Türk Nöroşirürji Dergisi 2014 , Vol 24 , Num - Ek
Endoscopic Endonasal Transsphenoidal Approach to the Pituitary Adenomas
Burak ÇABUK, İhsan ANIK, Savaş CEYLAN
Kocaeli Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı ve Hipofiz Araştırma Merkezi, Kocaeli, Türkiye Endoscopic endonasal transsphenoidal approach to the sellar region is now routinely used for the same indications as the conventional microsurgical technique in many centers around the world. In 1963, Guiot and colleagues first proposed the use of an endoscope as part of a transnasorhinoseptal microsurgical approach. This technique has gained increasing acceptance by neurosurgeons.

Endoscopic pituitary surgery differs from microscopic surgery since it requires a steep learning curve for endoscopic skills and two-dimensional visualization.

Better approaches are enabled for pituitary adenomas in the parasellar and suprasellar location with increasing endoscopic experience.

Pituitary adenomas invading the cavernous sinus are one of the greatest challenges in neurosurgical practice. Extended surgical techniques should be used for the removal of the cavernous sinus component in pituitary adenomas invading the cavernous sinus.

Extended approaches are essential for reaching the area from the lamina cribrosa to the cranio-cervical junction. Weiss originally described the extended transsphenoidal approach in 1987.

Improved visualization with 0° and angled endoscopes allow the surgeon to identify anatomic landmarks. Angled endoscopes especially provide great advantages for the removal of tumor remnants at the superior and lateral recesses. Different treatment modalities should be considered to achieve remission during the follow-up period in patients with secretory pituitary adenomas. Anahtar Kelimeler : Endoscopic endonasal approach, Pituitary adenomas, Transsphenoidal approach