Skull BaseInstitute

Los Angeles, California

Endoscope-assistedpituitary surgery

• “With currently available operating microscopes, depth of focus has been improved but the “straight” vision still limits visualization of hidden presellar and parasellar recesses and lateral recesses of the sphenoid bones in pituitary surgery.”

Helal MZ. Combined micro-endoscopic trans-sphenoid excisions of pituitary microadenomas. Eur Arch Otorhinolaryngol 1995;252:186-9.

Endoscope-assistedpituitary surgery

• “In contrast, the telescopic vision of the nasal endoscopes has an unlimited depth of focus with the angled telescopes providing added visualization of previously hidden recesses.”

Helal MZ. Combined micro-endoscopic trans-sphenoid excisions of pituitary microadenomas. Eur Arch Otorhinolaryngol 1995;252:186-9.

Assessment of the efficacy of endoscopy in the resection of

pituitary adenomas

Reza Jarrahy, M.D.

George Berci, M.D

Hrayr K. Shahinian, M.D.

Endoscope-assistedpituitary surgery

• Objective: To obtain evidence that the use of endoscopy in pituitary surgery improves visualization and outcomes

• Design: Case series with retrospective review of medical records, operative videotape

• Interventions: Endoscope-assisted microscopic tumor resection via sublabial transseptal transsphenoidal approach

Endoscope-assistedpituitary surgery

• Results:– 33% of all patients had tumor fragments that

were only able to be identified endoscopically (lateral recesses of sella).

– These patients represented 43% of cases of macroadenoma.

Endoscope-assistedpituitary surgery

• Conclusions:– Endoscopy provides distinct advantages over

microscopy in imaging intrasellar and parasellar structures during pituitary surgery.

– The potential impact upon the efficacy of tumor resection and subsequent rates of recurrence is significant when endoscopy is implemented as an imaging modality in this setting.

Jarrahy R, Berci G, Shahinian HK. Assessment of the efficacy of endoscopy in the resection of pituitary adenomas. Arch Otolaryngol Head Neck Surg. pending review.