Endoscopic Transnasal Transsphenoidal Microsurgery Versus the Sublabial Approach for the Treatment of Pituitary Tumors: Endonasal Complications

TLDR

The study aimed to compare nasal complications following transnasal transsphenoidal pituitary tumor surgery between traditional sublabial transseptal and endoscopic transseptal techniques. A retrospective review of 40 consecutive patients—20 undergoing endoscopic transseptal and 20 sublabial transseptal surgery—used self‑reported questionnaires and endoscopic examinations to assess postoperative nasal status. Endoscopic transseptal surgery resulted in shorter operative and hospital stays, eliminated recurrent epistaxis, snoring, and denture issues, and reduced septal perforation, synechia, and crust formation, while loss of nasal tip projection occurred only in the sublabial group, demonstrating fewer nasal and denture complications and time savings with comparable microscopic benefits.

Abstract

Abstract Objective: To evaluate the nasal complications after transnasal transsphenoidal operations for pituitary tumors, comparing two surgical techniques: traditional sublabial transseptal and endoscopic transseptal techniques. Study Design: We retrospectively evaluated by self‐reported questionnaire and endoscopic examination the nasal condition of 40 consecutive patients with pituitary tumors: 20 patients had endoscopic surgery and 20 had surgery with the traditional sublabial technique. Results: Compared with the traditional technique, the endoscopic approach was associated with a shorter operative time (about 40 min), shorter hospitalization time (about half), absence of recurrent epistaxis snoring and denture problems, and lower incidence of septal perforation, synechia, and crust formation. Furthermore, loss of nasal tip projection was found only in the group that had surgery with the sublabial technique. Conclusions: Endoscopically guided transseptal transsphenoidal 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 surgical field that are associated with the traditional approach.