Transsphenoidal approaches to the pituitary: a progression in experience in a single centre.
BACKGROUND
Evolving of a single centre by means of different transsphenoidal approaches during the survey of methodological advances in pituitary surgery is presented.


METHODS
Ninety-three consecutive patients with pituitary adenomas underwent transphenoidal pituitary operations at Gulhane Military Medical Academy from January 1996 to October 2007. Retrospective chart-based analysis of the surgical methods of transsphenoidal pituitary adenoma operations were done. Surgical methods were described. Outcomes and complications were presented. Attention is focused on the methodology of different surgical techniques of pituitary surgery.


RESULTS
During the evaluation period, 12 Sublabial approaches (1996-1998), 13 transseptal transsphenoidal approaches (1999-2000), 15 endonasal transsphenoidal approaches (2000-2004), 25 endoscopy assisted endonasal approaches (2002-2006) and 28 pure endoscopic endonasal approaches (2006-2007) were performed.


CONCLUSIONS
Technologic advancements in endoscopy and gaining experience in pituitary surgery drives neurosurgeons toward less invasive approaches.
Duz
Bulent
B
Department of Neurosurgery, School of Medicine, (GATA), Gulhane Military Medical Academy (GATA)TR-06018 Etlik, Ankara, Turkey. bduz@gata.edu.tr
Harman
Ferhat
F
Secer
Halil Ibrahim
HI
Bolu
Erol
E
Gonul
Engin
E
D000236:Adenoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002559:Cerebrospinal Fluid Rhinorrhea / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D004724:Endoscopy / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D009296:Nasal Cavity / Q000033:anatomy & histology / Q000601:surgery; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome