Clinical Outcomes of Endoscopic Unilateral Nasal Puncture Chopstick Technique for Transnasal Transsphenoidal Pituitary Adenoma Resection (A Report of 6 Cases)

WENG Raonan; JIANG Changzhen; ZHANG Jianwang; HUANG Dayang; SU Zhimin

doi:10.13919/j.issn.2095-6274.ZHJY202410030

Abstract：Objective To investigate the clinical efficacy of endoscopic single nostril chopstick technique for the removal of pituitary adenomas outside the pseudocapsule of the sphenoid sinus. Methods A retrospec-tive collection of clinical data was conducted on six patients who underwent endoscopic single nostril chopstick technique transnasal transsphenoidal pituitary adenoma surgery in the neurosurgery department of Anxi County Hospital from January 2021 to December 2023. The degree of imaging resection of pituitary tumors,endocrine conversion rate,and incidence of cerebrospinal fluid leakage were evaluated and analyzed after surgery. Re-sults no tumor residue was found in 6 patients after surgery,5 patients with headache showed significant relief,1 patient with amenorrhea resumed menstruation,and 3 patients with partial visual field defects showed significant improvement. Hormone levels in 3 patients with pituitary dysfunction were basically the same as before surgery,while hormone levels in other types of tumors were normal;One patient developed temporary diabetes insipidus 3 days after surgery and recovered after 1 week of treatment;None of the 6 patients experienced cerebrospinal fluid leakage. At a 3-month follow-up after surgery,3 patients still had mild headaches,1 patient with amenorrhea had regular menstruation,2 patients with pituitary dysfunction were basically the same as before surgery,and 1 patient had improved hormone levels;Pituitary MR plain scan+enhanced follow-up showed that the tumor was completely removed and no recurrence was observed;None of the 6 patients experienced diabetes insipidus or cerebro-spinal fluid leakage. Conclusion Endoscopic single nostril chopstick technique for the resection of pituitary adenomas outside the pseudocapsule of the nasal but-terfly has the advantages of minimal trauma,high tumor resection rate,high biochemical improvement rate,and low incidence of cerebrospinal fluid leakage. It is suitable for promotion and application.