Objective: We describe a new endoscopic transethmoid approach for pituitary surgery and to compare it with other surgical techniques.
Study design and setting: Eleven patients undergoing pituitary surgery from September 2000 through January 2002 underwent an image-guided endoscopic transethmoid procedure to remove pituitary tumors. Ease of approach, resection, exposure of the surgical field, and operative complications were documented.
Results: Endoscopic ethmoidectomy permits enhanced exposure and simplified tumor resection. The use of one nostril to stabilize the endoscope and the other to pass instruments affords a bimanual procedure that avoids the difficulty of small nares and keeping the scope fixed while exchanging instruments. Operative morbidity was low with no significant complications in this pilot study.
Conclusions: This approach opens a generous operative exposure while safely allowing room to endoscopically maneuver and affords direct access should revision surgery be needed.
Significance: This procedure uses a technique familiar to otolaryngologists and may be used for pituitary and other skull base tumors.