Download PDF
Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2015; 34(02): 139-143
DOI: 10.1055/s-0035-1554737
Review Article | Artigo de Revisão
Thieme Publicações Ltda Rio de Janeiro, Brazil

Endoscopic Endonasal Transsphenoidal Pituitary Tumors Approach: Nuances of Neurosurgical Technique

Abordagem endoscópica endonasal transesfenoidal para tumores hipofisários: detalhes da técnica neurocirúrgica
Flávio Ramalho Romero
1   Hospital das Clínicas, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
,
Jose Vicente Tagliarini
2   Department of Otolaryngology, UNESP, Botucatu, Brazil
,
Vânia dos Santos Nunes
3   Department of Endocrinology, UNESP, Botucatu, Brazil
,
Marco Antônio Zanini
4   Department of Neurosurgery, UNESP, Botucatu, Brazil
› Author Affiliations
Further Information

Publication History

29 September 2014

31 March 2015

Publication Date:
29 June 2015 (online)

Also available at
   Permissions and Reprints

Abstract

Pituitary tumors are responsible for 7 to 17% of all intracranial lesions. Over the past decade, advances in endoscopic microsurgical techniques have resulted in an increasingly aggressive endonasal approach to tumors of the midline skull base. We present our series emphasizing technical nuances of endoscopic endonasal transsphenoidal approach to treat pituitary adenomas.

Resumo

Tumores hipofisários são responsáveis por 7 a 17% de todas as lesões intracranianas. Durante a última década, avanços nas técnicas microcirúrgicas endoscópicas resultaram no aumento de acessos endonasais agressivos para tumores de base de crânio de linha média. Apresentamos nossa série de casos, com ênfase nos detalhes técnicos do acesso endoscópico endonasal transesfenoidal para o tratamento de tumores da hipófise.

