Neuroendoscope-assisted transsupraorbitai keyhole approach for the resection of large and giant pituitary adenomas

Objective To report our experience of using neuroendoscope-assisted transsupraorbital keyhole approach to remove large and giant pituitary adenomas.Methods Ten patients admitted to our hospital between Feb.2001 and Oct.2006 were performed on by neuroendoscope-assisted microsurgery via the supraorbital keyhole approach to remove their large and giant pituitary adenomas.Results Total tumor resection was achieved in 3 cases,subtotal in another 4 cases and partial in the remaining 3 cases.No postoperative death or severe complications.During the follow-up study ranged from 6 months to 5 years,the original symptoms were all relatively ameliorated: visual impairment was ameliorated in 8 out of 9 cases;among the 6 patients with abnormally high level of hormone,4 recovered to normal level;2 patients underwentγ-knife treatment after subtotal resection;1 out of the 3 patients undergone partial resection received endoscopic endonasal transsphenoidal surgery to totally remove the tumor and another one received conventional radiotherapy to control its symptoms. There was no obvious evidence of recurrence in our group during the follow-up.Conclusion Neuroendoscope-assisted microsurgery via the supraorbital keyhole approach is minimally invasive and efficacious for the resection of large and giant pituitary adenomas.