RESULTS OF THE LATERAL RHINOTOMY APPROACH IN TRANSSPHENOIDAL MICROSURGERY FOR GROWTH HORMONE-SECRETING PITUITARY-ADENOMA

The results of transsphenoidal microsurgery for growth hormone (GH)-se creting pituitary adenomas in a series of 47 patients are presented. A modified transsphenoidal approach with lateral rhinotomy was employed for the access to the sphenoid sinus. Remission, defined as mean GH c oncentration less than 2.5 ng/ml, was achieved in 79% of the patients. Macroadenoma size of the tumour and a GH concentration more than 50 n g/ml were factors unfavourable for the outcome. The experience of the lateral rhinotomy approach in transsphenoidal surgery of acromegaly ha s been favourable. The distance from the incision to the sella is shor ter than in rhinoseptal approaches, where the depth of the operative f ield is determined by the distance from the nasal spine to the sella. The lateral rhinotomy also allowed an exposure of the sella of adequat e width in all patients. These aspects of the procedure facilitated ad enoma removal.