Endoscopic endonasal transsphenoidal surgery: experience with 50 patients

Area of Science:

• Neurosurgery
• Endocrinology
• Otolaryngology

Background:

• The operating microscope was the traditional visualization tool in transsphenoidal surgery.
• Endoscopes have increasingly replaced microscopes for enhanced visualization during these procedures.

Purpose of the Study:

• To evaluate the efficacy and outcomes of endonasal endoscopic transsphenoidal surgery for pituitary adenomas and other sellar lesions.
• To assess patient recovery and complication rates associated with this minimally invasive technique.

Main Methods:

• Retrospective analysis of 50 patients undergoing transsphenoidal surgery.
• Utilized rigid endoscopes, with 48 cases performed solely endoscopically.
• Patient cohort included pituitary adenomas (n=44) and other sellar lesions (n=6).

Main Results:

• Successful treatment of various pituitary adenomas, including hormone-secreting and non-secreting types.
• High rates of clinical and biochemical resolution for Cushing's disease (7/8) and improvement for prolactinomas (14/17).
• Postoperative outcomes included unobstructed nasal airways, minimal discomfort, and short hospital stays (overnight for >50%).

Conclusions:

• Endonasal endoscopic transsphenoidal surgery is a safe and effective approach for pituitary adenomas.
• The technique provides excellent visualization and favorable patient outcomes, including rapid recovery.
• This minimally invasive method offers significant advantages over traditional surgical approaches.