Abstract
Introduction Endoscopic endonasal surgery has globally improved postoperative results in pituitary
adenomas.
Material and Methods We retrospectively analyzed 101 patients who underwent endonasal endoscopic surgery
for pituitary adenomas in the period from 2016 to 2021. Data on epidemiological variables,
preoperative radiological factors including tumor volume, tumor appearance, cavernous
sinus invasion (modified Knosp scale), degree of extension according to the SIPAP
(stands for the five directions in which a pituitary adenoma can extend: suprasellar,
infrasellar, parasellar, anterior, and posterior) classification, and preoperative
visualization of the healthy gland on magnetic resonance imaging (MRI) were collected
as well as intra- and postoperative cerebrospinal fluid (CSF) leak. As variables of
interest, data on the degree of tumoral resection and preservation of hormonal function
were collected.
Results Among the preoperative factors related to greater tumoral resection, we found a lesser
tumoral extension according to the SIPAP scale, and the absence of a postoperative
CSF leak had a statistically significant relation with greater hormonal preservation.
Conclusion The SIPAP classification is a simple-to-measure preoperative radiological variable
that could predict the extent of resection, and, conversely, the occurrence of a postoperative
CSF leak has been associated with an inferior endocrinological outcome in this type
of surgery.
Keywords
pituitary adenoma - endoscopic endonasal approach - hormonal deficiency - CSF leak
- sellar barrier - Knosp - SIPAP
