Endoscopic Endonasal Trans-Sphenoidal Pituitary Surgery (EETSS): Clinico-Radiological Presentation and Outcome in Ilorin: Our Experience
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Date
2021
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Publisher
Otorhinolaryngology Society of Nigeria.
Abstract
Objective: To share our experience on the clinical presentation and management of patients with pituitary adenoma using Endoscopic Endo-Nasal Trans-Sphenoidal Surgery (EETSS
Materials and Method: A retrospective review of all patients with non-functional pituitary macro-adenoma seen in who underwent EETS approach between May 2012 and April 2018. The clinical presentations of the patients were documented. All Patients had pre and postoperative visual assessment and they had radiologic investigation. Endocrine evaluations were done pre and postoperatively. All patients were operated by a combined team of Ear, Nose and Throat (ENT) surgeons and Neurosurgeons using rigid endoscope 18cm (4mm; 0 and 30 degree).
Results: A total of 18 patients; 12 females and 6 males, were operated via EETS. All patients had visual impairments at presentation which improved postoperatively in 14 patients. 6 patients were postmenopausal, 5 had amenorrhea with secondary infertility. There were two postoperative deaths in intensive care unit. The Mean hospital stay was 4.9 days. Histological diagnosis of pituitary adenoma in was made in 17 patients and one patient had malignant mucoepithelial tumour.
Conclusion: Pituitary tumour constituted about 10.5% of all intracranial tumors in our centre, visual impairment is the commonest presentation and total tumor resection via the EETS is about 78%. The approach showed improve vision in 2/3rd postoperatively, mean hospital stay was about 4.9days with nasal crust formation being the most observed complication and mortality of 11.1%.
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Keywords
Endoscopic, Endonasal, Transphenoidal, Pituitary, Visual impairment, Nasal Crust