Endoscopic endonasal transsphenoidal resection of pituitary adenomas: preliminary evaluation of consecutive cases.
BACKGROUND
Endoscopic endonasal transsphenoidal surgery has gained increasing acceptance by otolaryngologists and neurosurgeons. In many centers throughout the world, this technique is now routinely used for the same indications as conventional microsurgical technique for pituitary tumors.


OBJECTIVE
To present a surgical experience of consecutive endoscopic endonasal trans-sphenoidal resections of pituitary adenomas.


METHODS
In this study, consecutive patients with pituitary adenomas submitted to endoscopic endonasal pituitary surgery were evaluated regarding the rate of residual tumor, functional remission, symptoms relief, complications, and tumor size.


RESULTS
Forty-seven consecutive patients were evaluated; 17 had functioning adenomas, seven had GH producing tumors, five had Cushing's disease, and five had prolactinomas. Of the functioning adenomas, 12 were macroadenomas and five were microadenomas; 30 cases were non-functioning macroadenomas. Of the patients with functioning adenomas, 87% improved. 85% of the patients with visual deficits related to optic nerve compression progressed over time. Most of the patients with complaints of headaches improved (76%). Surgical complications occurred in 10% of patients, which included with two carotid lesions, two cerebrospinal fluid leaks, and one death of a patient with a previous history of complications.


CONCLUSIONS
Endoscopic endonasal pituitary surgery is a feasible technique, yielding good surgical and functional outcomes, and low morbidity.
Departamento de Otorrinolaringologia, Cabeça e Pescoço, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Carlos Takahiro
CT
Chone
Departamento de Otorrinolaringologia, Cabeça e Pescoço, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Marcelo Hamiltom
MH
Sampaio
Departamento de Otorrinolaringologia, Cabeça e Pescoço, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Eulalia
E
Sakano
Departamento de Otorrinolaringologia, Cabeça e Pescoço, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Jorge Rizzato
JR
Paschoal
Departamento de Endocrinologia, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Heraldo Mendes
HM
Garnes
Departamento de Patologia Cirúrgica, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Luciano
L
Queiroz
Departamento de Neurocirurgia, Hospital Centro Médico de Campinas, Campinas, SP, Brasil.
Antonio Augusto Roth
AA
Vargas
Departamento de Neurocirurgia, Hospital Centro Médico de Campinas, Campinas, SP, Brasil.
Yvens Barbosa
YB
Fernandes
Departamento de Neurocirurgia, Hospital Centro Médico de Campinas, Campinas, SP, Brasil.
Donizete C
DC
Honorato
Departamento de Neurocirurgia, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Mateus Dal
MD
Fabbro
Departamento de Neurocirurgia, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Henrico
H
Guizoni
Departamento de Neurocirurgia, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Helder
H
Tedeschi
D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000601:surgery*; D013100:Sphenoid Bone / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult