- Original article
- Open access
- Published:
Chronic nasal complication following endoscopic and microscopic direct transnasal transsphenoidal pituitary adenoma surgery
The Egyptian Journal of Otolaryngology volume 33, pages 20–23 (2017)
Abstract
Aim and background
Intranasal transsphenoidal access to the sella turcica for removing pituitary gland tumors has been known since the beginning of the last century. It can be done either endoscopic or microscopic. Postoperative nasal complications may happen. The purpose of this study was to assess the frequency of chronic oronasal alterations.
Methodology
33 patients who had previously undergone adenomectomy with a hypophyseal transsphenoidal approach using either the endoscopic or the direct transnasal microscopic technique; these patients were operated in different neurosurgical units. Assessement of nasal complications after 6 months was done.
Results
33 patients among them 18 patients were done by endoscopy and the other 15 were done by microscopy. No postoperative nasal complications in the endoscopy group 6 months postoperative while it is present in 3 cases of the microscopic group after the same time.
Conclusion
Direct transnasal approach provides safe transsphenoidal access to the sella with a very low rate of nasal complications.
References
Hardy J. Transsphenoidal hypophysectomy. J Neurosurg 1971; 34:582–594.
Hardy J. Surgery of the pituitary gland, using the open trans-sphenoidal approach. Comparative study of 2 technical methods. Ann Chir 1967; 21:1011–1022.
Monnier DS. Endonasal sequelae after hypophysectomy. Ann Otolaryngol Chir Cervicofac. 1998; 115:49–53
Petry C, Leães CG, Pereira-Lima JF, Gerhardt KD, Sant GD, Oliveria Mda C. Oronasal complications in patients after transsphenoidal hypophyseal surgery. Braz J Otorhinolaryngol 2009; 75:345–349.
Tabaee A, Anand VK, Barrón Y, Hiltzik DH, Brown SM, Kacker A, et al. Endoscopic pituitary surgery: a systematic review and meta-analysis. J Neurosurg 2009; 111:545–554.
Schaberg MR, Anand VK, Schwartz TH, Cobb W. Microscopic versus endoscopic transnasal pituitary surgery. Curr Opin Otolaryngol Head Neck Surg 2010; 18:8–14.
Nasseri SS, Kasperbauer JL, Strome SE, McCaffrey TV, Atkinson JL, Meyer FB. Endoscopic transnasal pituitary surgery: report on 180 cases. Am J Rhinol 2001; 15:281–287.
Sharma K, Tyagi I, Banerjee D, Chhabra DK, Kaur A, Taneja HK. Rhinological complications of sublabial transseptal transsphenoidal surgery for sellar and suprasellar lesions: prevention and management. Neurosurg Rev 1996; 19:163–167.
Eisele DW, Flint PW, Janas JD, Kelly WA, Weymuller EA Jr, Cummings CW. The sublabial transseptal transsphenoidal approach to sellar and parasellar lesions. Laryngoscope 1988; 98:1301–1308.
Griffith HB, Veerapen R. A direct transnasal approach to the sphenoid sinus. Technical note. J Neurosurg 1987; 66:140–142.
Cooke RS, Jones RA. Experience with the direct transnasal transsphenoidal approach to the pituitary fossa. Br J Neurosurg 1994; 8:193–196.
Tan LK, Jones RA. Nasal complications of the direct transnasal approach to the pituitary fossa. Br J Neurosurg 1995; 9:739–742.
Kennedy DW, Cohn ES, Papel ID, Holliday MJ. Transsphenoidal approach to the sella: the Johns Hopkins experience. Laryngoscope 1984;94:1066–1074.
Mampalam TJ, Tyrell JB, Wilson CB. Transsphenoidal microsurgery for Cushing’s disease: a report of 216 cases. Ann Intern Med 1988; 109:487–493.
Black PM, Zervas NT, Candia GL. Incidence and management of complications of transsphenoidal operation for pituitary adenomas. Neurosurgery 1987; 20:920–924.
Faria MA Jr, Tindall GT. Transsphenoidal microsurgery for prolactin-secreting pituitary adenomas. J Neurosurg 1982; 56:33–43.
Riche H, Jaboulay JM, Chiara Y, Peloux A. Complications post-operatoires de la voie trans-sphenoidale. Minerva Anestesiol 1992; 58:71–72.
Qu X, Yang J, Sun JD, et al. Transsphenoidal pseudocapsule-based extracapsular resection for pituitary adenomas. Acta Neurochir (Wien) 2011; 153:799–805.
Liu JK, Orlandi RR, Apfelbaum RI, Couldwell WT. Novel closure technique for the endonasal transsphenoidal approach. Technical note. J Neurosurg 2004; 100:161–164.
Hardy J, McCutcheon IE. Pituitary adenomas: pituitary macroadenomas. In: Apuzzo MLJ editor. Brain surgery: complication avoidance and management. New York, NY: Churchill Livingstone; 1993:276–295.
Hardy J, Vezina JL. Transsphenoidal neurosurgery of intracranial neoplasm. New York, NY: Raven Press 1976:261–275
Laws ER Jr, Kern EB. Complications of transsphenoidal surgery. Clin Neurosurg 1976; 23:401–416.
Laws ER Jr. Transsphenoidal approach to lesions in and about the sellaturcica. In: Schmidek HH, Sweet WH, editors. Operative neurosurgical techniques: indications, methods, and results. Philadelphia, PA: W.B. Saunders Co. 1988:309–319
Doty RL. Olfaction. Annu Rev Psychol 2001; 52:423–452.
Kahilogullari G, Beton S, Al-Beyati ES, Kantarcioglu O, Bozkurt M, Kantarcioglu E, et al. Olfactory functions after transsphenoidal pituitary surgery: endoscopic versus microscopic approach. Laryngoscope 2013; 123:2112–2119.
Wang S, Chen Y, Li J, Wei L, Wang R. Olfactory function and quality of life following microscopic endonasal transsphenoidal pituitary surgery. Medicine (Baltimore) 2015; 94:e465.
Author information
Authors and Affiliations
Corresponding author
Additional information
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Lasheen, H., Youssef, O. Chronic nasal complication following endoscopic and microscopic direct transnasal transsphenoidal pituitary adenoma surgery. Egypt J Otolaryngol 33, 20–23 (2017). https://doi.org/10.4103/1012-5574.199412
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.4103/1012-5574.199412