Advanced Endoscopic Neurosurgery, Removal of Pituitary Adenomas and Skull Base Tumors Using Transnasal Route

Project no. 23464 · Status: Kapanmış (Yayın bekleniyor) · 2022

Summary

Developed by Olympus (Tokyo, Japan), the endoscopic skull base surgery narrow band imaging system is an endoscopic technology that enhances the visualization of mucosal and submucosal vessels. It has been anticipated that this technology could improve the excision rates in pituitary adenomas. This study aimed to compare the surgical outcomes of pituitary adenoma cases, aged 18 and over, who were operated on for the first time at the Ege University Department of Neurosurgery by the same surgeon using this system over 2 years, with those operated on since 2017. Factors such as age, sex, preoperative and postoperative tumor size, excision rate, Knosp grade as an indicator of complexity, and pathology results were examined. During the project period, 39 patients were operated on using the Olympus system, and 22 of these patients were found to meet the study criteria. Conversely, among those operated conventionally, 23 patients were deemed suitable for the study. No difference was found between the two groups in terms of age (p=0.29), sex (p=0.67), and type of pathology (p=0.4). The complication rates of both groups were found to be similar. It was observed that cases with higher Knosp grades (n=18, 40%) had lower excision rates (p<0.001). The tumor size was found to be 11.79 cm³ in the Olympus group and 7.98% in the non-Olympus group (p=0.18). Knosp grades were also higher in the Olympus group, indicating cases with more invasion (p=0.039). In the analyses, the average excision rate in cases using the Olympus device was found to be 90.31%, compared to 92.07% in cases not using the device (p=0.296). Although the excision rates of the two groups were similar, the fact that similar results could be achieved despite higher surgical complexity in the Olympus group suggests that the use of this device could be beneficial for surgical outcomes. Therefore, it would be appropriate to conduct further studies with more patients for this purpose.

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