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Updated: Mar 7, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Microscopic Transnasal Transsphenoidal Surgery for Pediatric Pituitary Adenomas
Wei Jiao1, Yimin Huang, Wei Sun
1Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Abstract:
Microscopic transnasal transsphenoidal surgery (MTTS) has been a time-confirmed effective treatment for pituitary adenomas; however, the data supporting its use in pediatric patients is limited. In this study, the authors summarize the authors' 5-year experience of pituitary adenomectomy via MTTS in a pediatric population. The authors retrospectively reviewed the medical records of 35 patients aged ≤18 years who underwent microscopic transnasal transsphenoidal approach for pituitary adenomas between January 2011 and December 2015. Age, sex, symptoms, tumor size, extent of tumor resection, surgical outcomes, and complications were reviewed. All patients underwent MTTS 39 times. Total resection was obtained in 31 (88.6%) patients, while subtotal resection was achieved in 4 (11.4%) and no patient had partial resection. For the 21 patients with preoperative visual impairment, 18 (85.7%) resolved and 3 (14.3%) obtained subjective improvement. Of the 33 patients with preoperative hyperhormonal levels, endocrine function reduced to normal reference range in 28 (84.8%), decreased in 3 (9.1%) and 2 (6.1%) patients had no change. Diabetes insipidus occurred in 4 (11.4%) patients, of whom 1 patient (2.9%) developed persistent diabetes insipidus that was treated with Minirin. One patient incurred postoperative cerebrospinal fluid leakage that was resolved by lumbar drainage. Hypopituitarism occurred in 3 patients, of whom 1 patient developed permanent hypopituitarism that required hormone replacement therapy. There were no patients of death, intracranial hematoma, or meningitis. In conclusion, MTTS is a safe and effective surgical option for pediatric pituitary adenomas with minimal morbidity and excellent outcomes.
Insights
Microscopic transnasal transsphenoidal surgery (MTTS) is a safe and effective treatment for pediatric pituitary adenomas. This study shows high resection rates and significant symptom improvement with minimal complications in young patients.
Area of Science:
- Neurosurgery
- Pediatric Endocrinology
- Oncology
Background:
- Pituitary adenomas are rare in children, and data on surgical outcomes via microscopic transnasal transsphenoidal surgery (MTTS) is limited.
- MTTS is a standard treatment for pituitary adenomas, but its efficacy and safety in pediatric populations require further investigation.
Purpose of the Study:
- To evaluate the 5-year surgical outcomes and complications of MTTS for pituitary adenomas in pediatric patients.
- To assess the effectiveness of MTTS in achieving tumor resection and improving clinical symptoms in children.
Main Methods:
- Retrospective review of 35 pediatric patients (age ≤18 years) who underwent MTTS for pituitary adenomas between 2011 and 2015.
- Analysis of patient demographics, tumor characteristics, surgical outcomes (resection extent, symptom resolution), and postoperative complications.
Main Results:
- Total tumor resection was achieved in 88.6% of patients, with significant improvement in visual impairment (85.7%) and hyperhormonal levels (84.8%).
- Complications were minimal, including transient diabetes insipidus (11.4%), cerebrospinal fluid leakage (2.9%), and temporary hypopituitarism (8.6%). No deaths or major neurological events occurred.
Conclusions:
- Microscopic transnasal transsphenoidal surgery is a safe and effective surgical approach for pediatric pituitary adenomas.
- MTTS offers excellent outcomes, including high rates of tumor resection and symptom resolution, with a low incidence of morbidity in the pediatric population.
