Medical aspect of endoscopic endonasal transsphenoidal hypophysectomy in skull base center of Basra
Background: Endoscopic endonasal transsphenoidal (EETS) approach is a minimally invasive technique that has gained increased acceptability for the removal of sellar and para-sellar tumors. Objectives: To evaluate the EETH in the skull base center of Basra and compare our EETH procedures with others...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Medical Journal of Babylon |
| Subjects: | |
| Online Access: | http://www.medjbabylon.org/article.asp?issn=1812-156X;year=2021;volume=18;issue=3;spage=224;epage=229;aulast=Alali |
| _version_ | 1818733134706900992 |
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| author | Mustafa H Alali Firas T Obaid Ahmed M Al Abbasi |
| author_facet | Mustafa H Alali Firas T Obaid Ahmed M Al Abbasi |
| author_sort | Mustafa H Alali |
| collection | DOAJ |
| description | Background: Endoscopic endonasal transsphenoidal (EETS) approach is a minimally invasive technique that has gained increased acceptability for the removal of sellar and para-sellar tumors. Objectives: To evaluate the EETH in the skull base center of Basra and compare our EETH procedures with others done in different centers. Patients and Methods: A prospective observational study was carried out in Basra skull base center at Al-Sader Teaching Hospital between August 2017 and July 2019, and it included 50 patients (29 female and 21 male) with a female to male ratio of 1.38:1. We included all patients with a pituitary tumor fit for surgery, and there were no exclusion criteria. The standard technique involved a unilateral, endoscopic, and endonasal approach to the sella turcica via an anterior sphenoidotomy, with enlargement of the natural sphenoid ostium using powered instrumentation and 0° and 30° rigid endoscopes for visualization. This was performed as a joint procedure by a consultant otolaryngologist and a consultant neurosurgeon. Results: The most common presenting symptom for pituitary tumor was headache, which is present in 80% (40 patients) of patients, followed by visual disturbance in 56% (28 patients). The MRI study of the brain and sellar region shows that 46 patients (90%) were diagnosed as having pituitary adenomas. Eighty-four patients present had a tumor larger than 1cm in size. Sixty eight percent (34 patients) had an abnormal hormonal study before the operation, whereas 32% (16 patients) had a normal hormonal analysis. Histopathological examination of the tumors showed pituitary adenoma in 90% (45 patients), followed by craniopharyngiomas in 6% (three patients) and 2% (one patient) was Rathke’s cyst and 2% (one patient) was pituitary carcinoma. Postoperative follow-up result indicated headache improvement in 82% (34 patients), improvement in menstrual disturbance in 67% (13 patients), and vision improvement in 46% (13 patients). Seventy-four percent showed hormonal normalization after EETH, which is statistically significant (P < 0.05). Conclusion: This study show that endoscopic, endonasal, transsphenoidal hypophysectomy is a minimally invasive, effective, and safe procedure to remove pituitary tumors. |
| first_indexed | 2024-12-17T23:44:38Z |
| format | Article |
| id | doaj.art-c5a429e93f884187a147fd7b8e9ba36e |
| institution | Directory Open Access Journal |
| issn | 1812-156X 2312-6760 |
| language | English |
| last_indexed | 2024-12-17T23:44:38Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Medical Journal of Babylon |
| spelling | doaj.art-c5a429e93f884187a147fd7b8e9ba36e2022-12-21T21:28:21ZengWolters Kluwer Medknow PublicationsMedical Journal of Babylon1812-156X2312-67602021-01-0118322422910.4103/MJBL.MJBL_21_21Medical aspect of endoscopic endonasal transsphenoidal hypophysectomy in skull base center of BasraMustafa H AlaliFiras T ObaidAhmed M Al AbbasiBackground: Endoscopic endonasal transsphenoidal (EETS) approach is a minimally invasive technique that has gained increased acceptability for the removal of sellar and para-sellar tumors. Objectives: To evaluate the EETH in the skull base center of Basra and compare our EETH procedures with others done in different centers. Patients and Methods: A prospective observational study was carried out in Basra skull base center at Al-Sader Teaching Hospital between August 2017 and July 2019, and it included 50 patients (29 female and 21 male) with a female to male ratio of 1.38:1. We included all patients with a pituitary tumor fit for surgery, and there were no exclusion criteria. The standard technique involved a unilateral, endoscopic, and endonasal approach to the sella turcica via an anterior sphenoidotomy, with enlargement of the natural sphenoid ostium using powered instrumentation and 0° and 30° rigid endoscopes for visualization. This was performed as a joint procedure by a consultant otolaryngologist and a consultant neurosurgeon. Results: The most common presenting symptom for pituitary tumor was headache, which is present in 80% (40 patients) of patients, followed by visual disturbance in 56% (28 patients). The MRI study of the brain and sellar region shows that 46 patients (90%) were diagnosed as having pituitary adenomas. Eighty-four patients present had a tumor larger than 1cm in size. Sixty eight percent (34 patients) had an abnormal hormonal study before the operation, whereas 32% (16 patients) had a normal hormonal analysis. Histopathological examination of the tumors showed pituitary adenoma in 90% (45 patients), followed by craniopharyngiomas in 6% (three patients) and 2% (one patient) was Rathke’s cyst and 2% (one patient) was pituitary carcinoma. Postoperative follow-up result indicated headache improvement in 82% (34 patients), improvement in menstrual disturbance in 67% (13 patients), and vision improvement in 46% (13 patients). Seventy-four percent showed hormonal normalization after EETH, which is statistically significant (P < 0.05). Conclusion: This study show that endoscopic, endonasal, transsphenoidal hypophysectomy is a minimally invasive, effective, and safe procedure to remove pituitary tumors.http://www.medjbabylon.org/article.asp?issn=1812-156X;year=2021;volume=18;issue=3;spage=224;epage=229;aulast=Alaliendoscopic endonasal transsphenoidalhormonal normalizationpituitary tumors |
| spellingShingle | Mustafa H Alali Firas T Obaid Ahmed M Al Abbasi Medical aspect of endoscopic endonasal transsphenoidal hypophysectomy in skull base center of Basra Medical Journal of Babylon endoscopic endonasal transsphenoidal hormonal normalization pituitary tumors |
| title | Medical aspect of endoscopic endonasal transsphenoidal hypophysectomy in skull base center of Basra |
| title_full | Medical aspect of endoscopic endonasal transsphenoidal hypophysectomy in skull base center of Basra |
| title_fullStr | Medical aspect of endoscopic endonasal transsphenoidal hypophysectomy in skull base center of Basra |
| title_full_unstemmed | Medical aspect of endoscopic endonasal transsphenoidal hypophysectomy in skull base center of Basra |
| title_short | Medical aspect of endoscopic endonasal transsphenoidal hypophysectomy in skull base center of Basra |
| title_sort | medical aspect of endoscopic endonasal transsphenoidal hypophysectomy in skull base center of basra |
| topic | endoscopic endonasal transsphenoidal hormonal normalization pituitary tumors |
| url | http://www.medjbabylon.org/article.asp?issn=1812-156X;year=2021;volume=18;issue=3;spage=224;epage=229;aulast=Alali |
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