Semi-Nasal Septal Mucosal Flap:An Improved Technique In Endoscopic Transsphenoidal Surgery For Pituitary Adenoma-Feasibility,Indications,and Technical Prerequisites

Object:To study the role of semi-nasal septal mucosal flap in endoscopic transsphen-oidal surgery for pituitary adenoma.Method:Retrospective analysis of clinical data of 62 cases patients with pituitary adenoma who underwent endoscopic semi-nasal septal mucosal flap transsphenoidal surgery in the Department of Neurosurgery,Jiangxi Provincial People’s Hospital(JPPH)from 2016 to 2018 Result:In the 62 pituitary adenoma patients,55(88.71%)cases had no residual or recurrence of tumors,4 cases had residual tumors,and 3 cases had a recurrence.There were 5 cases(8.06%)with cerebrospinal fluid leakage,3 patients(4.84%)with intraoperative diaphragm sellae ruptured,and 2 cases of delayed cerebrospinal fluid leakage(2 cases patients had a long history of uncontrolled cough),2 cases were cured after the operation of cerebrospinal fluid rhinorrhea repair or conservative treatment.Intracranial infection(ICI)was occurred in 2 cases(3.23%).There were 17 cases(27.42%)with transient diabetes insipidus after the operation,and one with long-term diabetes insipidus(1.61%).There were 9 cases(14.52%)with new hypopituitarism after surgery.One patient was suffering from post-surgical epistaxis.Fifty-six(90.32%)patients had an excellent olfactory recovery postoperatively and did not affect healthy life.Four patients(6.45%)had significant hypoesthesia,2 patients(3.23%)had severe hypoesthesia and orolfactory anesthesia,all of whom were related to nasal mucosal adhesion and ethmoid sinusitis.Conclusion:The semi-nasal septal mucosal flap can also achieve a higher tumor resection rate,reduce nasal complications and improve patient comfort.