Complications after endoscopic endonasal transsphenoidal removal of pituitary adenomas

Mikhailov N.I.; Kalinin P.L.; Savin I.A.

doi:https://doi.org/10.17116/neiro201882061105

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Abstract:

The use of endoscopic technique has significantly extended the indications for surgery using the transsphenoidal approach. Currently, more than 90% of pituitary adenomas are operated on transsphenoidally. Transnasal removal of giant pituitary adenomas has become possible. Transition to the endoscopic endonasal approach in removal of pituitary adenomas changed the rate and structure of postoperative complications. We analyzed potential complications after endoscopic endonasal transsphenoidal removal of pituitary adenomas. These include complications of the approach itself (nasal bleeding, perforation of the nasal septum, impaired olfactory function, atrophic rhinitis, synechiae, mucoperiosteal flap necrosis, and external nasal deformities), infectious complications (meningitis, intracranial abscesses), cerebral circulation disorder (subarachnoid hemorrhage, cerebral vasospasm, injury to large vessels, intracranial hematomas), neuro-ophthalmological complications (visual and oculomotor disorders), endocrine (hypopituitarism, diabetes insipidus, hyponatremia) and somatic complications, and nasal liquorrhea. In conclusion, it should be noted that despite continuous improvement of the technique for endoscopic endonasal removal of pituitary adenomas, there is a risk of serious complications, which necessitates the development of techniques for prevention of these complications.

Keywords:

endoscopic neurosurgery

transsphenoidal neurosurgery

pituitary adenoma

Authors:

Mikhailov N.I.

Ivano-Matreninskaya Children’s Clinical Hospital, Irkutsk, Russia

Kalinin P.L.

NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva

Savin I.A.

Federal State Autonomous Institution «N.N. Burdenko National Medical Research Center for Neurosurgery» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia, 125047, Moscow, 4-th Tverskaya-Yamskaya str.,16, Russia

SPIN RSCI: 1342-7065
Scopus AuthorID: 35974373500
ORCID: 0000-0003-3874-4147

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