Abstract
Objectives: The purpose of this study is to evaluate the efficacy of the endoscopic transnasal approach to sphenoid sinus and clivus, for the treatment of isolated inflamatory pathology, tumor biopsy, and excision of pituitary tumors.
Methods: A retrospective review of 18 patients that were treated during the last 6 years in the Italian Hospital of Buenos Aires with transnasal technique, using a 30 degree rigid endoscope.
Results: Three patients with sphenoid inflamatory pathology: cronic sinusitis, mucocele (2), 1 with CN VI paresis, were cured (normal postoperative CT after 3 years). Seven were benign tumors biopsies: fibrous dysplasia, meningioma (3), prolactin cell adenomas (3). In one patient a mucosal flap of nasopharynx was performed and a clivus biopsy was obtained, resulting a metastasis carcinoma of cervix. Seven were hipophysis approaches: adenomas (6) and craniopharyngioma. The total or partial resection of the middle or superior turbinate was not necessary. There were no complications and postoperative morbidity was minimal.
Conclusion: The endoscopic transnasal approach to sphenoid is a fast and secure technique for the otorhinolaryngologists who are trained in endoscopic surgery. We consider this is the technique of choice for the treatment of localized sphenoid inflamatory disease and tumor biopsy. It provides significant advantages for safe excision of pituitary tumors.
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