Suboptimal Sphenoid and Sellar Exposure: A Consistent Finding in Patients Treated with Repeat Transsphenoidal Surgery for Residual Endocrine-inactive Macroadenomas

Abstract

In patients with residual sellar endocrine-inactive adenomas, a suboptimal opening at the sphenoid keel or sella at the first surgery and a high proportion of fibrous/rubbery tumors likely contributed to prior subtotal removal of otherwise accessible tumor. With a wider exposure, most noninvasive tumors can be totally removed, whereas invasive tumors can be effectively debulked. An endonasal reoperation is well tolerated with a low complication rate.