title: Endoscopic rhino-neurosurgical approach for non-adenomatous sellar and skull base lesions.
abstract: OBJECTIVE
  Since endoscopic endonasal transsphenoidal surgery requires skills of both neurosurgeons and otorhinolaryngologists, and the nose is the primary corridor of approach, we favour the term `endoscopic rhino-neurosurgery` and report on our interdisciplinary experience treating non-adenomatous lesions with skull base extension.
  
  
  METHODS
  Between 2004 and 2009, 58 patients with 21 different disease patterns underwent endoscopic rhino-neurosurgical procedures. Mean age was 39.9 years, 50% were female. Seven had undergone prior surgery. Clinically, 34.5% presented with visual field deficits and with nerve palsies. Preoperatively, 62.1% showed a normal pituitary function.
  
  
  RESULTS
  Mean follow-up was 13.1 months. The surgical goal depended on type of lesion; the intended extent of resection was achieved in 81%. Recovery from visual field deficits occurred in 80%. Neither deteriorated nor new cranial nerve palsies were observed. A normal endocrinological function could be maintained in 94.4%. Permanent diabetes insipidus occurred in 7 patients. Surgical complications included cerebrospinal fluid (CSF) leaks in 6 patients and meningitis in 4. All complications were managed successfully. There was no surgery-related mortality.
  
  
  CONCLUSIONS
  The endoscopic rhino-neurosurgical approach is applicable for a wide variety of lesions comprising sella and skull base. As our data prove, this technique can be performed with satisfying results in non-adenomatous lesions as well.
authors.affiliation: Department of Neurosurgery, Medical University Graz, Austria. senta.kurschel@medunigraz.at
authors.forename: Senta
authors.initials: S
authors.lastname: Kurschel
authors.forename: Verena
authors.initials: V
authors.lastname: Gellner
authors.forename: Georg
authors.initials: G
authors.lastname: Clarici
authors.forename: Hannes
authors.initials: H
authors.lastname: Braun
authors.forename: Heinz
authors.initials: H
authors.lastname: Stammberger
authors.forename: Michael
authors.initials: M
authors.lastname: Mokry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000601:surgery; D008875:Middle Aged; D044583:Neuroendoscopy / Q000379:methods*; D012658:Sella Turcica / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult