One-and-a-half nostril versus binostril endoscopic transsphenoidal approach to the pituitary adenomas: A prospective randomized controlled trial

Zhu, Junhao; Wen, Guodao; Tang, Chao; Cong, Zixiang; Cai, Xiangming; Yang, Jin; Ma, Chiyuan

doi:10.3389/fsurg.2022.1007883

Cited by 4 publications

(2 citation statements)

References 26 publications

(39 reference statements)

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“…Our team reported the OETA in 2016, which completely preserved the mucosa in the left nostril, especially the septal olfactory strip and the vascular pedicles of sphenopalatine, and reduced the risk of anosmia and epistaxis ( 9 ). The randomized controlled trial comparing the OETA and binostril approach showed that the OETA group had better olfaction function than the binostril group one month after surgery ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic 1½-transseptal approach for pituitary surgery

Cong

Zhu²,

Sun³

et al. 2023

Front. Oncol.

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BackgroundWe previously introduced the one-and-a-half (1½) nostril endoscopic transsphenoidal approach (OETA) to reduce the damage to the nasal structures. Here, we reported the modified approach which is called the endoscopic 1½-transseptal approach (EOTA) for pituitary surgery by combining the OETA and the microscopic transseptal approach to simplify intranasal procedures and protect nasal mucosa. In EOTA, we removed the sellar lesions in a corridor that is composed of the right submucosal space and the anterior left ½ nasal cavity.MethodsWe introduced EOTA with a detailed technical description and preliminary clinical outcomes. A total of 128 patients who underwent EOTA for pituitary surgery from July 2018 to September 2020 were reviewed for evaluation of the safety and efficacy of this approach.ResultsEOTA had a high gross total resection (GTR) rate and a 1ow complication rate. GTR was achieved in 106 (82.8%) patients, with 81.4% for pituitary adenomas and 93.3% for other non-adenomatous lesions. Post-operative complications included 3 patients (2.3%) with postoperative cerebrospinal fluid leak, 3 patients (2.3%) with diabetes insipidus, 5 patients (3.9%) with anterior pituitary insufficiency and 2 patients (1.6%) with meningitis. In addition, EOTA simplified the intranasal procedures, which led to shortened operation time (67.8 minutes). The results of ASK nasal-12, the Lund-Kennedy score, and the odor identification test showed that patients who underwent EOTA recovered quickly after surgery and the nasal cavity returned to the preoperative condition both apparently and physiologically one month after surgery.ConclusionsEOTA is a simple, safe and effective approach for pituitary lesions, which provides not only a sufficient surgical corridor for 2-surgeon/4- or 3-hands technique but also minimally invasive access to the sellar region.

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Section: Discussionmentioning

confidence: 99%

“…In 2016, our team proposed the one-and-a-half (1½) nostril endoscopic transsphenoidal approach (OETA) which maintains sufficient surgical freedom and retains as much nasal septal mucosa as possible ( 9 – 11 ).…”

Section: Introductionmentioning

confidence: 99%