Volume 2, Issue 1 (6-2016)                   Iran J Neurosurg 2016, 2(1): 6-10 | Back to browse issues page

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Poormousa R, Haddadi K, Shafizad M, Shafiee S. Endoscopic Endonasal Transsphenoidal Approach for Pituitary Adenomas: a Prospective Review of Our Early Experience . Iran J Neurosurg. 2016; 2 (1) :6-10
URL: http://irjns.org/article-1-36-en.html
1- MD, Assistant Professor of Otorhinolaryngology, Bo'ali Hospital, Mazandaran University of Medical Sciences, Sari, Iran
2- MD, Associate Professor of Neurosurgery, Orthopedic Research Center, Neurosurgery Department, Imam Hospital, Mazandaran University of Medical Sciences, Sari, Iran
3- MD, Assistant Professor, Neurosurgery Department, Imam Hospital, Mazandaran University of Medical Sciences, Sari, Iran
Abstract:   (5298 Views)

Background & Aim: Pituitary adenomas are a part of a dissimilar group of benign neoplasms. The development of endoscopic techniques for surgery of paranasal sinuses has increased the opportunity for an endoscopic approach with regard to the pituitary gland. Minimally invasive endoscopic pituitary surgery, in turn, permits a more thorough tumor resection and fewer associated surgical complications. This study aimed to determine the descriptive outcomes and the complication rates for endoscopic transsphenoidal hypophysectomies.

Methods & Materials/Patients: A prospective study was conducted from November 2012 to March 2015. 28 patients with proven symptoms of pituitary adenomas were included in this study, and regularly attended follow-up sessions.

Results: In our study, we operated on 28 patients with hypophysis adenoma with the help of an endoscopic setting. The male to female ratio was 1:2.5, with average age range of 35 to 45 years. Growth hormone (GH) adenoma appeared in 36% (10 patients), prolactinoma in 21% (six patients), Cushing’s disease in 18% (five patients) and non-functional adenoma in 18% (five patients). Gonadotroph adenomas were the least common at about seven percent. The most common symptoms in our series were headache and visual defects. Five patients including two with prolactinoma and three with GH adenoma presented apoplexy signs and symptoms.

Conclusion: Our series demonstrated that the endoscopic approach not only allows well anatomical visualization, and therefore facilitates the full oncological resection of tumors, but also reduces the incidence of pre-operative complications. 

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Type of Study: Research | Subject: Gamma Knife Radiosurgery

