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KMID : 0900220190260010026
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대한비과학회지
2019 Volume.26 No. 1 p.26 ~ p.31
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Clinical Usefulness of Trasseptal Transsphenoidal Approach for Pituitary Tumors with Septal Cartilage Removal and Replacement via Modified Killian Incision: Review of 42 Cases
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Kim So-Yeon
Yang Byung-Wook
Lee Young-Woo
Lee Kyung-Chul
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Abstract
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Background and Objectives: The conventional transseptal transsphenoidal approach can inhibit visualization of the surgi- cal field and may change the shape of external nose. We used the transseptal transsphenoidal technique to remove septal carti- lage except the L strut via a modified Killian’s incision and preserved the ‘key-stone area.’ The aim of this study was to verify the usefulness of this technique.
Subjects and Method: Retrospective analysis was carried out on 42 pituitary tumor patients who received this technique by a single otolaryngologist from March 2005 to March 2012 at Kangbuk Samsung Hospital.
Results: The mean patient age at time of surgery was 52 years, and 41 cases were pituitary adenoma and 1 was Rathke’s cleft cyst. Three patients had undergone prior surgery; of which 2 used a pterional approach and 1 a transsphenoidal approach. With regard to complication, there were 2 cases of CSF leakage and 5 cases of septal laceration. There were no cases of meningitis, deformity of external nose, septal perforation, anosmia, or sinusitis. In post operation follow up, 25 cases (59.5%) had no re- sidual tumor, while 17 cases (40.5%) had residual tumor.
Conclusion: This study reveals that transseptal transsphenoidal surgery with septal cartilage removal and a replacement tech- nique for a pituitary tumor are effective, allow easy exposure, and result in a low complication rate.
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KEYWORD
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Transsphenoidal approach, Pituitary adenoma, Killian incision
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