Keywords
Endonasal
Transphenoidal
Pituitary
Visual impairment
Nasal Crust
How to Cite
Abstract
Objective: To share our experience on the clinical presentation and management of patients with pituitary adenoma using Endoscopic
Endo-Nasal Trans-Sphenoidal Surgery (EETSS
Materials and Method: A retrospective review of all patients with non-functional pituitary macro-adenoma seen in who underwent EETS
approach between May 2012 and April 2018. The clinical presentations of the patients were documented. All Patients had pre and
postoperative visual assessment and they had radiologic investigation. Endocrine evaluations were done pre and postoperatively. All
patients were operated by a combined team of Ear, Nose and Throat (ENT) surgeons and Neurosurgeons using rigid endoscope 18cm
(4mm; 0 and 30 degree).
Results: A total of 18 patients; 12 females and 6 males, were operated via EETS. All patients had visual impairments at presentation which
improved postoperatively in 14 patients. 6 patients were postmenopausal, 5 had amenorrhea with secondary infertility. There were two
postoperative deaths in intensive care unit. The Mean hospital stay was 4.9 days. Histological diagnosis of pituitary adenoma in was made
in 17 patients and one patient had malignant mucoepithelial tumour.
Conclusion: Pituitary tumour constituted about 10.5% of all intracranial tumors in our centre, visual impairment is the commonest
presentation and total tumor resection via the EETS is about 78%. The approach showed improve vision in 2/3rd postoperatively, mean
hospital stay was about 4.9days with nasal crust formation being the most observed complication and mortality of 11.1%.