1. Landolt, AM. History of transsphenoidal pituitary surgery. In Landolt, AM, Vance, ML, Reilly, PL (Eds). Pituitary adenomas. London: Churchill Livingstone 1996:307-314.
2. Rosegay H. Cushing's legacy to transsphenoidal surgery. Journal of Neurosurgery. 1981;54(4):448-54. [DOI:10.3171/jns.1981.54.4.0448] [PMID]
3. Guiot G. Transsphenoidal approach in surgical treatment of pituitary adenomas: general principles and indications in non-functioning adenomas. Diagnosis and treatment of pituitary adenomas. Excerpta Medica, Amsterdam. 1973:159-78.
4. Hardy J. Transphenoidal microsurgery of the normal and pathological pituitary. Clinical Neurosurgery. 1969;16:185. [DOI:10.1093/neurosurgery/16.CN_suppl_1.185] [PMID]
5. Stammberger H. Endoscopic endonasal surgery—concepts in treatment of recurring rhinosinusitis. Part II. Surgical technique. Otolaryngology--Head and Neck Surgery. 1986;94(2):147-56. https://doi.org/10.1177/019459988609400203 [DOI:10.1177/019459988609400202] [PMID]
6. Jankowski R, Auque J, Simon C, Marchal JC, Hepner H, Wayoff M. How i do it: Head and neck and plastic surgery: Endoscopic pituitary tumor surgery. The Laryngoscope. 1992;102(2):198-202. [DOI:10.1288/00005537-199202000-00016] [PMID]
7. Jho HD. Endoscopic Endonasal Pituitary Surgery: Technical Aspects. Contemporary Neurosurgery. 1997;19(6):1. [DOI:10.1097/00029679-199719060-00001]
8. Carrau RL, Jho HD, Ko Y. Transnasal-Transsphenoidal Endoscopic Surgery of the Pituitary Gland. The Laryngoscope. 1996;106(7):914-8. [DOI:10.1097/00005537-199607000-00025] [PMID]
9. Prevedello, DM, Doglietto, F, Jane, JA Jr, Jagannathan, J, Han, J et al. History of endoscopic skull base surgery: its evolution and current reality. J Neurosurg 2007;107: 206-213. PMID: 17639897 [DOI:10.3171/JNS-07/07/0206] [PMID]
10. Cappabianca P, Alfieri A, De Divitiis E. Endoscopic endonasal transsphenoidal approach to the sella: towards functional endoscopic pituitary surgery (FEPS). min-Minimally Invasive Neurosurgery. 1998;41(02):66-73. [DOI:10.1055/s-2008-1052019] [PMID]
11. Alfieri A, Jho HD. Endoscopic endonasal approaches to the cavernous sinus: surgical approaches. Neurosurgery. 2001;49(2):354-62. https://doi.org/10.1097/00006123-200108000-00017 [DOI:10.1227/00006123-200108000-00017] [PMID]
12. Jho HD, Carrau RL, Ko Y, Daly MA. Endoscopic pituitary surgery: an early experience. Surgical Neurology. 1997;47(3):213-22. [DOI:10.1016/S0090-3019(96)00452-1]
13. JJho H, Alfieri A. Endoscopic endonasal pituitary surgery: evolution of surgical technique and equipment in 150 operations. min-Minimally Invasive Neurosurgery. 2001;44(01):1-2. [DOI:10.1055/s-2001-13590] [PMID]
14. de Paula Santos R, Zymberg ST, Abucham Filho JZ, Gregório LC, Weckx LL. Endoscopic transnasal approach to sellar tumors. Brazilian Journal of Otorhinolaryngology. 2007;73(4):463-75. [DOI:10.1016/S1808-8694(15)30098-7]
15. Jho HD, Carrau RL. Endoscopic endonasal transsphenoidal surgery: experience with 50 patients. Journal of Neurosurgery. 1997;87(1):44-51. [DOI:10.3171/jns.1997.87.1.0044] [PMID]
16. Mortini P, Losa M, Barzaghi R, Boari N, Giovanelli M. Results of transsphenoidal surgery in a large series of patients with pituitary adenoma. Neurosurgery. 2005;56(6):1222-33. [DOI:10.1227/01.NEU.0000159647.64275.9D] [PMID]
17. Santos, A., Neto, R., Veiga, J., et al. Endoscopic endonasal transsphenoidal approach for pituitary adenomas. Arq Neuropsiquiatr 2010;68 (4): 608-612.PMID: 7009800. [DOI:10.1590/S0004-282X2010000400024] [PMID]
18. Gómez-Amador JL, Martínez-Anda JJ, Morales-Martínez AH, Juan CD. Management of Complications in Endoscopic Endonasal Surgery for Pituitary Adenomas. Journal of Neurological Disorders. 2015. [DOI:10.4172/2329-6895.1000209]
19. Frank G, Pasquini E, Farneti G, Mazzatenta D, Sciarretta V, Grasso V, et al. The endoscopic versus the traditional approach in pituitary surgery. Neuroendocrinology. 2006;83(3-4):240-8. [DOI:10.1159/000095534] [PMID]
20. Dehdashti AR, Ganna A, Karabatsou K, Gentili F. Pure endoscopic endonasal approach for pituitary adenomas: early surgical results in 200 patients and comparison with previous microsurgical series. Neurosurgery. 2008;62(5):1006-17. [DOI:10.1227/01.neu.0000325862.83961.12] [PMID]
21. Cappabianca P, Cavallo LM, Colao A, de Divitiis E. Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas. Journal of Neurosurgery. 2002;97(2):293-8. [DOI:10.3171/jns.2002.97.2.0293] [PMID]
22. Ciric I, Ragin A, Baumgartner C, Pierce D. Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery. 1997;40(2):225-37. [DOI:10.1097/00006123-199702000-00001] [PMID]
23. Hadad G, Bassagasteguy L, Carrau RL, Mataza JC, Kassam A, Snyderman CH, et al. A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. The Laryngoscope. 2006;116(10):1882-6. [DOI:10.1097/01.mlg.0000234933.37779.e4] [PMID]
24. Wang SS, Li JF, Chen HJ, Wang RM. Clinical application of anatomy landmarks for microscopic endonasal transsphenoidal surgery for pituitary adenomas. Journal of Craniofacial Surgery. 2013;24(5):1785-9. [DOI:10.1097/SCS.0b013e3182a210ab] [PMID]

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