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Endoscopic Transnasal Surgery of Sellar Region


Authors: P. Matoušek 1,3,4 ;  R. Lipina 2,3;  T. Paleček 2,3;  P. Štrympl 1;  T. Pniak 1,3;  Pavel Komínek 1,3
Authors‘ workplace: ORL klinika FN Ostrava 1;  Neurochirurgická klinika FN Ostrava 2;  Centrum endoskopické chirurgie baze lební FN Ostrava 3;  Lékařská fakulta FN Ostrava 4
Published in: Otorinolaryngol Foniatr, 61, 2012, No. 3, pp. 172-177.
Category: Original Article

Overview

Objective:
The paper presents our experience with endoscopic technique and advantages of interdisciplinary collaboration in the endoscopic approach to cranial base.

Material and method:
The patients operated on for intracranial pathology by transnasal approach at the Center of endoscopic surgery of cranial base, Faculty Hospital in Ostrava, were enrolled in the study. The surgery was indicated by neurologist and the approach to the tumor was evaluated by otorhinolaryngologist.

Results:
Since January 2008 till January 2011 the authors performed 105 surgeries for pathology in the area of anterior cranial fossa by transnasal endoscopic approach. Ninety patients suffered from adenoma of hypophysis (83 nonfunctional and 7 functional ones). Non-pituitary lesions were the reason for surgery in 15 patients (meningioma 3 times, craniopharyngioma 6 times, epidermoid cyst once, metastasis in the sellar region once, Rathke recess cyst twice, dermoid cyst twice). In 83 patients with nonfunctional adenomas of hypophysis control MR examination resulted in radical resection with 67 patients (80%) and in the remaining 17 patients (20%) partial resection was used. From the total of 15 non-pituitary lesions, radical extirpation was performed in eleven patients.

Serious complications were observed in 8 patients (4 times postoperative liquorrhea, diabetes insipidus 3 times, pseudoaneurysm of carotid artery once), there was no mortality. Postoperative deterioration of vision was not observed.

Conclusions:
Endoscopic transnasal approach is a minimally invasive approach which makes it possible to solve adenoma of hypophysis and other pathological conditions in the sellar region.

Key words:
transnasal endoscopic surgery of cranial base, sellar region tumors.


Sources

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Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)
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