Endoscopic endonasal pituitary surgery: surgical and outcome analysis of 50 cases.
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.


CONCLUSIONS
The endoscopic endonasal transsphenoidal approach for removing pituitary lesions is a form of minimally invasive surgery offering excellent postoperative results.
Charalampaki
Patra
P
Department of Neurosurgery, Johannes Gutenberg University of Mainz, Langenbeckstr. 1, 55131 Mainz, Germany. charalampaki@yahoo.de
Reisch
Robert
R
Ayad
Ali
A
Conrad
Jens
J
Welschehold
Stefan
S
Perneczky
Axel
A
Wüster
Christian
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000601:surgery*; D013101:Sphenoid Sinus / Q000601:surgery*; D016896:Treatment Outcome