Download PDF
J Neurol Surg B Skull Base 2013; 74(04): 241-246
DOI: 10.1055/s-0033-1342916
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Concomitant Transsphenoidal Approach to the Anterior Skull Base and Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis

Madeleine R. Schaberg
1   Department of Otolaryngology–Head and Neck Surgery, The New York Eye and Ear Infirmary, New York, New York, USA
,
Gopi B. Shah
2   Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
,
James J. Evans
3   Division of Neuro-Oncologic Neurosurgery and Stereotactic Radiosurgery, Department of Neurological Surgery, Thomas Jefferson University, Jefferson Medical College, Philadelphia, Pennsylvania, USA
,
Marc R. Rosen
4   Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University, Jefferson Medical College, Philadelphia, Pennsylvania, USA
› Author Affiliations
Further Information

Publication History

20 April 2012

25 January 2012

Publication Date:
03 April 2013 (online)

    Permissions and Reprints

Abstract

Objectives To describe outcomes of endoscopic resection of sellar tumors with concomitant endoscopic sinus surgery for patients with chronic rhinosinusitis (CRS).

Design Retrospective chart review.

Setting Tertiary care medical center.

Participants Patients who underwent endoscopic transsphenoidal surgery for excision of anterior skull base lesions and simultaneous functional endoscopic sinus surgery (FESS) for CRS between January 2006 and January 2011 by senior authors (MRR and JJE).

Main Outcomes Measured Short- and long-term postoperative complications.

Results Fourteen patients were identified. Average follow-up was 27 months. All patients had preoperative symptoms consistent with CRS. No patients were treated with preoperative antibiotics. Surgical pathology revealed chronic sinusitis in all specimens. Pathology of the intracranial lesions included 11 pituitary macroadenomas, one craniopharyngioma, one chondrosarcoma, and one cholesterol granuloma. Short-term postoperative morbidities included a sphenoid polyp, one adhesion, and one case of pharyngitis. Long-term outcomes included one frontoethmoidal mucocele, one recurrence of nasal polyps, and three cases of acute sinusitis. There were no intracranial complications for the entire follow-up period.

Conclusions Transsphenoidal surgery can safely be performed in the setting of CRS without increased risk of intracranial complications.

Keywords

endoscopic endonasal transsphenoidal approach - anterior cranial base - nasal complications - pituitary - endoscopic sinus surgery
 

  • References

  • 1 Youssef AS, Agazzi S, van Loveren HR. Transcranial surgery for pituitary adenomas. Neurosurgery 2005; 57 (1, Suppl): 168-175 , discussion 168–175
    CrossrefPubMedGoogle Scholar
  • 2 Musleh W, Sonabend AM, Lesniak MS. Role of craniotomy in the management of pituitary adenomas and sellar/parasellar tumors. Expert Rev Anticancer Ther 2006; 6 (Suppl. 09) S79-S83
    CrossrefPubMedGoogle Scholar
  • 3 Adams PF, Hendershot GE, Marano MA. Centers for Disease Control and Prevention/National Center for Health Statistics. Current estimates from the National Health Interview Survey, 1996. Vital Health Stat 10 1999; 200 (200) 1-203
    PubMedGoogle Scholar
  • 4 Rosenfeld RM. Clinical practice guideline on adult sinusitis. Otolaryngol Head Neck Surg 2007; 137 (3) 365-377
    CrossrefPubMedGoogle Scholar
  • 5 Heo KW, Park SK. Rhinologic outcomes of concurrent operation for pituitary adenoma and chronic rhinosinusitis: an early experience. Am J Rhinol 2008; 22 (5) 533-536
    CrossrefPubMedGoogle Scholar
  • 6 Curone M, D'Amico D, Maccagnano E, Bussone G. Fatal Aspergillus brain abscess in immunocompetent patient. Neurol Sci 2009; 30 (3) 233-235
    CrossrefPubMedGoogle Scholar
  • 7 Rajshekhar V. Surgical management of intracranial fungal masses. Neurol India 2007; 55 (3) 267-273
    CrossrefPubMedGoogle Scholar
  • 8 Lubbe D, Semple P. Pre-operative assessment of patients undergoing endoscopic, transnasal, transsphenoidal pituitary surgery. J Laryngol Otol 2008; 122 (6) 644-646
    PubMedGoogle Scholar
  • 9 Senior BA, Ebert CS, Bednarski KK , et al. Minimally invasive pituitary surgery. Laryngoscope 2008; 118 (10) 1842-1855
    CrossrefPubMedGoogle Scholar
  • 10 DeKlotz TR, Chia SH, Lu W, Makambi KH, Aulisi E, Deeb Z. Meta-analysis of endoscopic versus sublabial pituitary surgery. Laryngoscope 2012; 122 (3) 511-518
    CrossrefPubMedGoogle Scholar