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Endoscopic Pituitary Adenoma Resection

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Evolution of Endoscopic Pituitary Adenoma Resection

Endoscopic Pituitary resection via a trans-sphenoidal approach is relatively noninvasive, using the nasal passages and knowledge of the anatomy of the paranasal sinuses to navigate to the base of the skull. Both sides of the nasal passages are accessed, and traditionally a portion of the posterior nasal septum is resected to create a window, allowing surgical instrumentation via both nasal passages simultaneously.

Once the skull base underlying the pituitary gland is encountered (the sella turcica), the bony skull base can be drilled away in order to expose the pituitary adenoma. Commonly, a skilled Otolaryngologist will perform this portion of the procedure to provide adequate exposure for the Neurosurgeon. Next, the neurosurgeon will perform the pituitary adenoma resection through on nasal passage, while the Otolaryngologist controls an endoscopic camera in the contralateral nasal passage to provide visualization.

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