Abstract
Advances in optics, miniaturization, and endoscopic instrumentation have revolutionized surgery in the past decade. Current progress in the field of endoscopy promises to further this evolution: endoscopic telescopes and instruments have improved upon the optical and technical limitations of the microscope, and require an even less invasive approach to the sella. Pituitary surgery is traditionally within the realm of the neurosurgeon. However, since the reintroduction of the transseptal transsphenoidal approach and endoscopic transnasal transsphenoidal approach to the sella turcica for resection of pituitary adenoma, otolaryngologists have been active partners in the surgical management of these patients. Otolaryngologists have lent their expertise in nasal and sinus surgery, assisting the neurosurgeon with the operation. The otolaryngologist has the advantage of familiarity with the techniques and instruments used to gain exposure of the sella turcica by transnasal approach. Hence, the otolaryngologist provides the exposure, and the neurosurgeon resects the tumour. Such collaboration has resulted in decreased rates of complication and morbidity. We hereby discuss our experience of treating 54 cases of pituitary tumour by endoscopic transnasal approach at our hospital.
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References
Heilman CB, Shucart WA, Rebeiz EE (1997) Endoscopic sphenoidotomy approach to the sella. Neurosurgery 41(3):602–607
Dew LA, Haller JR, Major S (1999) Transnasal transsphenoidal hypophysectomy: choice of approach for the otolaryngologist. Otolaryngol Head Neck Surg 120(6):824–827
Kenan PD (1979) The rhinologist and the management of pituitary disease. Laryngoscope 89(2 Pt 2 Suppl 14):1–26
Cappabianca P, Alfieri A, Divitiis ED (1998) Endoscopic endonasal transsphenoidal approach to the sella: towards Functional Endoscopic Pituitary Surgery. Minim Invas Neurosurg 41:66–73
Gamea A et al (1994) The use of the rigid endoscope in transsphenoidal pituitary surgery. J Laryngol Otol 108:19–22
Griffith HB, Veerapen R (1987) A direct transnasal approach to the sphenoid sinus. Technical note. J Neurosurg 66:140–142
Hardy J (1971) Transsphenoidal hypophysectomy. J Neurosurg 34:582–594
Hirsch O (1956) Pituitary tumors. A borderland between cranial and transsphenoidal surgery. N Engl J Med 254:937–939
Jho HD et al (1997) Endoscopic pituitary surgery: an early experience. Surg Neurol 47:213–223
Lund VJ (1997) Extended applications of endoscopic sinus surgery—the territorial imperative. J Laryngol Otol 111:313–315
Sethi DS, Pillay PK (1995) Endoscopic management of lesions of the sella turcica. J Laryngol Otol 109:956–962
Sethi DS et al (1995) Endoscopic anatomy of the sphenoid sinus and sella turcica. J Laryngol Otol 109:951–955
Stankiewicz JA (1989) The endoscopic approach to the sphenoid sinus. Laryngoscope 99:218–221
Aron DC, Tyrrell JB, Wilson CB (1995) Pituitary tumors: current concepts in diagnosis and management. West J Med 162:340–352
Welbourn RB (1986) The evolution of transsphenoidal pituitary microsurgery. Surgery 100:1185–1190
Cushing H (1914) Surgical experience with pituitary disorders. JAMA 63:1515–1525
Jankowski R, Auque J, Simon C, Marchal JC, Hepner H, Wayoff M (1992) Endoscopic pituitary tumor surgery. Laryngoscope 102(198–20):2
Jho HD, Carrau RL (1996) Endoscopy assisted transsphenoidal surgery for pituitary adenoma. Technical note. Acta Neurochir 138:1416–1425
Jarrahy R, Berci G, Shahinian HK (2000) Assessment of the efficacy of endoscopy in pituitary adenoma resection. Archives Otolarygol Head Neck Surg 126:1487–1490
Hardy J (1969) Transphenoidal microsurgery of the normal and pathological pituitary. Clin Neurosurg 16:185–217
Ciric I, Ragin A, Baumgartner C, Pierce D (1997) Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery 40:225–236 (discussion 236–227)
Welbourn RB (1986) The evolution of transsphenoidal pituitary microsurgery. Surgery 100:1185–1190
Varshney S (2008) Rhinologist and pituitary tumour. Guj J A.O.I. 5(1):1–4
Bansal KK, Gupta C, Varshney S, Kukreti R, Gupta A (2005) Visual deterioration after trans-sphenoidal surgery for pituitary adenoma- a rare but severe complication: case report with review of literature (case report). Indian J Otolaryngol and Head Neck Surg (special issue: 179–181)
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Varshney, S., Gupta, C., Bansal, K.K. et al. Endoscopic Trans-Nasal Trans-Sphenoidal (TNTS) Approach For Pituitary Adenomas: Our Experience. Indian J Otolaryngol Head Neck Surg 65 (Suppl 2), 308–313 (2013). https://doi.org/10.1007/s12070-011-0457-6
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DOI: https://doi.org/10.1007/s12070-011-0457-6