Endoscopic endonasal pituitary surgery: Surgical and outcome analysis of 50 cases

Abstract

Objective

Microsurgical transsphenoidal surgery for pituitary tumors has been standard therapy for decades and was established by Harvey Cushing in the early twentieth century. Today, endoscopy is increasingly accepted in the therapy of pituitary lesions. In this retrospective study, we analysed the surgical technique and outcome of 50 patients with pituitary lesions treated with an endoscopic endonasal trans-sphenoidal approach.

Methods

Between January 2004 and July 2005, 50 patients (30 female and 20 male) with pituitary tumors were operated upon using an endoscopic endonasal trans-sphenoidal procedure without nasal speculum or postoperative nasal packing. The follow-up period ranged from 3 to 18 months.

Results

All patients had normal airways through both nostrils immediately after extubation. Postoperative discomfort was minimal and hospitalization was 4–5 days. Three patients developed postoperative transient diabetes insipidus, persisting in one for a further 2 months. Among the 50 patients, total tumor removal was achieved in 47 patients (94%), subtotal in two patients (4%). One patient died intraoperatively due to subarachnoid haemorrhage.

Conclusion

The endoscopic endonasal transsphenoidal approach for removing pituitary lesions is a form of minimally invasive surgery offering excellent postoperative results.