Keywords

pituitary tumors - transsphenoidal approach - skull base tumors

Palavras chave

tumores hipofisários - acesso transesfenoidal - tumores de base de crânio
 

  • References

  • 1 Kovacs K, Horvath E. Pathology of pituitary tumors. Endocrinol Metab Clin North Am 1987; 16 (3) 529-551
    PubMedSearch in Google Scholar
  • 2 Ezzat S, Asa SL, Couldwell WT , et al. The prevalence of pituitary adenomas: a systematic review. Cancer 2004; 101 (3) 613-619
    CrossrefPubMedSearch in Google Scholar
  • 3 Scheithauer BW, Kovacs KT, Laws Jr ER, Randall RV. Pathology of invasive pituitary tumors with special reference to functional classification. J Neurosurg 1986; 65 (6) 733-744
    CrossrefPubMedSearch in Google Scholar
  • 4 Hofstetter C, Anand VK, Schwartz TH. Endoscopic transsphenoidal pituitary surgery. Oper Tech Otolaryngol 2011; 22: 206-214
    CrossrefPubMedSearch in Google Scholar
  • 5 Kulkarni MV, Lee KF, McArdle CB, Yeakley JW, Haar FL. 1.5-T MR imaging of pituitary microadenomas: technical considerations and CT correlation. AJNR Am J Neuroradiol 1988; 9 (1) 5-11
    PubMedSearch in Google Scholar
  • 6 Freda PU, Beckers AM, Katznelson L , et al; Endocrine Society. Pituitary incidentaloma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2011; 96 (4) 894-904
    CrossrefPubMedSearch in Google Scholar
  • 7 Casanueva FF, Molitch ME, Schlechte JA , et al. Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas. Clin Endocrinol (Oxf) 2006; 65 (2) 265-273
    CrossrefPubMedSearch in Google Scholar
  • 8 Cappabianca P, Cavallo LM, Esposito F, De Divitiis O, Messina A, De Divitiis E. Extended endoscopic endonasal approach to the midline skull base: the evolving role of transsphenoidal surgery. Adv Tech Stand Neurosurg 2008; 33: 151-199
    PubMedSearch in Google Scholar
  • 9 Cappabianca P, Cavallo LM, Colao A, de Divitiis E. Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas. J Neurosurg 2002; 97 (2) 293-298
    CrossrefPubMedSearch in Google Scholar
  • 10 de Divitiis E, Cappabianca P, Cavallo LM. Endoscopic transsphenoidal approach: adaptability of the procedure to different sellar lesions. Neurosurgery 2002; 51 (3) 699-705 , discussion 705–707
    CrossrefPubMedSearch in Google Scholar
  • 11 Kassam AB, Prevedello DM, Carrau RL , et al. Endoscopic endonasal skull base surgery: analysis of complications in the authors' initial 800 patients. J Neurosurg 2011; 114 (6) 1544-1568
    CrossrefPubMedSearch in Google Scholar
  • 12 Gardner PA, Kassam AB, Snyderman CH , et al. Outcomes following endoscopic, expanded endonasal resection of suprasellar craniopharyngiomas: a case series. J Neurosurg 2008; 109 (1) 6-16
    Search in Google Scholar
  • 13 Jho HD. Endoscopic transsphenoidal surgery. J Neurooncol 2001; 54 (2) 187-195
    Search in Google Scholar
  • 14 Schwartz TH, Fraser JF, Brown S, Tabaee A, Kacker A, Anand VK. Endoscopic cranial base surgery: classification of operative approaches. Neurosurgery 2008; 62 (5) 991-1002 , discussion 1002–1005
    CrossrefPubMedSearch in Google Scholar
  • 15 Snyderman CH, Pant H, Carrau RL, Prevedello D, Gardner P, Kassam AB. What are the limits of endoscopic sinus surgery?: the expanded endonasal approach to the skull base. Keio J Med 2009; 58 (3) 152-160
    CrossrefPubMedSearch in Google Scholar
  • 16 Singh A, Wessell AP, Anand VK, Schwartz TH. Surgical anatomy and physiology for the skull base surgeon. Oper Tech Otolaryngol 2011; 22: 184-193
    CrossrefPubMedSearch in Google Scholar
  • 17 Cushing H. The Weir Mitchell Lecture. Surgical experience with pituitary disorders. JAMA 1914; 63: 1515-1525
    CrossrefPubMedSearch in Google Scholar
  • 18 Cohen-Gadol AA, Liu JK, Laws Jr ER. Cushing's first case of transsphenoidal surgery: the launch of the pituitary surgery era. J Neurosurg 2005; 103 (3) 570-574
    CrossrefPubMedSearch in Google Scholar
  • 19 Griffith HB, Veerapen R. A direct transnasal approach to the sphenoid sinus. Technical note. J Neurosurg 1987; 66 (1) 140-142
    CrossrefPubMedSearch in Google Scholar
  • 20 Guiot G, Rougerie J, Fourestier M, Fournier A, Comoy C, Vulmiere J. Une nouvelle technique endoscopique: explorations endoscopiques intracraniennes. Presse Med 1963; 72: 1225-1231
    PubMedSearch in Google Scholar
  • 21 Jho HD, Carrau RL. Endoscopy assisted transsphenoidal surgery for pituitary adenoma. Technical note. Acta Neurochir (Wien) 1996; 138 (12) 1416-1425
    CrossrefPubMedSearch in Google Scholar
  • 22 Yano S, Hide T, Shinojima N, Hasegawa Y, Kawano T, Kuratsu J. Endoscopic endonasal skull base approach for parasellar lesions: Initial experiences, results, efficacy, and complications. Surg Neurol Int 2014; 5: 51-53
    CrossrefPubMedSearch in Google Scholar
  • 23 Laufer I, Anand VK, Schwartz TH. Endoscopic, endonasal extended transsphenoidal, transplanum transtuberculum approach for resection of suprasellar lesions. J Neurosurg 2007; 106 (3) 400-406
    CrossrefPubMedSearch in Google Scholar
  • 24 Cavallo LM, Prevedello DM, Solari D , et al. Extended endoscopic endonasal transsphenoidal approach for residual or recurrent craniopharyngiomas. J Neurosurg 2009; 111 (3) 578-589
    CrossrefPubMedSearch in Google Scholar
  • 25 DeKlotz TR, Chia SH, Lu W, Makambi KH, Aulisi E, Deeb Z. Meta-analysis of endoscopic versus sublabial pituitary surgery. Laryngoscope 2012; 122 (3) 511-518
    CrossrefPubMedSearch in Google Scholar
  • 26 Rotenberg B, Tam S, Ryu WH, Duggal N. Microscopic versus endoscopic pituitary surgery: a systematic review. Laryngoscope 2010; 120 (7) 1292-1297
    CrossrefPubMedSearch in Google Scholar
  • 27 Goudakos JK, Markou KD, Georgalas C. Endoscopic versus microscopic trans-sphenoidal pituitary surgery: a systematic review and meta-analysis. Clin Otolaryngol 2011; 36 (3) 212-220
    CrossrefPubMedSearch in Google Scholar
  • 28 Gao Y, Zhong C, Wang Y , et al. Endoscopic versus microscopic transsphenoidal pituitary adenoma surgery: a meta-analysis. World J Surg Oncol 2014; 12: 94-99
    CrossrefPubMedSearch in Google Scholar
  • 29 Ammirati M, Wei L, Ciric I. Short-term outcome of endoscopic versus microscopic pituitary adenoma surgery: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 2013; 84 (8) 843-849
    CrossrefPubMedSearch in Google Scholar