KBB-Forum 2023 , Cilt 22, Sayı 2

COMPARISON OF MICROSCOPIC AND ENDOSCOPIC SURGICAL APPROACHES IN PITUITARY ADENOMAS

Derya ABEŞ 1, MD Gökhan KURAN 2, MD Ayşe KARAKAYA 4, MD Mustafa Çağrı DERİCİ 2, MD Yurdal GEZERCAN 3, MD
1Aksaray Eğitim Araştırma Hastanesi, KBB, Aksaray, Turkey
2Adana Şehir Hastanesi, KBB, Adana, Turkey
3Adana Şehir Hastanesi, Nöroşirürji, Adana, Turkey
4Eskişehir Şehir Hastanesi, KBB, Eskişehir, Turkey Objective: To compare the endoscopic endonasal transsphenoidal approach and microscopic transnasal transsphenoidal approach, which are used in the surgical treatment of pituitary adenomas.

Method: Eighty-six patients who underwent surgery for pituitary adenoma and whose files and radiologic examinations could be accessed from archive records were included in the study. The files of the patients were examined retrospectively, and their ages, gender, preoperative laboratory and imaging findings, length of hospital stay, postoperative complications, postoperative laboratory and imaging findings were evaluated.

Results: Endoscopic surgery was performed in 45 of 86 patients, and microscopic surgery was performed in 41. Twenty of the patients in the endoscopic group had non-functional pituitary adenomas, and 25 had functional adenomas. In the microscopic group, 23 patients had non-functional pituitary adenomas, and 18 had functional adenomas. In the endoscopic group, radiologic remission was achieved in 37 (82.2%) adenomas. In the microscopic group, remission was achieved in 16 (39%) adenomas. Hormonal remission was achieved in 16 (64%) functional adenomas in the endoscopic group. In the microscopic group, hormonal remission was achieved in five (27.8%) functional adenomas. In the endoscopic group, 26 patients had various complications; in the microscopic group, 22 patients had various complications. The median length of hospitalization of the patients in the endoscopic group was 5 days and 7 days in the microscopic group.

Conclusion: This study seems to indicate that endoscopic endonasal transsphenoidal surgery can provide a better tomur resection and preservation of pituitary gland. Keywords : Pituitary adenoma; transsphenoidal approach; endoscopic endonasal; microscopic transnasal