Removal of sellar tumors involving beyond the sellar turcica via endoscopic trans-nasal-nasal septum-sphenoid approach

Objective To summarize the experience in removal of sellar tumors involving beyond the sellar turcica via endoscopic trans-nasal-nasal septum-sphenoid approach,and to evaluate the surgical effect and complications.Methods 13 cases of sellar tumors involving beyond the sellar turcica were involved.In all csess,a procedure was carried out which including endoscopic resection of the posterior part of the middle turbinate,and nasal septum and the anterior wall of bilateral sphenoid sinuses,abrasion of the bone of base-sella and surroundings in order to remove the tumors.The efficacy and complications were assessed.Results Postoperative pathological examination demonstrated that pituitary adenoma occurred in 8 patients,cranopharyngioma in 4 and meningioma in one.The tumors were completely removed in 8 cases,partially removed in 4.The another one died 6 days after operation.The major postoperative complications included diabetes insipidus in 13 cases,cerebrospinal fluid leak in three,meningitis,and hypothalamic failure in one each.Conclusion Modified endoscopic trans-nasal-sphenoid approach may be a choice for sellar tumors involving beyond the sellar turcica.However,it is necessary to make a choice carefully because of the severe surgical risks.