Comparison of Endoscopic and Microsurgical Techniques for Transsphenoidal Pituitary Surgery

Abstract

Aim: In this retrospective analysis we aimed to determine the effectiveness of endoscopic, and microsurgical resection techniques, and their comparative impact on surgical outcomes in patients with pituitary adenomas operated via transphenoidal approach.

Material and Methods: Medical records of 54 patients with pituitary adenomas (patients with endocrinally inactive adenomas, n=18; growth hormone adenomas, n=18 or 18 prolactinomas, n=18), managed by microscopic endonasal transphenoidal technique (n=31) , endonasal transphenoidal technique (n=23) in The Ministry of Health, İzmir Tepecik Training, and Research Hospital were analyzed.

Results: Postoperative mean hospitalization periods were 4.4 days for endoscopic, and 6.8 days for microsurgical surgery. In a total of 23 endoscopic interventions rhinorrhea (n=2; 8.6 %), and transient diabetes insipidus (n= 1; 4.3 %) were seen. Only partial resection could be performed on 3 (12.9 %) patients, and 2 of them (8.6 %) relapsed within an average of 14 months. After microsurgical operations rhinorrhea (n=3; 9.6 %), transient (n=7; 22.6 %), and permanent diabetes insipidus (n=1; 3.2 %), minor nosebleed (n=1; 3.2 %), hyposmia (n=1; 3.2 %), and total optimalic, and oculomotor nerve involvement (n=1; 3.2 %) were detected.

Conclusion: Endonasal transaminasenssphenoidal surgery performed either by endoscopic or microsurgical approaches is a safe, and effective therapeutical modality in pituitary adenomas.Endoscopic pituitary surgery has provided highly satisfactory outcomes.