Transsphenoidal approaches to the pituitary: a progression in experience in a single centre

Acta Neurochir (Wien). 2008 Nov;150(11):1133-8; discussion 1138-9. doi: 10.1007/s00701-008-0135-y. Epub 2008 Oct 29.

Abstract

Background: Evolving of a single centre by means of different transsphenoidal approaches during the survey of methodological advances in pituitary surgery is presented.

Materials and methods: Ninety-three consecutive patients with pituitary adenomas underwent transphenoidal pituitary operations at Gulhane Military Medical Academy from January 1996 to October 2007. Retrospective chart-based analysis of the surgical methods of transsphenoidal pituitary adenoma operations were done. Surgical methods were described. Outcomes and complications were presented. Attention is focused on the methodology of different surgical techniques of pituitary surgery.

Findings: During the evaluation period, 12 Sublabial approaches (1996-1998), 13 transseptal transsphenoidal approaches (1999-2000), 15 endonasal transsphenoidal approaches (2000-2004), 25 endoscopy assisted endonasal approaches (2002-2006) and 28 pure endoscopic endonasal approaches (2006-2007) were performed.

Conclusions: Technologic advancements in endoscopy and gaining experience in pituitary surgery drives neurosurgeons toward less invasive approaches.

MeSH terms

  • Adenoma / pathology
  • Adenoma / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebrospinal Fluid Rhinorrhea / epidemiology
  • Cerebrospinal Fluid Rhinorrhea / physiopathology
  • Cerebrospinal Fluid Rhinorrhea / prevention & control
  • Endoscopy / methods*
  • Endoscopy / statistics & numerical data
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / instrumentation
  • Minimally Invasive Surgical Procedures / methods
  • Nasal Cavity / anatomy & histology
  • Nasal Cavity / surgery
  • Neurosurgical Procedures / instrumentation
  • Neurosurgical Procedures / methods*
  • Neurosurgical Procedures / statistics & numerical data
  • Pituitary Gland / pathology
  • Pituitary Gland / surgery*
  • Pituitary Neoplasms / pathology
  • Pituitary Neoplasms / surgery*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / prevention & control
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Hemorrhage / physiopathology
  • Postoperative Hemorrhage / prevention & control
  • Preoperative Care / methods
  • Preoperative Care / standards
  • Retrospective Studies
  • Sphenoid Bone / anatomy & histology
  • Sphenoid Bone / pathology
  • Sphenoid Bone / surgery*
  • Treatment Outcome