Abstract:ObjectiveTo observe the effect of transsphenoidal pituitary adenoma removal via posterior ethmoid and septum approach by opening horizontal part of middle turbinate basal lamella.Methods50 patients with pituitary adenoma were enrolled in this study. The anterior wall of sphenoid sinus was endoscopically exposed and fully opened by lateralizing the posterior part of middle turbinate after removing horizontal part of basal lamella and posterior septum, and then the pituitary adenoma was removed through the sellar floor. Time of operation, volume of blood loss, length of hospital stay, complications (cerebrospinal fluid leakage, diabetes insipidus, intracranial infection, neurological impairment), postoperative nasal function, total resection of the tumor and death were recorded.ResultsThe average operation time was 2.2 hours with an average blood loss volume of 245 ml. The average hospitalization time was 6.2 days, and intraoperative cerebrospinal fluid leakage occurred and was cured with simultaneous repair in 12 cases. The cases numbers of postoperative diabetes insipidus, hyposmia/anosmia and hypopituitarism were 3, 12 and 4, respectively. Visual acuity due to tumor compression or stroke got improved after operation without intraoperative optical nerve damage. Total tumor resection was achieved in 43 cases without death.ConclusionWith advantages of clear surgical field, high total resection rate of tumor, minimal invasion, high safety as well as proper protection of nasal function, the endoscopic surgery of pituitary adenoma via posterior ethmoid and septum approach after the opening the horizontal part of middle turbinate basal lamella is worth popularizing and applying in clinic.
