Increased role of the otolaryngologist in endoscopic pituitary surgery: endoscopic hydroscopy of the sella.
BACKGROUND
The aim of this study was to discuss the use of nasal irrigation and suction systems in endoscopic pituitary surgery to examine the sella and facilitate tumor removal. We describe a new technique of sellar exploration.


METHODS
Following the endoscopic approach to the pituitary by the otolaryngology team, pituitary masses are resected. Then, the ClearESS nasal irrigation and suction system is used by the otolaryngology team to visualize the sella ("hydroscopy"). The combination of this ClearESS technology and angled endoscopes is used to scrutinize previously inaccessible areas of the tumor bed.


RESULTS
Over 50 patients have undergone minimally invasive pituitary surgery via the endoscopic approach with postresection hydroscopy of the sella. The use of angled endoscopes in combination with the ClearESS technology greatly increased visualization of the sella, thereby facilitating complete tumor removal. There have been no complications associated with the use of hydroscopy.


CONCLUSIONS
The use of angled endoscopes in conjunction with hydroscopy increases visualization of the sella. The otolaryngologist plays a critical role in this examination with manipulation of the angled endoscopes. Therefore, the role of the otolaryngologist is extended beyond the approach to the pituitary.
Senior
Brent A
BA
Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7070, USA.
Dubin
Marc G
MG
Sonnenburg
Robert E
RE
Melroy
Christopher T
CT
Ewend
Matthew G
MG
D019723:Endoscopes; D004724:Endoscopy; D006801:Humans; D010036:Otolaryngology; D010819:Physician's Role; D010911:Pituitary Neoplasms / Q000601:surgery*; D012658:Sella Turcica / Q000601:surgery*; D013100:Sphenoid Bone / Q000601:surgery