Abstract
Endoscopic transsphenoidal surgery (eTSS) is widely employed for the surgical treatment of pituitary adenoma.
Surgery-assisted endoscopy offers a wider visual field than previous methods and allows surgeons to readily
approach the cavernous sinus, which is the most difficult area to resect. Extensive opening of the sellae floor is
necessary when the tumor invades the cavernous sinus; however, the evidence supporting this remains inadequate.
We retrospectively investigated 31 consecutive cases of pituitary adenoma that were treated via endoscopic
transphenoidal surgery. These cases were divided into 2 groups based upon the wideness of the sellae opening
(wide-opening group and narrow-opening group), and the patients’ age, sex, operating time, Knosp grade, tumor
resection rate and side effects were evaluated. As a result, tumor resection rates were significantly higher in
wide-opening group compared with the narrow-opening group. This finding suggests that wide opening of the
sellae floor contributes to extensive resection of pituitary adenoma. In this study, as a limitation, grouping was
performed chronologically (recently cases were grouped in the wide-opening group), so that the operators’ learning curve could be a confounder. Further investigations, including a prospective study, should be conducted to
confirm these findings.
