Surgical resection of pituitary adenoma via neuroendoscopic single-nostril transsphenoidal approach: a clinical analysis

Objective　To explore the technique and clinical efficacy of single-nostril transsphenoidal neuroendoscopic resection of pituitary adenomas. Methods　A total of 47 patients with pituitary adenoma, among them 21 were male and 26 female, aged 15-70 years old with a mean of 42.7 years, were treated with neuroendoscopic single-nostril transsphenoidal surgical resection in the Air Force General Hospital of PLA from August 2007 to August 2013. Clinical data were analyzed retrospectively, including the operative results, complications, and follow up results. Results　Post-operative MRI revealed that the tumor was totally removed in 38 (80.9%) patients, and subtotally in 9 (19.1%, the tumors were large and had invaded the cavernous sinus). Post-operative improvement of clinical symptoms was achieved in 40 (85.1%) patients, among them, headache disappeared in 35 patients, vision and visual field improved in 30 patients. Among the 47 patients, an increase in prolactin hormone (PRH type) was seen in 29, an increase in growth hormone (GH type) in 6, and non-functioning pituitary carcinoma in 12 patients. In 80% (28/36) of the patients hormone secretion was improved after the operation, including 23 of PRH type and 5 of GH type. Post-operative complications were diabetes insipidus in 10 patients, cerebrospinal fluid leakage in 8 and meningitis in one. All the patients were followed up for 6 months up to 6 years, and no death occurred. Conclusion　Single-nostril transsphenoidal endoscopic surgery consists of many advantages, such as minimal trauma, clear visual field, higher total resection rate, and rapid recovery after operation, therefore it is a safe and effective approach for the resection of pituitary adenomas. DOI: 10.11855/j.issn.0577-7405.2015.05.15