Evaluation of Subfrontal, Pterional and Endoscopic Endonasal Approaches for Surgical Management of Suprasellar Pituitary Adenoma with Parasellar Extension
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- Category: Vol. 85, March 2017
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Evaluation of Subfrontal, Pterional and Endoscopic Endonasal Approaches for Surgical Management of Suprasellar Pituitary Adenoma with Parasellar Extension, HELMY A. ELDESSOUKY, SHERIF G. AL-MEKAWI, ALAA A. ABD EL-AZIZ, OMAR M. EL-FALAKY, MOHAMED ALAA EL-DIN MOHAMED and MOHAMED ABD EL-HADY MOHAMED
Abstract
Background: Several critical structure traverse suprasellar and parasellar regions including the circle of Willis, optic nerves and optic chiasm, hypothalamus, pituitary infundibulum, and the infundibular and suprachiasmatic recesses of the third ventricle. There are several pathological lesions in this area, pituitary adenomas and suprasellar meningiomas constitute the most common lesions.
Patients and Methods: Eighteen patients with suprasellar pituitary adenomas with parasellar extension were operated via subfrontal, pterional and endoscopic endonasal approaches, all had immediate post operative CT scan and followed-up clinically and radiologically for 6 months.
Results: Regarding presenting symptoms, intraoperative assessment of each approach, tumor excision radicallity, post operative status, ICU and hospital stay.
Conclusion: Visual symptoms were found to be the most common affecting symptoms in all of these study patients followed by headache. The most common post operative complication was lid edema followed by CSF leak.
Radical excision performed in 8 patients via pterional approach, in 6 patients via subfrontal approach and in 3 patients via endoscopic endonasal approach.