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One-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas—a technical report
BACKGROUND: Binostril endoscopic transsphenoidal approach (BETA) provides sufficient manipulation space and wide endoscopic vision, although it increases the trauma of nose. Mononostril endoscopic transsphenoidal approach (META) has minimal trauma of nose, at the expense of space within the operatio...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111234/ https://www.ncbi.nlm.nih.gov/pubmed/27846864 http://dx.doi.org/10.1186/s40463-016-0174-y |
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author | Wen, Guodao Tang, Chao Zhong, Chunyu Li, Junyang Cong, Zixiang Zhou, Yuan Liu, Kaidong Zhang, Yong Tohti, Mamatemin Ma, Chiyuan |
author_facet | Wen, Guodao Tang, Chao Zhong, Chunyu Li, Junyang Cong, Zixiang Zhou, Yuan Liu, Kaidong Zhang, Yong Tohti, Mamatemin Ma, Chiyuan |
author_sort | Wen, Guodao |
collection | PubMed |
description | BACKGROUND: Binostril endoscopic transsphenoidal approach (BETA) provides sufficient manipulation space and wide endoscopic vision, although it increases the trauma of nose. Mononostril endoscopic transsphenoidal approach (META) has minimal trauma of nose, at the expense of space within the operation. We describe a one-and-a-half nostril endoscopic transsphenoidal approach (OETA) that combines the advantages of BETA and META. METHODS: We introduced OETA for pituitary adenomas with a detailed technical description. A retrospective analysis was also performed on 57 consecutive patients who underwent one-and-a-half nostril endoscopic transsphenoidal surgery between March 2014 and June 2015 at Jinling hospital. RESULTS: The gross total resection rate was 79%. The gross complete resection rate of Knosp grade 3 tumors were 63.6, and 27.3% in grade 4 tumors. Postoperative hormone remission was achieved in 14 out of 18 (77.8%) patients with secreting adenomas. Postoperative abnormal visual function improvement was achieved in 23 out of 32 patients (73%) with preoperative visual dysfunction. The overall intra-operative CSF leak was 17.5%, with the postoperative CSF leak decreased to 3.5% after the sellar reconstruction with the unilateral “rescue” nasoseptal flap procedure. The main sinonasal complaints 2 weeks after surgery were: loss of sense of smell (28%), decrease in sense of taste (4%), trouble breathing during the day (18%), thick nasal discharge (36%), post nasal discharge (8%), dried nasal material (6%), and headache (6%). Three months after surgery, there were no reports of decrease of taste, post nasal discharge, or dried nasal material. Other complaints were decreased significantly. Six months after surgery, the main complaints of sinonasal quality of life were negligible, and overall health status was near complete recovery to preoperative status. CONCLUSIONS: The one-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas is a simple and reliable technique. It provides not only a sufficient surgical corridor for a 2-surgeon/4 or 3-hands technique, but also ensures minimal invasion of the nasal canal. |
format | Online Article Text |
id | pubmed-5111234 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-51112342016-11-25 One-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas—a technical report Wen, Guodao Tang, Chao Zhong, Chunyu Li, Junyang Cong, Zixiang Zhou, Yuan Liu, Kaidong Zhang, Yong Tohti, Mamatemin Ma, Chiyuan J Otolaryngol Head Neck Surg Original Research Article BACKGROUND: Binostril endoscopic transsphenoidal approach (BETA) provides sufficient manipulation space and wide endoscopic vision, although it increases the trauma of nose. Mononostril endoscopic transsphenoidal approach (META) has minimal trauma of nose, at the expense of space within the operation. We describe a one-and-a-half nostril endoscopic transsphenoidal approach (OETA) that combines the advantages of BETA and META. METHODS: We introduced OETA for pituitary adenomas with a detailed technical description. A retrospective analysis was also performed on 57 consecutive patients who underwent one-and-a-half nostril endoscopic transsphenoidal surgery between March 2014 and June 2015 at Jinling hospital. RESULTS: The gross total resection rate was 79%. The gross complete resection rate of Knosp grade 3 tumors were 63.6, and 27.3% in grade 4 tumors. Postoperative hormone remission was achieved in 14 out of 18 (77.8%) patients with secreting adenomas. Postoperative abnormal visual function improvement was achieved in 23 out of 32 patients (73%) with preoperative visual dysfunction. The overall intra-operative CSF leak was 17.5%, with the postoperative CSF leak decreased to 3.5% after the sellar reconstruction with the unilateral “rescue” nasoseptal flap procedure. The main sinonasal complaints 2 weeks after surgery were: loss of sense of smell (28%), decrease in sense of taste (4%), trouble breathing during the day (18%), thick nasal discharge (36%), post nasal discharge (8%), dried nasal material (6%), and headache (6%). Three months after surgery, there were no reports of decrease of taste, post nasal discharge, or dried nasal material. Other complaints were decreased significantly. Six months after surgery, the main complaints of sinonasal quality of life were negligible, and overall health status was near complete recovery to preoperative status. CONCLUSIONS: The one-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas is a simple and reliable technique. It provides not only a sufficient surgical corridor for a 2-surgeon/4 or 3-hands technique, but also ensures minimal invasion of the nasal canal. BioMed Central 2016-11-15 /pmc/articles/PMC5111234/ /pubmed/27846864 http://dx.doi.org/10.1186/s40463-016-0174-y Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Research Article Wen, Guodao Tang, Chao Zhong, Chunyu Li, Junyang Cong, Zixiang Zhou, Yuan Liu, Kaidong Zhang, Yong Tohti, Mamatemin Ma, Chiyuan One-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas—a technical report |
title | One-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas—a technical report |
title_full | One-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas—a technical report |
title_fullStr | One-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas—a technical report |
title_full_unstemmed | One-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas—a technical report |
title_short | One-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas—a technical report |
title_sort | one-and-a-half nostril endoscopic transsphenoidal approach for pituitary adenomas—a technical report |
topic | Original Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111234/ https://www.ncbi.nlm.nih.gov/pubmed/27846864 http://dx.doi.org/10.1186/s40463-016-0174-y |
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