Surgical resection of complex sphenoclival lesions via a whole-course endoscopic extended transsphenoidal approach under neuronavigation: report of 15 cases / 南方医科大学学报

ABSTRACT

<p><b>OBJECTIVE</b>To study the clinical value of the whole-course endoscopic extended transsphenoidal approach assisted by neuronavigation in surgical resection of complex sphenoclival lesions.</p><p><b>METHODS</b>Image reconstruction and registration were performed for 15 patients with complex sphenoclival lesions using the neuronavigation system, and the bilateral nasal extended transsphenoidal approach was adopted to remove the lesions with a whole-course endoscopic procedure.</p><p><b>RESULTS</b>Postoperative pathological examination reported pituitary adenomas in 7 cases, chordomas in 5 cases, and cavernous angiomas in 3 cases. Total removal of the lesions was achieved in 10 cases, subtotal removal in 4 cases, and partial removal in 1 case. Transient polyuria occurred in 3 cases and 2 patients experienced temporary cerebrospinal rhinorrhea. No death occurred in these cases after the operation. During the follow-up ranging from 3 to 26 months, only 2 patients with partial lesion removal showed recurrence and received subsequent radiotherapy.</p><p><b>CONCLUSION</b>The combination of whole-course endoscopic technique and neuronavigation can help improve the surgical outcomes and reduce complications of complex sphenoclival lesion removal via the extended transsphenoidal approach.</p>