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KMID : 0942820020010020093
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Journal of Korean Brain Tumor Society
2002 Volume.1 No. 2 p.93 ~ p.101
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Transsphenoid Approach
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Park Sang-Keun
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Abstract
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First successful removal of pituitary tumor via the transsphenoidal approach was reported in 1907. Even though the admittable benefits of this approach based on direct and short extracranial route to sellar region, its clinical application came up against wall due to higher morbidity and mortality rates. But this approach had been used and developed continuously by a large numbers of named neurosurgeons. With the development of antibiotic drugs and modern microinstrumentation, transsphenoidal approach is the preferred approach for lesions confined to the sellar turcica and parasellar regions, and in some cases lesions of clibus as well. The routes of access for the transsphenoidal approach are sublabial transseptal, endonasal submucosal transseptal, direct endonasal with septal pushover, and endonasal endoscopic. Recently efforts have been made to use frameless stereotaxy, real-time intraoperative imaging, and the endoscope to improve effectiveness of the approach with minimal morbidities. Transsphenoidal surgery seems to be a reasonably safe procedure, with a mortality rate of less than 1%. However, a significant number of complications do occur, especially performed by less experienced surgeons. In hope of being better understood of this procedure the author has reviewed related literatures, and presents the history, the technique, the complications, and the modern evolution of transsphenoidal approach.
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KEYWORD
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Transsphenoidal approach, Pituitary tumor, Surgical technique, Sellar turcica
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