[Resection of extensive pituitary adenoma via supraorbital keyhole with endoscope-assisted microneurosurgery].

OBJECTIVE

To study the methods and techniques of the treatment for extensive suprasellar pituitary adenoma and repairing hole.

METHODS

From Feb. 2001 to Mar. 2003, 9 patients with extensive suprasellar pituitary adenoma underwent resection via supraorbital keyhole with endoscope-assisted microneurosurgery. Then the remaining tumor was removed with neuro-endoscopy via I and II space of optic chiasma. The small bone flap was fixed with Ti clamp.

RESULTS

After the tumor was removed with microneurosurgery, the remaining tumor was still found with endoscope in 7 cases. Remaining tumor was totally removed in 6 cases, almost removed in 3 cases. The vision improvement was found in 7 cases one week after surgery. In the other 2 cases, the vision remained unchanged. Follow-up was conducted in 6 cases for 6 to 22 months. Neuroradiological recovery of MRI with no recurrence of tumor was observed. No complication of incision was present.

CONCLUSION

Enough intra and extra-cranial space can be provided to operate via orbital roof approach to sellar tumors. Endoscope-assisted microneurosurgery can increase the total-resection and successful rate treatment for extensive suprasellar pituitary adenoma, reduce the possibility of complication, and protect the function of brain from being injured. Fixation of small bone flap with Ti clamp is safe, easy and reliable.