Complications of trans-sphenoidal surgery: The Wellington experience

Background: All patients who underwent trans-sphenoidal surgery between Jan uary 1984 and December 1998 were reviewed to assess morbidity resulting fro m this operation. Methods: There were 185 operations on 165 patients. The operative approach was sublabial in 80 cases and transnasal in 105. One surgeon (VB) performed the vast majority of operations. Results: Complications included nasal perforation (7.6%), transient diabete s insipidus (4.9%), permanent diabetes insipidus (3.8%), cerebrospinal flui d fistula (4.3%), donor site haematoma (2.2%) and residual tumour haemorrha ge (1.6%) causing ophthalmoplegia (1.1%) and loss of vision (1.1%). Other c omplications included epistaxis (1.1%), meningitis (0.5%) and sinusitus (0. 5%). Injury to the anterior superior alveolar nerve also occurred in the su blabial approach in 63% of patients. There were no perioperative deaths. Conclusions: There is a small but significant risk of a number of complicat ions that should be considered for informed consent of this procedure.