Surgical outcome of the endoscopic endonasal approach for non-functioning giant pituitary adenoma

Background: Transphenoidal endoscopic approach is minimal invasive surgery in case of pituitary adenoma. Objective : To see the outcome of transphenoidal endoscopic and microscopic approach in case of pituitary tumor. Results : This study showed among the 37 patients, 25 (67.6%) were done by transphenoidal microscopic approach and 12 (32.4%) patients were done by endonasal endoscopic approach. Among the 12 patients 8(66.7%) were male and 4(33.3%) were female. Among the 25, patients 15(60%) were male and 10(40%) were female. It was documented that in 12 patients, 10(83.3%) were macroadenoma and 2(16.7%) were microadenoma. It was evident that among the 25 patient 18(72%) were macroadenoma and 7(28%) were microadenoma. Among 12 patients, 11 (91.7%) had preoperative visual disturbance and 1(8.3%) had normal vision. It was observed that among 25 patients, 23(92%) patients had preoperative visual disturbance and 2 (8%) patients had normal vision. Tumor was totally removed in 9(75%) patients in endoscopic approach and 14(56%) in microscopic approach. Clinically 10(83.3%) patients were improved in endoscopically and 16(64%) patients were improved in microscopic group. Conclusion: It was concluded that endoscopic endonasal approach is better than transphenoidal microscopic approach. Bangladesh Journal of Neuroscience 2015; Vol. 31 (1): 21-29

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Infrasellar Endoscopic Endonasal Approach for a Pituitary Adenoma Extending into the Third Ventricle, with Anterior Displacement of the Pituitary Gland

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0037-1620261 ◽

2018 ◽

Vol 79 (S 02) ◽

pp. S233-S234

Author(s):

Georgios Zenonos ◽

Eric Wang ◽

Juan Fernandez-Miranda

Keyword(s):

Pituitary Adenoma ◽

Pituitary Gland ◽

Outcome Measures ◽

Third Ventricle ◽

Visual Fields ◽

Endoscopic Endonasal Approach ◽

Endonasal Approach ◽

Endoscopic Endonasal ◽

Anterior Displacement ◽

The Third

Objectives The current video presents the nuances of the infrasellar endoscopic endonasal approach for a pituitary adenoma extending into the third ventricle, with anterior displacement of the pituitary gland. Design The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon at a teaching academic institution. Participants The case refers to 73-year-old female patient who was found to have a sellar mass after failure of vision to improve with cataract surgery. She also reported a several-month history of progressive loss of vision along with daily retro-orbital headaches. The adenoma extended into the clivus as well as in the retrosellar and suprasellar regions, eroding into the floor of the third ventricle. The normal gland was displaced anteriorly. Main Outcome Measures The main outcome measures consisted of reversal of patient symptoms (headaches and visual disturbance), recurrence-free survival based on imaging, as well as absence of any complications. Results The patient's headaches and visual fields improved. There was no evidence of recurrence. Conclusion The infrasellar endoscopic endonasal approach is safe and effective for pituitary adenomas extending into the third ventricle, with anterior displacement of the pituitary gland.The link to the video can be found at: https://youtu.be/zp_06mEyRvY.

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