J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2012-304583
  • Editorial commentary

Endoscopic versus microscopic pituitary surgery

  1. John A Jane Jr
  1. Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, USA
  1. Correspondence to Dr Edward H Oldfield, Department of Neurosurgery, University of Virginia, POB 800212, CDW Room 3530—Hospital Drive, Charlottesville, VA 22908-0212, USA; eho4u{at}
  • Received 10 December 2012
  • Revised 10 December 2012
  • Accepted 28 December 2012
  • Published Online First 23 January 2013

In recent years, endoscopic approaches to the pituitary and skull base are being used with increasing frequency for pituitary tumours and other tumours originating in the anterior skull base.

Ammirati and colleagues report the results of their meta-analysis comparing the results of the short-term outcome of pituitary surgery performed using a purely endoscopic approach versus a microscopic approach.1 They included comparison of mortality, extent of tumour removal and complications (cerebrospinal fluid leak, meningitis, vascular complications, visual complications, diabetes insipidus, hypopituitarism and cranial nerve injury) in their analysis. They conclude that the only significant difference with these two approaches is that the incidence of vascular injury was increased with endoscopic surgery. The types …

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