Endoscopic Transnasal Transsphenoidal Approach: An East African Center’s Experience

Background and Objective: The endoscopic trans nasal approach is becoming the preferred minimally invasive approach to the sellar and clival region. We review the cases done at our center and describe the importance of neuronavigation intraoperatively in terms of disease clearance and minimizing complications.

Method: Retrospective analysis of patients who underwent endoscopic transsphenoidal surgeries between 2016 and 2018 at a single center in East Africa.

Result: Eighteen cases were analyzed, out of which 16 cases were of pituitary adenoma and 2 cases of clival cyst. Among pituitary adenoma, the tumor was nonsecreting in 14 and secreting in 2 patients. Out of the secretory tumors, the one was the growth hormone producer and the other one was the prolactinoma. No patient developed postoperative complications in terms of CSF rhinorrhea or meningitis; however, there was recurrence of disease in three patients over two years of follow-up. Two patients had diabetes insipidus postoperatively which was managed medically.

Conclusion: The endoscopic transsphenoidal approach to seller tumors proved to be safe when the majority of the tumors were nonsecreting. Use of navigation minimizes the risk of complications and enhances surgical outcome in terms of disease removal.