Endoscopic Endonasal Excision of Pituitary Tumors Using a Mono-nostril Technique

  • AMIR AZIZ Department of Neurosurgery Unit 1, Lahore General Hospital Lahore
  • YASER-UD- DIN
  • ZUBAIR AHMED Department of Neurosurgery Unit 1, Lahore General Hospital Lahore
  • SHARUKH RIZVI Department of Neurosurgery Unit 1, Lahore General Hospital Lahore
  • HABIB SULTAN Department of Neurosurgery Unit 1, Lahore General Hospital Lahore
  • ANWAR CHAUDHRY Department of Neurosurgery Unit 1, Lahore General Hospital Lahore
  • RIZWAN MASOOD Department of Neurosurgery Unit 1, Lahore General Hospital Lahore
Keywords: Endoscopic, mono-nostril, trans-sphenoid, pituitary, CSF rhinorrhea

Abstract

Objectives: The purpose of this study is to assess the effectiveness and advantage of endoscopic mono-nostril approach to the pituitary tumors.
Materials and Methods: We analyzed 70 patients undergoing transsphenoidal mono-nostril excision of pituitary tumors from September, 2016 to March, 2018.
Results: We operated 70 patients, out of which 51 were males and 19 were females; the age of the patients ranged from 15 years to 65 years.In our study, out of 70 patients, 61 (87.1%) patients had excellent results with total tumor resection, marked visual improvement, early discharge on the second post-operative day, resuming their daily activities within two weeks and recurrence free interval of 1 year. Nine (12.8%) of our patients had a partial excision of the tumor, whereby there was improvement of headaches in all of them while visual status remained at the pre-operative status. Five (7.1%) of our patients had a post-operative cerebral spinal fluid (CSF) rhinorrhea, 4 (5.7%) in total excision group and 1 (1.4%) in partial excision group. These patients of CSF leak were retained in hospital and their mean stay in hospital was 12  4. 
Conclusion: We consider that endoscopic mono-nostril excision of the pituitary tumor is a relatively safer, effective, minimally invasive procedure; whereby there is a fast recovery, early discharge and good cosmetic results.

References

1. Bushe K. A., Halves E. Modifid Technique of transnasal operation for Hypophyseal- pituitary axis. J. Acta Neurochirurgica. 1978; 41 (1–3): 163–175.
2. Yaniv E., Rappaport Z. H. Endoscopic Transseptal Transsphenoidal Surgery for Pituitary Tumors. Neurosurgery, 1997; 40 (5): 944–946.
3. Jho H. D., Carrau R. L. Endoscopic endonasal trans-sphenoidal surgery: experience with 50 patients.Neurosurgical Focus, 1996; 87 (1): 44–51.
4. Cappabianca P., Cavallo L. M., de Divitiis E. Endoscopic Endonasal Transsphenoidal Surgery. Neurosurgery, 2004; 55 (4): 933–941.
5. Cappabianca P., Cavallo L. M., Colao A., Del Basso De Caro M., Esposito F., Cirillo S., et al. Endoscopic Endonasal Transsphenoidal Approach: Outcome Analysis of 100 Consecutive Procedures. Min - Minimally Invasive Neurosurgery, 2002; 45 (4): 193–200.
Published
2019-12-28
Section
Original Article