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August 14-16, 2017 | Toronto, Canada
BRAIN DISORDERS AND DEMENTIA CARE
4
th
International Conference on
Neurosurg, an open access journal
ISSN: 2471-9633
P
ituitary tumors are most commonly approached through
the trans sphenoidal approach, and tumor resection
is most often performed using the operating microscope.
More recently the endoscope has been introduced for use
either as an adjunct to or in lieu of the microscope. Both the
microscopic and endoscopic transsphenoidal approaches to
pituitary tumors allow safe and effective tumor resection.
This study showed the advantages and disadvantages of the
pure transsphenoidal endoscopic approach compared with
the standard microscopic approach. Patients and methods:
This is a retrospective study of forty patients presented
with pituitary macroadenoma including both sexes, with
ranging age from 20-50 years. These patients presented
to the neurosurgery department of Al-Azhar university
hospitals during the period from October 2010 to October
2013. The Patients were divided into two groups: The
1stgroup; included 20 patients, who subjected to endoscopic
endonasal transsphenoidal pituitary surgery. The 2nd group;
included 20 patients, were subjected to classic microscopic
sublabial transsphenoidal pituitary surgery. Results: This
comparative study was including two groups; the first group
representing twenty patients with pituitary tumors who
operated using endoscopic transsphenoidal technique; and
the second group showed twenty patients with pituitary
tumors were operated using the microscopic sublabial
transsphenoidal technique. The patients in the first group
included 5 males (25%) and 15 females (75%) and in the
second group included 8 males (40%) and 12 females (60%)
with age ranging from (20-50) years (median: 35 years). They
are presented by one or more symptoms. The commonest
symptoms were headache (92.5%), followed by endocrinal
symptoms (80%), then visual symptoms (75%). In the first
group total removal of the lesion was achieved in 10 cases
(50%), while subtotal removal was achieved in 8 cases(40%),
and partial removal was achieved in 2cases (10%). While
in the second group total removal was achieved in 5 cases
(25%), subtotal removal was achieved in 7 cases (35%) and
partial removal was achieved in 8 cases (40%). Conclusion:
The pure endoscopic approach is a safe, effective approach to
sellar region tumors that offers several advantages over the
microscopic approach. It provides an excellent wide-angle
and magnified view of the operative anatomy, and although
it requires more anatomical exposure it remains within the
group of minimally invasive approaches to the sella. High
disease control rates and low rates of complications are
some of the most important points related to the technique.
Some of the factors related to the success of endoscopic
surgery are lesion size, suprasellar/ parasellar extension, and
the degree of sella floor erosion.
Speaker Biography
Mahmoud Farid Neurosurgery MD, Ph.D. associate professor of Neurosurgery faculty
of medicine Al Azhar University. Has completed his Ph.D. of Neurological surgery at Al
Azhar University, Cairo, Egypt in 2004. His specialist training involved intense study,
research and teaching of both non operative and operative care and treatment of spine
and brain surgery. He has authored numerous public international and national works
and provides presentations on topics related to the brain and spinal lesions. Expertise
in all neurological field and special interest in skull base surgery and microscopic
minimal invasive spine surgery. He has experience of work in the Neurosurgery field in
Gulf area from 2010 until present were cranial and spinal cases has been managed as
well as the peripheral nerves lesions.
e:
faridneuro@yahoo.comEndoscopic versus microscopic approach for management of pituitary tumors
Mahmoud Farid
Al-Azhar University, Egypt
Mahmoud Farid, Neurosurg 2017, 2:2
DOI: 10.21767/2471-9633-C1-005