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ORIGINAL ARTICLE
Year : 2016  |  Volume : 32  |  Issue : 3  |  Page : 130-140

Endoscopic endonasal transsphenoidal surgery: predictors for disease control in a consecutive series of pituitary adenomas


1 Department of Otorhinolaryngology, University Hospital Brussels, Vrije Universiteit Brussel, Brussels, Belgium; Department of Otorhinolaryngology, Minia University Hospital, Minia University, Minia, Egypt
2 Department of Otorhinolaryngology, Minia University Hospital, Minia University, Minia, Egypt
3 Department of Neurosurgery, University Hospital Brussels, Vrije Universiteit Brussel, Brussels, Belgium
4 Department of Otorhinolaryngology, University Hospital Brussels, Vrije Universiteit Brussel, Brussels, Belgium

Correspondence Address:
Mostafa Ismail
Universitair Ziekenhuis Brussel Campus, Jette Laarbeeklaan 101, 1090 Brussels, Belgium

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1012-5574.186523

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Background Endoscopic endonasal transsphenoidal surgery for pituitary lesions has been predestined and evolved since its incipient description. However, tumour size and extrasellar extensions of pituitary adenomas remain a challenge for disease control (DC) after surgery. This study was conducted to evaluate the predictors that determine the early outcome in a consecutive series of pituitary adenomas operated using an endoscopic transsphenoidal approach. Materials and methods Sixty-five consecutive pituitary adenomas presenting over a 36-month period subjected to excision through an entirely endoscopic transsphenoidal approach were reviewed. DC, based on the extent of tumour resection and endocrinological remission, was evaluated according to the recent radiological and hormonal consensus criteria. Results Of 65 pituitary adenomas operated, 24 were endocrinally nonfunctioning and 41 were functioning adenomas. The follow-up duration ranged from 3 to 33 months. The overall DC was 67.7% as measured using total tumour resection and endocrinal cure. Cavernous sinus invasion, suprasellar extension and revision surgery negatively influenced DC of pituitary adenomas. Postoperative complications related to surgical resection of adenomas were seen in 12 cases (18.5%) − mainly, cerebrospinal fluid leakage, anterior pituitary insufficiency, and diabetes insipidus. Conclusion This study reports standards for DC in a short follow-up series of purely endoscopic pituitary surgeries and identifies pituitary lesions associated with preoperative predictors that can influence postoperative outcome. These results authenticate the efficacy and safety of endoscopic endonasal transsphenoidal surgery in the treatment of pituitary adenomas, providing favourable DC for both functioning and nonfunctioning pituitary adenomas.


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