Endoscopic Endonasal Transsphenoidal Surgery: A Retrospective E valuation of 100 Cases

Abstract

Objective: Endoscopic endonasal and transsphenoidal surgery have been commonly used primarily for pituitary adenomas, and also other tumors of sellar and parasellar regions and rhinorrhea, and optic nerve surgeries. In the present study, we evaluated results of 100 patients who underwent endoscopic endonasal surgery in our clinic.

Material and Methods: Fifty- three female (53%) and 47 male (47%) patients with a median age of 46.8 (15-77) years were included in the study. The most frequently detected pathologies were secretory pituatory adenoma in 59, and non-functional adenoma pituitary adenoma in 28 patients. Other established diagnoses were meningioma (n= 5), craniopharyngioma (n=3), chordoma (n=1), neuroendocrine tumor (n=1), germinoma (n=1), Rathke cleft cyst (n=1), and ossified fibroma (n=1). Epistaxis (n=12), diabetes insipidus (n= 11), CSF leak ( n= 15) in respective number of patients. Major vascular injuries did not occur. Two patients developed menengitis.

Discussion: After transsphenoidal surgeries CSF fistula (0.5-15%), epistaxis (0.6%), transient DI (11.99 %),and persistent DI (3.41%) have been reported in indicated percentages. While remission and resection rates have been reported as 60-80% in the literature.

Conclusion: In our series, rate of epistaxis was found to be higher than those reported in literature. Transient diabetes insipidus (DI), remission and resection rates were in accordance with the literature findings, while incidence of persistent diabetes was relatively lower. There was no major vascular injury in our series. Two patients died because of meningitis and its complications.