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Endoscopic, endonasal, trans-sphenoidal hypophysectomy: retrospective analysis of 171 procedures

Published online by Cambridge University Press:  29 June 2012

S Kumar ,
A Darr ,
C G Hobbs  and
W V Carlin
S Kumar*
Affiliation:
Department of Ear, Nose and Throat, City General Hospital, University Hospital of North Staffordshire NHS Trust, Stoke-on-Trent, UK
A Darr
Affiliation:
Department of Ear, Nose and Throat, City General Hospital, University Hospital of North Staffordshire NHS Trust, Stoke-on-Trent, UK
C G Hobbs
Affiliation:
Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore
W V Carlin
Affiliation:
Department of Ear, Nose and Throat, City General Hospital, University Hospital of North Staffordshire NHS Trust, Stoke-on-Trent, UK
*
Address for correspondence: Ms S Kumar, ENT Department, University Hospital of North Staffordshire, London Road, Stoke-on-Trent ST4 6QG, UK E-mail: [email protected]
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Abstract

Introduction:

Endoscopic, transnasal management of pituitary gland neoplasms is a widely accepted alternative to the traditional microscopic approach. This study aimed to determine outcomes and complication rates for the largest UK series of endoscopic, trans-sphenoidal hypophysectomies reported to date.

Methods:

We performed a retrospective analysis of 136 primary resections and 35 revision cases performed at a tertiary referral centre.

Results and analysis:

Total tumour resection was confirmed in over 85 per cent of primary and revision cases, with biochemical remission in 60 per cent. The incidence of complications such as epistaxis, sphenoid sinus problems, endocrine insufficiency, visual disturbance, post-operative haemorrhage, cranial nerve injury and mortality was significantly lower, compared with similar series using the microscopic approach.

Conclusion:

Despite its steep ‘learning curve’, our series demonstrates that the endoscopic approach not only allows superior anatomical visualisation and therefore facilitates full oncological resection of tumours, but also reduces the incidence of peri-operative complications.

Keywords

HypophysectomyEndoscopic Surgical ProcedureSphenoid SinusComplicationsCosts
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 10 , October 2012 , pp. 1033 - 1040
Copyright
Copyright © JLO (1984) Limited 2012

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