2012, Number 2
Otorrinolaringología 2012; 57 (2)
Tristán HCP, Castañeda LMR, Pintos MLM
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ABSTRACTBackground: Currently, the surgical treatment of pituitary adenomas in more than 95% of the cases is via transnasal. The use of endoscopic approaches has opened new possibilities which can be more effective in the resection of pituitary adenomas.
Objective: To compare the effectiveness of the endoscopic approach with that of transseptosphenoidal approach.
Material and methods: We performed a case control, prospective and retroelective study of patients with diagnosis of pituitary adenoma treated with transnasal approaches. Fifty-one patient files were reviewed and divided into two groups. Group E: patients with endoscopic approach (N = 23) and group T: with transseptosphenoidal approach (N = 28) in the Regional Hospital Lic. Adolfo López Mateos from January 2002 to February 2009. The study included patients with diagnosis of pituitary adenoma, managed surgically, with follow up of at least six months and complete file.
Results: Fifty-one complete files were reviewed. Mean age of patients was of 48.3 years ± 4.91. Microadenoma accounted for 73.9% patients with endoscopic approach and macroadenoma, 26.1%, with a mean size of 12.9 cm. Immediate complications with endoscopic approach were: insipid diabetes (8.7%), extrusion of nasal packing (4.3%) and amaurosis (4.3%). Mediate complications were: residual septal deviation (4.3%), and formation of synechiae (4.3%). In the group T immediate complications were: insipid diabetes (21.4%), epistaxis (7.1%) and extrusion of nasal packing (3.6%). Mediate complications were: granuloma formation in surgical wound (7.1%), septal perforation (7.1%) and synechiae formation (3.6%, p › 0.05). Recurrence with endoscopic technique was 17.4% and with transseptosphenoidal approach 21.4% (p › 0.05).
Conclusions: The present complications were expected as reported in the literature; however, the comparison between the two techniques is not statistically significant.