Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas

Abstract

Transsphenoidal surgery, either microscopic or endoscopic, is a safe procedure in experienced hands, but serious complications still occur and must be reduced as much as possible. Additional improvement can be expected with greater experience and new technical developments. A coordinated team effort with other dedicated colleagues from different specialties is advised.

Effectiveness of Endoscopic Endonasal Transsphenoidal Surgery Using a Neuronavigation: Clinical Results of 178 Pituitary Adenomas

“…The reported complication rates of TSS are 9.1%, 23.4% and 22.1% [1,14,16], which are far higher than ours. Damage to the carotid artery leads to serious complications ( Table 6).…”

“…Damage to the carotid artery leads to serious complications ( Table 6). Cappabianca et al and Gondim et al reported carotid artery injury rates of 0.7%-0.9% [14,16]. Preventing such damage might thus be one advantage of endoscopic TSS with navigation [17].…”

“…Gross total, subtotal and partial removal was defined as the absence of residual tumor on MRI, <20% and ≥20% remaining tumor, respectively [14].…”

Full Endoscopic Transsphenoidal Surgery for Pituitary Adenoma-emphasized on Surgical Skill of Otolaryngologist

“…Some clinical investigations [14,15] suggested that the learning curve to grasp the endoscopic pituitary surgery required 40 to 80 operations. We consider this number never enough for a surgeon to be proficient in the practice of nasal endoscope.…”

“…In the pituitary surgery, the procedure by nasal endoscope has a lot of advantages that microscope can't afford [3][4][5][6][7][8][9][10][11][12][13][14][15]17], though it also has several disadvantages, however which will be overcomed along with the continuously developing of new instruments and new techniques.…”