Endoscopic Endonasal Transsphenoidal Approach for Pituitary Adenomas: a Prospective Review of Our Early Experience

Abstract

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.

Keywords

• Endoscopic
• Surgery
• Transnasal
• Hypophyseal
• Pituitary Adenoma