title: Efficacy of Microsurgical Sublabial Approach (MSA) Versus Endoscopic Endonasal Approach (EEA) for the Treatment of Pituitary Adenomas Based on Radiological and Hormonal Outcome.
abstract: The purpose of this study was to compare the surgical efficacy of the microsurgical sublabial approach (MSA) versus the endoscopic endonasal approach (EEA) for the treatment of pituitary adenomas, based on short-term (12 months) radiological and endocrinological follow-up.
  
  
  
  One hundred and fourteen patients affected by pituitary adenoma were enrolled at our Unit between January 2007 and February 2012; 72 were treated with MSA, and 42 with EEA. The preoperative parameters considered were: type of lesion (secreting or nonsecreting), lesion size, presence of intralesional hemorrhage, lesion perimeter (nodular vs. uniform), intrasellar vs. suprasellar, involvement of cavernous sinus, and osteodural infiltration. Hormonal assays and magnetic resonance imaging (MRI) scans were performed at 12 months after the surgical procedure.
  
  
  
  Univariate analysis of the data documented a statistically significant difference in favor of MSA for the subgroups of secreting adenomas (90.9 % vs. nonsecreting 48.3 %), microadenomas (100 % vs. macroadenomas 57.1 %), adenomas without osteodural infiltration (87.5 % vs. 55.5 % with the infiltration) or those without intralesional hemorrhage (75 % vs. 45.9 % with the hemorrhage), and growth hormone (GH) adenomas (88.8 % vs. 43.7 %). Multivariate analysis confirmed the greater effectiveness of MSA for the treatment of micro-secreting adenomas.
  
  
  
  Recent advances in the EEA for treating pituitary adenomas could lead to this modality replacing the microsurgical technique. In our experience the MSA allowed us to achieve better results in the treatment of microadenomas.
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy. pierpaolo.mattogno@gmail.com.
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Mattogno
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors.forename: Annunziato
authors.initials: A
authors.lastname: Mangiola
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lofrese
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors.forename: Vera
authors.initials: V
authors.lastname: Vigo
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Anile
mesh_terms: D049913:ACTH-Secreting Pituitary Adenoma / Q000097:blood / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery; D000236:Adenoma / Q000097:blood / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013006:Growth Hormone / Q000097:blood; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000097:blood / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D009296:Nasal Cavity; D057605:Natural Orifice Endoscopic Surgery; D044583:Neuroendoscopy / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D010911:Pituitary Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D011388:Prolactin / Q000097:blood; D015175:Prolactinoma / Q000097:blood / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D013006:Growth Hormone
keywords: Endoscopic; Microadenoma; Microsurgical; Pituitary adenoma; Sublabial; Trans-sphenoidal