Endoscopic transnasal transsphenoidal microsurgery versus the sublabial approach for the treatment of pituitary tumors: Endonasal complications

Objective: To evaluate the nasal complications after transnasal transspheno idal operations for pituitary tumors, comparing two surgical techniques: tr aditional sublabial transseptal and endoscopic transseptal techniques. Stud y Design: We retrospectively evaluated by self-reported questionnaire and e ndoscopic examination the nasal condition of 40 consecutive patients with p ituitary tumors: 20 patients had endoscopic surgery and 20 had surgery with the traditional sublabial technique. Results: Compared with the traditiona l technique, the endoscopic approach was associated with a shorter operativ e time (about 40 min), shorter hospitalization time (about half), absence o f recurrent epistaxis snoring and denture problems, and lower incidence of septal perforation, synechia, and crust formation. Furthermore, loss of nas al tip projection was found only in the group that had surgery with the sub labial technique. Conclusions: Endoscopically guided transseptal transsphen oidal surgery is simple to perform and time-saving, and it results in fewer nasal and denture complications than the sublabial technique. At the same time, it allows the surgeon all the benefits of the binocular microscopic s urgical field that are associated with the traditional approach.