title: Endoscopic endonasal trans-sphenoidal approach for pituitary adenomas: is one nostril enough?
abstract: BACKGROUND
  Over the past decade, the endoscopic endonasal trans-sphenoidal approach has been used to resect pituitary adenomas. However, in the use of this procedure, some research teams prefer a two-nostril method, whereas other groups are in favor of the one-nostril method. Here, we present a series of pituitary adenomas and try to confirm whether or not one nostril is enough for endoscopic resection of most pituitary adenomas.
  
  
  METHODS
  A total of 250 consecutive patients who underwent an endoscopic endonasal trans-sphenoidal approach were reviewed retrospectively, of which 200 were via the unilateral nostril (group 1) and 50 were via bilateral nostrils (group 2). Surgical and clinical outcomes were analyzed.
  
  
  RESULTS
  For microadenomas, intrasellar macroadenomas and macroadenomas with moderate extrasellar extension, the prevalence of gross total resection (GTR), hormonal outcome and visual improvement were similar between the two groups. The one-nostril group had better results for duration of surgery and blood loss, with fewer rhinological complications. However, for macroadenomas with extensive extrasellar invasion, GTR was obtained in two of seven patients in group 2 but none in group 1.
  
  
  CONCLUSIONS
  The one-nostril method, which is relatively fast and minimally invasive, is adequate for endoscopic resection of most pituitary adenomas with moderate extension.
authors.affiliation: Department of Neurosurgery, The First Hospital of China Medical University, Nanjing Street 155, Heping District, Shenyang, 110001, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Han
authors.forename: Xiaoxu
authors.initials: X
authors.lastname: Ding
authors.forename: Xinxin
authors.initials: X
authors.lastname: Tie
authors.forename: Yuan
authors.initials: Y
authors.lastname: Liu
authors.forename: Junze
authors.initials: J
authors.lastname: Xia
authors.forename: Aihui
authors.initials: A
authors.lastname: Yan
authors.forename: Anhua
authors.initials: A
authors.lastname: Wu
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery*; D009666:Nose / Q000601:surgery; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult