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Transsphenoidal hypophysectomy through the external rhinoplasty approach
P J Koltai1, D B Goufman, S M Parnes
1Division of Otolaryngology, Albany Medical College, NY 12208.
Summary
The external rhinoplasty approach offers a reliable method for transsphenoidal hypophysectomy, providing excellent nasal exposure of the pituitary gland. This technique minimizes cosmetic deformity and nasal tip projection loss.
Area of Science:
- Neurosurgery
- Otolaryngology
- Endocrinology
Background:
- Transsphenoidal hypophysectomy is a key surgical procedure for pituitary gland pathologies.
- The sublabial transseptal technique, introduced by Cushing in 1910, is a recognized approach.
- Refinements in surgical techniques aim to improve outcomes and minimize complications.
Purpose of the Study:
- To evaluate the efficacy and safety of the external rhinoplasty approach for transsphenoidal hypophysectomy.
- To describe the surgical technique and patient outcomes over a 10-year period.
- To assess the cosmetic and functional results of the external approach.
Main Methods:
- Retrospective review of 111 transsphenoidal hypophysectomy cases performed between 1982 and 1992.
- Detailed description of the external rhinoplasty technique for pituitary surgery.
- Analysis of patient demographics, pathologies, surgical outcomes, and complications.
Main Results:
- 111 patients underwent transsphenoidal hypophysectomy using the external technique.
- Common pathologies included pituitary adenomas (101 cases).
- Complications included septal perforations, CSF rhinorrhea, hemorrhages, and one carotid artery injury.
Conclusions:
- The external rhinoplasty approach is a reliable and facile method for pituitary surgery.
- It provides adequate nasal exposure of the sphenoid sinus and pituitary gland.
- The technique preserves nasal tip projection and avoids significant cosmetic deformity.