ENDOSCOPIC TRANSSPHENOIDAL APPROACH FOR PITUITARY ADENOMA SURGERY
1GATA Haydarpasa Eğitim Hastanesi, Kulak Burun Boğaz Servisi, İstanbul, Türkiye2GATA Haydarpaşa Eğitim Hastanesi, Beyin ve Sinir Cerrahisi Servisi, İstanbul, Türkiye Introduction: Pituitary tumor surgery with endoscopic transnasal transsphenoidal approach has increased in popularity with advancing in surgical appliances and view. The aim of this study is only to convey our endoscopic transnasal transsphenoidal approach experiences of pituitary adenomas accompanied by literatures.
Material and Methods: 27 patients with a diagnosis of pituitary adenoma at Department of Neurosurgery in GATA Haydarpasa Training Hospital were evaluated retrospectively between the years 2006-2011 and they were operated together with Ear Nose Throat Department. The age, gender, presenting symptoms, cerebral magnetic resonance imaging findings, paranasal computed tomography, pathology, hospital stay, intraoperative and postoperative complications, the materials used during surgery, follow-up periods and hormone levels were evaluated.
Results: 27 patients with pituitary adenomas were included to study. 20 of the patients were male and 7 were female. The mean age of patients was 40.8 ± 15.25 years (range 9-88). Mean follow-up duration was 25.5 months. 21 lesions (77.7%) were identified as macroadenoma. Functioning pituitary adenoma was found in 23 patients (85.18%). 16 patients with prolactinoma (69.56%), 4 patients with GH-secreting (17.39%), one patient each in the ACTH, FSH / LH and TSH-secreting adenomas were found. Success of surgery in 17 patients were complete (62.96%), six (22.22%) patients were partial, 4 (14.81%) patients were found to be subtotal. Only two of the patients had complications. Hospital stay of the patients was 6.03 days (range 2-38).
Conclusion: Successful endoscopic pituitary surgery requires extensive training by using an endoscope and careful planning of the surgery. Endoscopic transnasal transsphenoidal approach has been shown to be a safe and highly effective. It is the primary treatment in providing tumor control and hormonal stabilization in the majority of patients.
Keywords : Pituitary, adenoma, transsphenoidal, endoscopic, complication