Abstract Issue

Volume 13 Issue 3 (March) 2024

Original Articles

Pituitary tumor- An experience of Endoscopic approach of transseptal transphenoid excision of pituitary.
Dr. M.Kavidha, Dr. S.Saravana Kumar

Background: Endoscopic surgery is performed through the sphenoid sinus to remove tumors from the pituitary gland and skull base. This minimally invasive surgery, Using endoscope camera and light to remove tumors gives magnified view and can reach near to the tumor. For Pituitary tumors type of surgical approach depends on the type of tumor, its exact location, its size, and whether it has spread into nearby structures. This study is done in a case series of 25 cases who underwent Endoscopic approach of transseptal transphenoid excision of pituitary. Material and Methodology: A retrospective review of case records of patients who had endoscopic endonasal transeptal transsphenoidal approach forpituitary tumors under general anesthesia were included. A total of 25 transphenoidal surgeries were performed duringthis study period. This study was done in a tertiary care teaching hospital in department of ENT. IHEC approval was received before starting study. Results: The mean age of patients was 35 years (18-50 years). There were 14 females and 11 Males. 23 (92%) were macroadenoma (> 10 mm), and 2 (8%) were microadenoma (< 10 mm). Other than hormonal symptoms the most common presenting complaints included visual symptoms—changes in visual acuity or visual field deficits, headache, menstrual cycle disturbance or infertility/ impotence and acromegaly features.Subtotal resection could be done in 5 cases with residual tumor in the cavernous sinus. 7 patients had Intra op/Post op complications and were treated successfully. The common complications encountered were Nasal synechae, cerebrospinal fluid leak, epistaxis, septalperforation. Average hospital stay was 5.2 days and average surgery time was 117 minutes. Close follow-up was maintained. The most common indications for longer hospitalization included prior co-morbid conditions which required extended monitoringor rehabilitation. Conclusion: At present the Transseptal -Transsphenoidal removal of pituitary tumor approach represents the standard approach by which the vast majority of pituitary adenomas are surgically resected. Endoscopic pituitary surgery is useful in all micro- and macro- pituitary adenomas including those with suprasellar and cavernous sinus extension.

 
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