Expanded Endoscopic Endonasal Approach for Resection of Residual Parasellar Growth Hormone Secreting Pituitary Adenoma in a Patient with Kissing Internal Carotid Arteries: Technical Nuances

A 43-year-old male presented with acromegaly after a lack of biochemical remission from a previous surgery. Key endoscopic endonasal steps including wide bilateral sphenoidotomies, right middle clinoidectomy to access the clinoidal carotid and the retrogenu compartment, identification of the top of the paraclival carotid by drilling across the sella floor, division of the sellar floor dura to increase the intercarotid distance, and transcavernous mobilization of medial wall.

Publication History

Article published online:
07 February 2025