Endoscopic Endonasal Transsphenoidal Approach for Pituitary Tumors: 70 Cases Single Surgeon Experience

Objective: To present single-surgeon experience with 70 cases Dx with pituitary tumors treated via endoscopic endonasal transsphenoidal approach. Patient and Methods: Retrospective analysis, January, 2007 to December, 2013 of 70 patients with pituitary tumors with respect of age, sex, presentation, postoperative improvement, and complications. We had 44 males and 26 females with ages of 22 to 90 years and an average of 55.49 years. All patients have been followed up for at least 3 months postoperatively. Results: Overall 30 patients had headache (3 in apoplexy), 29 presented with visual defects, 7 with endocrinopathy (4 GH, 3 Cushing), 1 with disturbed level of consciousness due to hydrocephalus, and 3 patients were incidentally discovered. In addition, hormonal profile was abnormal in 25, more patients presented with other symptoms. Postoperative 3/4 normal GH and IGF levels, 2/3 normal cortisol levels;28/30 visual improvements, 2 unchanged due to irreversible optic neuropathy despite total tumor resection. Complications: One patient back with delayed CSF leak treated with lumbar drain for 3 days with no surgical intervention, one panhypopituitarism, two permanent DI. Recurrence in six patients due to cavernous sinus residual tumor (five did not require surgical treatment; one with high MEB required surgical treatment via same approach). Conclusion: Endoscopic endonasal transsphenoidal treatment of pituitary tumor is the safest and most effective approach with a very low rate of complications.