Endoscopic transnasal approach to sellar tumors
Rodrigo de Paula Santos , Samuel Tau Zymberg , Júlio Zaki Abucham Filho, Luis Carlos Gregório, Luc Louis Maurice Weckx
Transsphenoidal surgery for sellar region tumors is
traditionally done only by neurosurgeons. The use of
endoscopes has permitted a direct transnasal approach to the
sphenoidal sinus, without dissection of the septal mucosa,
reducing postoperative morbidity. Aim: The purpose of
this study was to assess the technical difficulties, and per
and postoperative complications of the otolaryngological
management of the endoscopic transnasal approach to
the sellar region. Material and Method: 159 patients
undergoing sellar region surgery between March 2001 and
December 2006 were assessed retrospectively. 91 patients
who underwent 95 endoscopic transnasal procedures were
included in this study. Study design: a clinical retrospective
study. Results: The endoscopic transnasal technique was
feasible for every patient, independent of age, anatomical
variations, tumor characteristics, tumor etiology, and previous
surgical history. There was no need to remove the middle
turbinate or septal deviations in any of the cases. The most
significant peroperative complication was CSF leak during
tumor removal (13.68%). Postoperative complications were:
nasal bleeding (8.42%), CSF leak (8.42%), and meningitis
(2.19). Conclusion: The transnasal endoscopic approach
was accomplished with minimal invasion, preserving
nasal structures in all 95 procedures, independent of age,
anatomical variations, tumor characteristics,tumor etiology,
and previous surgical history.
