Endoscopic Transnasal Surgery of Sellar Region

Authors: P. Matoušek 1,3,4 ;  R. Lipina 2,3;  T. Paleček 2,3;  P. Štrympl 1;  T. Pniak 1,3;  Pavel Komínek 1,3
Authors‘ workplace: ORL klinika FN Ostrava 1;  Neurochirurgická klinika FN Ostrava 2;  Centrum endoskopické chirurgie baze lební FN Ostrava 3;  Lékařská fakulta FN Ostrava 4
Published in: Otorinolaryngol Foniatr, 61, 2012, No. 3, pp. 172-177.
Category: Original Article


The paper presents our experience with endoscopic technique and advantages of interdisciplinary collaboration in the endoscopic approach to cranial base.

Material and method:
The patients operated on for intracranial pathology by transnasal approach at the Center of endoscopic surgery of cranial base, Faculty Hospital in Ostrava, were enrolled in the study. The surgery was indicated by neurologist and the approach to the tumor was evaluated by otorhinolaryngologist.

Since January 2008 till January 2011 the authors performed 105 surgeries for pathology in the area of anterior cranial fossa by transnasal endoscopic approach. Ninety patients suffered from adenoma of hypophysis (83 nonfunctional and 7 functional ones). Non-pituitary lesions were the reason for surgery in 15 patients (meningioma 3 times, craniopharyngioma 6 times, epidermoid cyst once, metastasis in the sellar region once, Rathke recess cyst twice, dermoid cyst twice). In 83 patients with nonfunctional adenomas of hypophysis control MR examination resulted in radical resection with 67 patients (80%) and in the remaining 17 patients (20%) partial resection was used. From the total of 15 non-pituitary lesions, radical extirpation was performed in eleven patients.

Serious complications were observed in 8 patients (4 times postoperative liquorrhea, diabetes insipidus 3 times, pseudoaneurysm of carotid artery once), there was no mortality. Postoperative deterioration of vision was not observed.

Endoscopic transnasal approach is a minimally invasive approach which makes it possible to solve adenoma of hypophysis and other pathological conditions in the sellar region.

Key words:
transnasal endoscopic surgery of cranial base, sellar region tumors.


1. Cappabianca, P., Alieri, A., de Divitiis, E.: Endoscopic endonasal transsphenoidal approach to the sella: towards functional endoscopic pituitary surgery. Minim. Invasive Neurosurg., 41, 1998, s. 66-73.

2. Dehdashti, A. R., Ganna A., Karabatsou K. et al.: Pure endoscopic endonasal approach for pituitary adenomas: early surgical results in 200 patients and comparison with previous microsurgical series. Neurosurgery, 62, 2008, s. 1006-1017.

3. Česák, T., Náhlovský, J., Hosszů, T. et al.: Longitudinální sledování růstu pooperačních reziduí afunkčních adenomů hypofýzy. Cesk. Slov. Neurol. N., 72/105, 2009, 2, s. 115-124.

4. Frank, G., Pasquini, E., Farneti, G. et al.: The endoscopic versus the traditional approach in pituitary surgery. Neuroendocrinology, 83, 2006, s. 240-248.

5. Gardner, P. A., Kassam, A. B., Thomas, A. et al.: Endoscopic endonasal resection of anterior cranial base meningiomas. Neurosurgery, 63, 2008, s. 36-54.

6. Hondám, J. A, Schops, M., de Almedia, J. P. C. et al.: Endoscopic endonasal transsphenoidal surgery: surgical resultsof 228 pituitary adenomas treated in a pituitary center. Pituitary, 13, 2010, s. 68-77.

7. Jankovsky, R., Auque, J., Simon, C. M. et al.: Endoscopic pituitary surgery. Laryngoscope, 102, 1992, s. 198-202.

8. Jho, H., Carrau, R.: Endoscopic endonasal transsphenoidal surgery: experience with i fifty patients. J. Neurosurg., 87, 1997, s. 44-51.

9. Kassam, A. B,, Prevedello, D. M., Carrau, R. L. et al.: Endoscopic endonasal skull base surgery: analysis of complications in the authors‘ initial 800 patients. J. Neurosurg., 17, 2010, s. 1-25.

10. Koren, I., Hadar, T., Rappaport Z. H., Yaniv, E.: Endoscopic transnasal transsphenoidal microsurgery versus the sublabial approach for the treatment of pituitary tumors: endonasal complications. Laryngoscope, 109, 1999, s. 1838-1840.

11. Tabaee, A., Anand, V. K,, Barrón, Y. et al.: Endoscopic pituitary surgery: a systematic review and meta- analysis. J. Neurosurg., 111, 2009, s. 545-554.

Audiology Paediatric ENT ENT (Otorhinolaryngology)
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account