Assessment of endoscopic uses in transnasal transsphenoidal Approaches for pituitary tumors

ABSTRACT

Transsphenoidal approaches usually are the preferred method for treatment of pituitary tumor because of a lower risk of complications. Microscope alone has been used in treatment of such tumor. Recently, with minimal invasive surgery, endoscope has been introduced as an alternative and effective tool in transsphenoidal surgery. This study aims to evaluate the benefit of endoscopic alone or assisted microscopic transnasal transsphenoidal surgeries for pituitary tumors. Between January 2004 and till March 2006, 50 patients [26 males and 24 females] were surgically treated in three departments of neurosurgery. Assisted endoscopic surgeries were done in 38 patients and 12 had direct endoscopic resection. The majority of pituitary tumors patients were macroadenomas in 94% and 58% were presented with sellar and suprasellar extension. The common pituitary tumor was non-secreting adenomas [58%], followed by prolactinomas [18%], and unexpected metastasis [10%], while the least was Cushing disease [2%] and poly hormonal adenoma [2%]. The long term outcome revealed 58% of patients showed remission, 34% improved, 8% had stationary course, and no one had worsen of his condition. The incidence of diabetes insipidus [DI] in this study was relatively high 18% and 6% developed persistent DI after surgery. No recurrence rate was reported during follow up. Uses of endoscope in endonasal transsphenoidal surgeries for pituitary tumors are safe and effective in radical resection of the tumor