[Transnasal-transsphenoidal endoscopic surgery of the sellar region]

Abstract

Transnasal transsphenoidal endoscopic approach to the sella turcica has recently become an option to the pituitary surgery which could predominate in a near future.

Objectives: To evaluate through the analysis of our results whether it is possible to perform in our Hospital the endoscopic transnasal transsphenoidal approach to the sella with results at least as good as those we obtain with the microscopic sublabial transseptal transsphenoidal approach.

Material and methods: As the first stage of a three stage randomized trial, this is a prospective study of 10 patients operated on, using transnasal transsphenoidal endoscopic approach between august 2002 and August 2003 at the department of neurosurgery of "Hermanos Ameijeiras Hospital".

Results: Six patients had pituitary macroadenomas and four had cerebrospinal fluid leak through the sellar floor. In five of six macroadenomas total tumor resection was obtained and in the other one a subtotal resection was performed. Two of four patients with cerebrospinal fluid leak could be cured while the other two patients do not. Complications were present in 30% of cases, but in only 1 (10%) it reached the postoperatory period.

Conclusions: Transnasal transsphenoidal endoscopic approach to the sella can be done save enough in our Hospital to justify the start of the second stage of one randomized trial to determine if the endoscopic technique is better than the usual transsphenoidal approach.