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

The Egyptian Journal of Otolaryngology volume 32, pages 130–140 (2016)Cite this article

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Abstract

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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Authors and Affiliations

  1. Department of Otorhinolaryngology, University Hospital Brussels, Vrije Universiteit Brussel, Brussels, Belgium

    Mostafa Ismail MD & Olaf Michel

  2. Department of Neurosurgery, University Hospital Brussels, Vrije Universiteit Brussel, Brussels, Belgium

    Jean D’Haens

  3. Department of Otorhinolaryngology, Minia University Hospital, Minia University, Minia, Egypt

    Mostafa Ismail MD & Balegh Abdelhak

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  1. Mostafa Ismail MD
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  2. Balegh Abdelhak
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  3. Jean D’Haens
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  4. Olaf Michel
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Correspondence to Mostafa Ismail MD.

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Ismail, M., Abdelhak, B., D’Haens, J. et al. Endoscopic endonasal transsphenoidal surgery: predictors for disease control in a consecutive series of pituitary adenomas. Egypt J Otolaryngol 32, 130–140 (2016). https://doi.org/10.4103/1012-5574.186523

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