patient outcomes with minimal complications.
Area of Science:
- Otolaryngology
- Neurosurgery
- Endoscopic Surgery
Background:
- Endoscopic endonasal approach is effective for pituitary tumors.
- Septal mucosa loss is a drawback of standard techniques.
- A novel technique is needed to mitigate these disadvantages.
Purpose of the Study:
- To introduce the "double nasoseptal flap" technique.
- To evaluate its outcomes in endoscopic transsphenoidal pituitary surgery.
- To assess functional and morphological results and complications.
Main Methods:
- A variation of the endonasal approach using bilateral nasoseptal flaps.
- Thirty patients underwent the double nasoseptal flap technique.
- Preoperative and postoperative assessments included Visual Analogue Scale (VAS), septal integrity, sphenoid sinusitis, synechia, and crusting.
Main Results:
- Mean VAS improved from 71 mm to 67 mm postoperatively (p > 0.01).
- No septal perforations, synechia, or sphenoid sinusitis were observed.
- Only 10% of patients experienced minimal crusting in the sphenoethmoidal recess.
Conclusions:
- The double nasoseptal flap technique provides wider surgical exposure.
- It leads to better postoperative morphological and functional outcomes.
- The technique is safe, preventing perforations and minimizing crusting.
