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Updated: Dec 23, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Comparative analysis of rhinologic outcomes in Cushing disease and non-functioning pituitary adenoma in patients
Mariana D C Toro1, Thiago L I Serrano2, Fernando A L Marson3,4
1Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medical Sciences, State University of Campinas, Tessália Viera de Camargo, 126, Campinas, São Paulo, 13083-887, Brazil. mdctoro@gmail.com.
Purpose:
Adrenocorticotropic hormone (ACTH) secreted by pituitary tumors lead to changes in nasal cavity anatomy and physiology. As a consequence of hormonal alteration, there is an abnormal soft tissue and an increased capillary fragility, inducting to a thinner mucosa that acts in the healing process. We compared post-operative nasal alterations in patients with Cushing's disease versus patients with non-functioning macroadenomas who underwent endoscopic endonasal transsphenoidal surgery.
Methods:
A retrospective study with 14 patients with Cushing's disease who underwent initial transsphenoidal endonasal surgery for an ACTH-secreting adenoma was conducted. Forty-two patients who underwent the same surgery for non-functioning adenomas were selected as controls. The following data were collected: operative technique, endoscopic alterations in late post-operative period and post-operative nasal complaints.
Results:
There were 13/14 (92.9%) females with Cushing disease versus 23/42 (54.8%) in the non-functioning adenoma group. Surgical approach was similar in both groups, with no differences in flap usage, turbinectomies or ethmoidectomies. No difference occurred concerning endoscopic alterations or nasal complaints in post-operative period.
Conclusions:
Post-operative results are similar, and healing could be expected to be equal.

