ABSTRACT
Objective: this study was designed to evaluate transnasal trans-sphenoidal endoscopic-controlled approach and compare it to the standard sublabial transnasal transseptal trans-sphenoidal microsurgical approach for sellar lesions
Design: prospective study
Materials and Methods: forty patients with sellar lesions were included in this work that was conducted between June 1997 and January 2002. Twenty patients were approached by the classic sublabial transnasal transseptal transsphenoidal microsurgical technique described by Hardy and another group of 20 patients were managed endoscopically Patients were allocated randomly to either group. All patients had clinical, radiological, ophthalmic and endocrine evaluation prior to surgery. Both techniques were compared as regard accessibility, visibility, duration of surgery, completion of lesion resection, morbidity including trauma to nasal skeleton and length of hospitalization and return to work
Results: lesions accessibility, visibility and completion of resection were better with the endoscopic-controlled technique. Mean [SD] operative times were significantly reduced in the endoscopic group vs. the sublabial group: 2.7 [0.7] hours vs. 3.4 [0.9] hours. Hospital stay ranged between 1-3 days for endoscopic group and 4-10 days for the sublabial microsurgical group. There was significant reduction in trauma to nasal skeleton in endoscopic group. There were no major complications in both techniques
Conclusion: the emerging endoscopic-controlled transnasal trans-sphenoidal approach for lesions in the sella is safe and effective alternative to the standard sublabial transnasal transseptal transsphenoidal microsurgical approach. It has the advantage of minimal invasiveness