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Occam’s razor in minimally invasive pituitary surgery: tailoring the endoscopic endonasal uninostril trans-sphenoidal approach to sella turcica

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Abstract

Background

Since the introduction of the endoscopic endonasal approaches in the field of skull base surgery during the last two decades, several variants of the sella turcica endoscopic surgery have been described. The aim of this study is to provide a stepwise description of one of these variants in a minimally invasive/maximally efficient perspective.

Method

For the majority of our sella turcica pathologies, we have progressively adopted a uninostril endoscopic approach that is very conservative towards the nasal mucosa with a very limited mucosal incision, resection of the vomer and allowing an almost ad integrum sellar floor reconstruction, without compromising the efficacy and completeness of both surgical oncologic and endocrine targets.

Conclusion

The uninostril trans-sphenoidal endoscopic endonasal approach to sella turcica is tailored to ally maximal efficiency and minimal invasiveness.

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Conflicts of interest

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Authors and Affiliations

  1. Service de Neurochirurgie A, Groupement Hospitalier Est, Hospices Civils de Lyon, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, 59 Boulevard Pinel, Bron, Lyon, 69500, France

    Moncef Berhouma & Emmanuel Jouanneau

  2. Faculty of Medicine Lyon Est, Claude Bernard University Lyon 1, Lyon, France

    Moncef Berhouma

  3. Department of Neurosurgery, Lausanne University Hospital, Lausanne, Switzerland

    Mahmoud Messerer

  4. INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Equipe Neuro-oncologie et Neuro-inflammation, Faculté de Médecine Lyon Sud, Université de Lyon I, Lyon, France

    Emmanuel Jouanneau

  5. Faculty of Medicine Lyon Sud, Claude Bernard University Lyon 1, Lyon, France

    Emmanuel Jouanneau

Authors
  1. Moncef Berhouma
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  2. Mahmoud Messerer
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  3. Emmanuel Jouanneau
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Corresponding author

Correspondence to Emmanuel Jouanneau.

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Berhouma, M., Messerer, M. & Jouanneau, E. Occam’s razor in minimally invasive pituitary surgery: tailoring the endoscopic endonasal uninostril trans-sphenoidal approach to sella turcica. Acta Neurochir 154, 2257–2265 (2012). https://doi.org/10.1007/s00701-012-1510-2

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  • DOI: https://doi.org/10.1007/s00701-012-1510-2

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