Clinical Outcome and Complication of Endoscopic Endonasal Transsphenoidal Surgery (ETSS) for Pituitary Adenoma: A Retrospective Study at Prime Teaching Hospital Peshawar


  • Musawer Khan Neurosurgeon
  • Arif Hussain Department of Neurosurgery, Prime Teaching Hospital, Peshawar – Pakistan
  • Mumtaz Ali Department of Neurosurgery, Prime Teaching Hospital, Peshawar – Pakistan



Endoscopic endonasal transsphenoidal surgery, Pituitary adenoma, Diabetes insipidus, Microadenomas


Objectives:  The study aimed to ascertain the clinical outcome and complications of endoscopic endonasal transsphenoidal surgery (ETSS) for pituitary adenomas.

Material & Methods:  A retrospective study conducted at the Department of Neurosurgery Prime Teaching Hospital Peshawar, Pakistan. Pituitary adenoma was diagnosed in 89 patients on MRI Brain with contrast and post-surgical biopsy. Post-surgical outcomes and complications were documented.

Results:  Out of 89 patients, 54% were male, and 46% female patients. The mean age was 42 ± 5 years. Headache was reported in 92% as a most common presentation, followed by decreased visual acuity in 62 %, amenorrhea in 22%, and acromegaly in 29% of patients. Overall, the symptoms related to surgical improvement were observed in 72% of patients. A good surgical outcome was observed in 80% of patients with microadenomas, as compared to the patients with macroadenomas. The most common complication was the transient diabetes insipidus followed by Cerebrospinal fluid (CSF) leak and post-operative hematoma.

Conclusion:  Endoscopic endonasal transsphenoidal surgery (ETSS) is a safe, less invasive, cosmetically effective technological advancement for pituitary adenomas.


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