[Direct transnasal approach. Description and feasibility in 60 patients].
OBJECTIVE
The direct transnasal approach is a less invasive approach to the sella turcica and represents an alternative to the sublabial transsphenoidal approach with minor oro-nasal complications. In this study, we describe this approach with emphasis on post-operative course.


METHODS
We studied retrospectively 60 patients operated on consecutively by a transnasal approach between January 1996 and December 2000.


RESULTS
There were 47 macroadenomas, 9 microadenomas and 4 non-adenomatous pathologies. Despite its narrowness, the transnasal approach was possible in all cases and allowed tumor removal as satisfactory as with the sublabial approach. Eight patients had complications not directly related to the approach: 1 death (meningitis with brain stem ischemia), 3 pituitary fossa hematomas, 4 rhinorrheas and 2 meningitis. Seven patients had complications related to the approach: 2 nasal obstructions, 1 nasal dryness, 2 sinusitises and 2 hyposmias. All these local complications were transitory and disappeared within 3 months.


CONCLUSIONS
In our experience, the direct transnasal approach is safe, quick and less invasive than the sublabial approach.
Moufid
A
A
Services de Neurochirurgie et Neurotraumatologie, CHRU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France. amoufid@aol.fr
Ghorbel
M
M
Moreau
J J
JJ
Vidal
J
J
Alibenali
M
M
Hallacq
P
P
Lagarrigue
J F
JF
D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000033:anatomy & histology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies; D012658:Sella Turcica / Q000601:surgery*; D013525:Surgical Instruments
La voie transnarinaire directe. Description et faisabilité à propos de 60 cas.