Treatment of pituitary adenomas invading cavernous sinus with neuroendoscopy assisted by multiple techniques

Objective To study the effectiveness of treating giant pituitary adenomas invading cavernous sinus with neuroendoscopy assisted by multiple techniques. Methods A total of 72 patients who underwent neuroendoscopic surgery and 55 patients who underwent microscopic surgery for giant pituitary adenomas were enrolled in this retrospective analysis. Both groups received expanded endoscopic endonasal transsphenoidal approach,intraoperative application of navigation,and Doppler. The clinical data of two groups were compared. Results The two groups were significantly different in total tumor removal rate,operation time,postoperative nasal patency,and postoperative recurrence rate( P = 0. 004,P = 0. 0003,P = 0. 000,and P = 0. 002,respectively),whereas the cerebrospinal fluid leakage,postoperative diabetes insipidus,and cranial nerve injury were not significantly different( P 0. 05). Conclusions Expanded neuroendoscopic endonasal transsphenoidal approach assisted by multiple techniques is the preferred surgical method for giant invasive pituitary adenomas invading cavernous sinus. The lateral cavernous sinus approach and the further molecular biology research willbring more options for the treatment of invasive pituitary adenomas.