Endoscopic Endonasal Surgery for Pituitary Adenomas Using a Collaborative Multidisciplinary Approach:

Abstract

Zushi ENT clinic Osaka prefectureThis study was aimed at evaluating the results of collaborative endoscopic endonasal transsphenoidal surgery EETS performed by a multidisciplinary team comprising otolaryngologists and neurosurgeons for pituitary adenomas PAs , and at evaluating the safety of this procedure.We performed a retrospective review of the medical records of 123 consecutive operations of 102 patients who underwent EETS for PAs between July 2003 and May 2016 in Osaka City General Hospital.The incidence of the postoperative complication of rhinosinusitis was assessed retrospectively. Sphenopalatine artery bleeding was recorded in 2 patients 1.6 , acute sphenoiditis occurred in 1 patient 0.8 , and CSF leak was recorded in 3 patients 2.4 , of which 1 0.8 developed bacterial meningitis. The clinical course of the olfactory symptoms could be clearly delineated in 36 patients, of which none had anosmia. Postoperatively, none of the cases that developed permanent nasal obstruction, deterioration of salivary function, lacrimal gland dysfunction or palatal sensitivity decrease.In conclusion, EETS is a reasonably safe surgical modality for PAs. With recent advances in endoscopic technologies, the scope of transnasal surgery, especially for skull base surgery, including for PAs, has expanded remarkably. Our results indicate that a collaborative approach involving a multidisciplinary team comprising otolaryngologists and neurosurgeons can contribute to effective management of postoperative complications, including rhinosinusitis.