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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Minimizing the approach to maximize the nasal quality of life in patients undergoing endoscopic pituitary surgery

Meeting Abstract

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  • Oliver M. Müller - Universitätsklinikum Essen der Universität Duisburg-Essen, Klinik und Poliklinik für Neurochirurgie, Essen, Deutschland
  • Boris Stuck - HNO Klinik, Universitätsklinikum Essen, Essen, Deutschland
  • Yahya Ahmadipour - Klinik für Neurochirurgie, Universitätsklinikum Essen, Essen, Deutschland
  • Karsten H. Wrede - Universitätsklinikum Essen der Universität Duisburg-Essen, Klinik und Poliklinik für Neurochirurgie, Essen, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen der Universität Duisburg-Essen, Klinik und Poliklinik für Neurochirurgie, Essen, Deutschland
  • Bernd-Otto Hütter - Universitätsklinikum Essen der Universität Duisburg-Essen, Klinik und Poliklinik für Neurochirurgie, Essen, Deutschland
  • Nicolai El Hindy - Universitätsklinikum Essen der Universität Duisburg-Essen, Klinik und Poliklinik für Neurochirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.25.04

doi: 10.3205/17dgnc326, urn:nbn:de:0183-17dgnc3263

Published: June 9, 2017

© 2017 Müller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: The transnasal endoscopic approach to lesions in sellar region has been implemented in daily praxis. Yet, many patients suffer from diminished nasal quality of life. This is to propose a minimized endoscopic approach to the sellar floor in order to maintain physiological nasal conditions as far as possible.

Methods: From June 2015 to July 2016 a total of 47 consecutive patients have been operated for pituitary adenomas. All cases have been managed endoscopically with preservation of the inferior and middle turbinate as well as the much of the posterior part of the nasal septum as possible. The vomer was not resected on a regular base. The nasal ostium was bilaterally opened to allow the passage of the endoscope and the instruments, respectively. Rhino-septal splints were routinely placed postoperative and left in place for at least 9 days.

Results: There were 23 female and 24 male patients (mean age 55.8 years; range 18-89years, standard deviation 18y). Of 47 adenomas, there were 8 hormone secreting tumors. 7 cases were recurrent adenomas. All operations could be carried out without the necessity to extend the operative approach. Extent of tumor resection was not inferior compared to a cohort of patients operated before with a dramatically greater operative corridor. Visualization of the situs was sufficient in all cases.

Conclusion: Minimizing the endoscopic approach without sacrificing the middle turbinate and protecting as much of the posterior nasal septum and the vomer seems to be not associated with limited tumor resection. Patients nasal quality of life will be presumably better maintained, even though prospective studies are needed to prove this suggestion.