Comparison between endoscopic vs. microscopic removal of hypophyseal adenoma: a retrospective study

To compare endoscopic and neuronavigation-assisted microscopic removal of hypophyseal adenoma in order to detect those variables statistically associated to clinical failures of each technique. Forty-eight patients (27 males and 21 females) with hypophyseal adenoma were treated with microscopy (6 patients) or endoscopic removal (42 patients). Surgery was performed via endonasal trans-sphenoidal approach. Correlations between tumor dimensions (standard and macro-tumor) or surgical techniques (endoscopy vs. microscopic technique) vs. residual tumor, surgical complication (i.e. rhinoliquorrea) and persisting visual deficit, were evaluated. No statistical significance was detected among the studied variables. On the basis of reported data, both techniques are safe if the surgeon is well trained. Neuronavigation applied during endonasal trans-sphenoidal microscopic surgery can precisely define the localization and removal of lesions in the sella region with respect to the margins of important anatomical structures in the neighborhood, decreasing the rate of complications.