Endoscopic versus Microscopic Pituitary Adenoma Surgery: A Single-center Study

Area of Science:

• Neurosurgery
• Endocrinology
• Otolaryngology

Background:

• Transsphenoidal surgery is standard for pituitary adenomas.
• Comparative efficacy of microscopic versus endoscopic techniques requires further study.

Purpose of the Study:

• To compare microscopic and endoscopic transnasal approaches for pituitary adenoma treatment.

Main Methods:

• Retrospective analysis of 259 microscopic and 140 endoscopic surgeries.
• Evaluation of imaging, hormonal, ophthalmological outcomes, and complications.
• Fisher's exact test for statistical analysis of dichotomous variables.

Main Results:

• Higher rates of invasive macroadenomas in the endoscopic group (56.4% vs 35.5%).
• Endoscopic surgery showed higher, though not statistically significant, rates of total resection (46.8% vs 35%) and hormonal control (64% vs 33.3%) for invasive cavernous sinus pathology.
• No significant differences in individual postoperative complications between the two approaches.

Conclusions:

• Both microsurgical and endoscopic transnasal approaches are safe and effective for pituitary adenomas.
• Endoscopic surgery may yield superior results for invasive pituitary adenomas.