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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.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 1, 1994
PubMed
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.

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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.

Related Experiment Videos

  • 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.