[The endonasal approach to pituitary adenomas: experience in 105 procedures].
OBJECTIVE
The endonasal approach to the sella turcica is supposed to simplify surgical techniques and reduce the risk and sequelae linked to removal of pituitary adenomas. We report our experience with 105 procedures using this approach.


METHODS
The series included 45 men and 60 women, aged 17 to 83 years. Their intrasellar lesions were: 43 non-functional adnomas, 37 prolactinomas, 7 GH- adenomas, 9 corticotrop adenomas, 9 miscellaneous lesions (abscess, Rathke cleft cysts, empty sella). Mean duration of the procedures was 50 minutes. Mean hospital stay was 4 days.


RESULTS
There were no deaths. Morbidity included: 1 (0.95%) rhinorrhea associated with meningitis which cured without sequelae, 11 (10.5%) transient diabetes insipidus lasting no longer than 48 hours, 2 cases of permanent diabetes insipidus (1 non-functional macroadenoma, 1 pituitary abscess), 1 transient hyposmia (3 months), 2 transient nasal obstructions. There were no cases of septal perforation, nasal deformation, partial or complete mucosal anesthesia, nasal pain, dental pain, or epistaxis.


CONCLUSIONS
This surgical approach is easier to perform and causes less rhinological sequelae than the sublabial transsphenoidal approach. It allows an as effective tumor removal than the latter. Hospitalization stay is significantly shortened.
Service de Neurochirurgie, Department de Neuro Anesthesie Reanimation, Centre Hospitalier Sainte-Anne, 1 rue Cabanis, 75014 Paris, France. roux@chsa.broca.inserm.fr
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Roux
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Nataf
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Devaux
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Djian
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Joly
D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D010911:Pituitary Neoplasms / Q000601:surgery*; D015175:Prolactinoma / Q000601:surgery; D013514:Surgical Procedures, Operative / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
D019382:Human Growth Hormone; D000324:Adrenocorticotropic Hormone