Türk Nöroşirürji Dergisi 2015 , Vol 25 , Num 1
The Comparison of Endoscopic and Microscopic Transsphenoidal Approaches in Pituitary Surgery
Hakan ÖZALP1, Gökmen KAHİLOĞULLARI1, Kutsal Devrim SEÇİNTİ1, Bora TETİK1, Melih BOZKURT1, Cem MEÇO2, Ağahan ÜNLÜ1
1Ankara Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, Ankara, Türkiye
2Ankara Üniversitesi, Tıp Fakültesi, Kulak Burun Boğaz Hastalıkları Anabilim Dalı, Ankara, Türkiye
AIM: The aim of study was to compare the microscopic and endoscopic transsphenoidal approaches in pituitary adenomas.

MATERIAL and METHODS: 59 patients with pituitary adenomas were operated via the transsphenoidal approach. Thirty-one patients were operated with a microscope (microscope group (MG)) and 28 were operated with an endoscope (endoscopic group (EG)). The cases were evaluated and compared in terms of age, sex, endocrine type of the tumor, presence of visual symptoms, plasma biochemistry and hormone levels, pre and postoperative imaging parameters, presence of residual tumor, and remission and complication rates.

RESULTS: In secretory adenomas, early remission was achieved at a rate of 63% in MG and 86% in EG and late remission was achieved at a rate of 50% in MG and 93% in EG. On follow-up magnetic resonance imaging, total excision was achieved at a rate of 52% in MG and 79% in EG. Cerebrospinal fl uid leakage was observed at a rate of 45% in MG and 64% in EG. Pituitary insuff iciency occurred in 12% or MG and 7% of EG patients. Transient diabetes insipidus occurred in 2 patients in MG and 3 patients in EG but all cases improved except one patient in MG. Only one patient died in the postoperative period due to cardiac problems.

CONCLUSION: The results reveal that the endoscopic approach is superior to the microscopic approach in the transsphenoidal approach for pituitary adenomas in various aspects including hormonal and radiological results and complication rates. Anahtar Kelimeler : Pituitary adenoma, Transsphenoidal approach, Microscope, Endoscope