The authors report use of a minimally invasive endoscopic procedure, unilateral endonasal
hemisphenoidotomy, for removal of lesions contained in the sella. The entire procedure
was performed through a single nostril with the use of an endoscope. A unilateral
endonasal hemisphenoidotomy (1.5 cm × 1.5 cm) was performed and was sufficient to
expose the sellar floor for successful removal of adenomas confined to the sella in
three patients. Neither outfracturing the midline septum nor exposure of the opposite
sphenoid ostium was necessary for adequate visualization, tumor exposure, or instrument
maneuverability. There was, however, a learning curve required in order to become
facile and efficient with the equipment. All lesions were completely resected. When
compared to a bilateral endoscopic endonasal sphenoidotomy as practiced by us, the
operative time was reduced and the length of stay was 1 - 2 days. There was less operative
trauma, patients appeared to experience less pain immediately postoperatively, and
their satisfaction was very high. In conclusion, for resection of this group of intrasellar
tumors, the hemisphenoidotomy procedure proved to be less invasive and traumatic,
more simple, and faster than the standard bilateral endoscopic sphenoidotomy.
Key words
Endonasal - Endoscopic - Transsphenoidal - Hemisphenoidotomy - Pituitary - Minimally
Invasive
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Corresponding Author
D B MorelandM. D., F.A.C.S
Director
Buffalo Neurosurgery Group
Sisters Hospital
Buffalo, NY 14214
U.S.A.
Email: E-mail: bng@buffnet.net
Fax: Fax: + 1716-677-6006
