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Related Concept Videos

The Pituitary Gland01:17

The Pituitary Gland

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The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
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Related Experiment Video

Updated: Dec 18, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Transnasal Transsphenoidal Approach for Pituitary Tumors: An ENT Perspective.

Vaibhav A Chandankhede1, S K Singh1, Ravi Roy1

  • 1Department of ENT-HNS, Army Hospital (Research & Referral), Delhi Cantt, 110010 India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|June 20, 2020
PubMed
Summary

The endoscopic transnasal transsphenoidal approach is effective for pituitary adenoma resection, with manageable complications. This study highlights techniques for skull base repair and CSF leak management, emphasizing a skilled, team-based approach for favorable outcomes.

Keywords:
Pituitary adenomaPostoperative complicationsTransnasal transsphenoidal approach

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Area of Science:

  • Neurosurgery
  • Otolaryngology
  • Endocrinology

Background:

  • The endoscopic transnasal transsphenoidal (ETNTS) approach, established in 1992, is a standard surgical technique for benign pituitary adenomas.
  • Pituitary adenomas require precise surgical resection to minimize complications and preserve pituitary function.

Purpose of the Study:

  • To prospectively evaluate the incidence, preoperative assessment, operative findings, and outcomes of the ETNTS approach for pituitary adenomas.
  • To analyze skull base repair techniques, complication rates, and management strategies from an ENT perspective.

Main Methods:

  • A prospective analysis of 141 patients undergoing ETNTS for pituitary adenomas between January 2017 and May 2019.
  • Data collected included patient demographics, adenoma characteristics, operative findings (including CSF leak), surgical time, skull base repair methods, and complications.

Main Results:

  • The highest incidence of ETNTS was observed in the 41-50 age group (mean age 42.6 years); macroadenomas (123 cases) were more common than microadenomas (18 cases).
  • Peroperative cerebrospinal fluid (CSF) leak occurred in 30.5% of cases, managed with various closure techniques. Neurological and rhinological complications were each 6.38%.

Conclusions:

  • The ETNTS approach demonstrates reduced morbidity and complications for pituitary adenoma resection.
  • Effective management of CSF leaks and meticulous skull base repair, requiring skilled teamwork, are crucial for favorable surgical outcomes.