Endoscopic endonasal approach to pituitary adenoma with invasion to the cavernous sinus
Endoskopska endonazalna odstranitev hipofiznega adenoma s širjenjem v kavernozni sinus

english

2011

volume 16, issue 33

adenom   tumor 

Slovensko zdravniško društvo, Združenje za endoskopsko kirurgijo

Introduction. Transsphenoidal removal is the first-choice treatment for pituitary adenoma. Endoscopic view and dedicated instruments allow for removalof invasive adenomas from different cavernous sinus compartments. Patients and methods. Thirteen patients with intraoperatively confirned pituitary adenoma invading the cavernous sinus were enroled in the study. Middle turbinectomy and posterior ethmoidectomy permitted maximal anterior sphenoidotomy and lateral exposure of the sphenoid sinus, and allowed drillingof the lateral wall of sphenoid toward the orbital apex and unroofing of the superior orbital fissure and foramen rotundum. A neuronavigational system was used for surgical planning. Results. The patients were followed up for 14.6 months (range 3-40 months). Vision improved in 4/13 patients; in the rest it remained normal or was as good as before surgery. Small residual tumors were seen or suspected in 5/13 patients (subtotal removal > 90%). The preoperative level of pituitary function was preserved in 11/13 cases. All secretory adenomas were either cured or controlled with pharmacological agents.

15.06.2012