Mononostril endoscopic transsphenoidal approach to sellar and peri-sellar lesions: Personal experience and literature review

Abstract

Our mononostril approach of transnasal transsphenoidal surgery shows better results compared with previously published reports in regards to radicality, low cerebrospinal fluid leaks and morbidity. The very low rate of nasal complains is particularly remarkable.

One-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas—a technical report

“…With respect to postoperative morbidity, our results are comparable to that of other published series [1, 3, 4, 7–9, 20] in regards to factors such as postoperative CSF leakage (3.5%), anterior pituitary insufficiency (5.3%), and temporary diabetes insipidus (5.3%). In this study, the cases with the pituitary adenomas with Knosp grade 3 to 4 accounted for 52.6% of the total cases (30/57).…”

“…Our surgical outcomes were equivalent to or superior to those reported in the literature for endoscope based series [1, 3, 4, 7–9], including 79% gross tumor resection rate, 77.8% hormonal remission rate, and 72% improvement in visual function. In our opinion, this outcome may be attributable to the wide panoramic view of the endoscope, independent of both the width and depth of the access, which is not affected by the OETA.…”

“…Compared with traditional sublabial or transseptal microscopic approach, ETSS offers minimal invasiveness, fewer complications, and overall improved outcomes [6, 7]. Traditionally, there are two approaches to endoscopic transsphenoidal surgery for pituitary adenomas: the two nostrils (binostril) approach and the one nostril (mononostril) approach [8, 9]. Both of the approaches have positives and negatives associated with them.…”

Extended endoscopic endonasal approach for pituitary adenoma: a single-center experience of 171 patients

“…According to a previous epidemiology study, about 16.7% of the general population show changes in the pituitary gland [1]. PA can be classified by diameter and divided into microadenomas (<1 cm), macroadenomas (1-4 cm), or giant adenomas (>4 cm) [1,2].Depending on endocrinological status, PA can be classified as nonfunctioning or functioning.…”

“…Over the last two decades, following the development of optical techniques, endoscopic endonasal surgery for PAs has been progressively accepted by many neurosurgeons and has become popular in many clinical centers. Increasing numbers of neurosurgeons now choose the endoscopic endonasal approach as the first option to resect PA, due to the wider visualization and reduced trauma [13][14][15][16]. However, the standard transsphenoidal approach fails to expose PAs invading the anterior cranial base, cavernous sinus, and clivus [17].…”