Navigation-assisted microscopic removal of hypophyseal adenoma: a retrospective study

Neuronavigation is a commonly used technology that provides continuous, three-dimensional information for the precise localization of and surgical trajectory to brain lesions. This study was performed to evaluate the role that navigation can play in assisting microsurgical trans-sphenoidal surgery for precise localization and removal of pituitary tumours while simultaneously preserving pituitary gland function. Six patients (3 males and 33 females)with hypophyseal adenomas were treated with neuronavigation-assisted removal. Surgery was performed via endonasal trans-sphenoidal approach. Three patients had residual adenomas and two of the relapsed. There was one post operative rhinoliquorrea. In two cases the visual deficit did not significantly improved after operation. No statistical significance was detected among tumor dimensions with residual tumor, surgical complication (i.e. rhinoliquorrea), persisting visual deficit and used of abdominal fat for closing the sphenoidal field, respectively. Microneurosurgical trans-sphenoidal techniques combined with neuronavigation systems can precisely define the localization and removal of lesions in the sella region with respect to the margins of important anatomical structures in the neighbourhood and the endocrinological functionality of the pituitary gland. Neuronavigation can be easy applied during endonasal trans-sphenoidal microscopic surgery and requires a minimal amount of time. It makes operation easier, faster, and probably safer.