ABSTRACT
Endoscopic pituitary and parasellar surgery (EPPS) is a well-established technique for the treatment of sellar and parasellar tumours, especially pituitary adenomas, craniopharyngiomas and meningiomas.1 The advantages it offers, compared with microscopic approaches, include a superior close-up view of the relevant anatomy and an enlarged working angle along with panoramic vision within the surgical area.1,2 Several studies have shown that EPPS decreases postoperative discomfort and hospitalization
time as well leading to faster recovery in comparison with the conventional microscopictechnique. Compared with open transsphenoidal surgery, EPPS is associated with shorter operative times and lessblood loss.1-3
Access to the pituitary gland through the nasal cavity and sphenoid sinus has been described since the past century, using several approaches including the sublabial microscopic to endoscopic transsphenoidal approach. The sellar region and planum sphenoidale can be approached endoscopically directly using the transnasal, transseptal, modified transseptal or transnasal/transseptal binostril method.1,2,4,5
It is often the otorhinolaryngologist who performs the surgical approach through the nasal cavity to the sphenoid sinus because they are more familiar with the anatomy and instrumentation, and have the requisite technical skills, and the neurosurgeon who removes the tumour.1,5,6 This multidisciplinary team approach is not only important in this surgery but is vital in the preoperative assessment of these patients and their postoperative management. Radiologists, intensivists, endocrinologists, anaesthetists and paramedical staff also play a key role.5
