Comparative Study Of Endoscopic Endonasal Trans-sphenoidal Approach Through The One-nostril And Two-nostrils For Pituitary Adenomas

ObjectiveTo compare the clinical application and complications of endoscopic endonasal trans-sphenoidal approach through the one-nostril and two-nostrils for pituitary adenomas resection.MethodsReview retrospectively the clinical datas of 80 pituitary adenoma patients who had got the surgery in our hospital from May 2012 to December 2016,of which 45 were via the unilateral nostril group and 35 were via bilateral nostrils group.Tumor resection rate,improvement of clinical symptoms and hormonal level,the incidence of complications(CSF leak,epistaxis,intracranial infections,diabetes insipidus,etc)were compared between two groups.ResultsFor microadenomas,intrasellar macroadenomas and partially extrasellar extension macroadenomas,tumor resection rate,hormonal outcome,visual improvement were similar beteween two groups.But one-nostril group had fewer rhinological complications.However,for the macroadenomas with extensive extrasellar invasion,tumor resection rate of two-nostrils group was better than the one of unilateral nostril group.ConclusionThe one-nostril method is adequate for most microadenomas and some macroadenomas,two-nostrils method is especially suitable for the macroadenomas with extensive extrasellar invasion.