Abstract
Endoscopic surgery by the transethmoidal·transsphenoidal approach for pituitary adenomas provides not only a well-illuminated, clear view of the entire sphenoidal sinus, but enables the use of a variety of endoscopes with different visual angles. Since the sella turcica can be completely visualized, the risk of leaving tumor tissue behind is greatly reduced. Another, major advantage of this approach is that a second surgery can be easily performed at a future date, if necessary. Pituitary adenomas accompanied by chronic sinusitis involve the risk of infection in the sella turcica. For this reason, the correction of both conditions in a single operation is contraindicated. Surgery for the chronic sinusitis should be performed first, and only when that condition has completely disappeared should the adenoma be excised. In this case, the selection of the transethmoidal·transsphenoidal approach makes it possible to operate on the pituitary adenoma using the same route that was used to correct the chronic sinusitis. We have recently diagnosed three cases of pituitary adenoma accompanied by chronic sinusitis. Endoscopic intranasal surgery was performed first. Several months later, once the suinus mucosa, had epithelized, the pituitary adenoma was excised using the same route. Thus, in cases where the presence of a pituitary adenoma is accompanied by chronic sinusitis and two sargeries are required, endoscopic surgery via the transethmoidal·transsphenoidal approach is very advantageous.
