The trans-nasal endoscopic approach for pituitary tumours, was started by doing sphenoidotomy
, on both the sides or the side where the sinus was larger.
A presumptive diagnosis of a mucocoele was made and an endoscopic transnasal sphenoidotomy
confirmed the diagnosis.
As the lesion was debulked with a microdebrider (Stryker; Michigan, USA), large middle meatal antrostomy and fronto-ethmoid sphenoidotomy
of Cases Polypectomy 6 Polypectomy + Uncinectomy 3 Polypectomy + Uncinectomy + Bullectomy + 1 Ethmoidectomy Polypectomy + Uncinectomy + Ethmoidectomy 2 Polypectomy + Uncinectomy + Septoplasty 2 Polypectomy + Septoplasty 2 Uncinectomy + Bullectomy + Ethmoidectomy + 1 Sphenoidotomy
Polypectomy + Ethmoidectomy + Septoplasty 1 Uncinectomy + Ethmoidectomy 1 Uncinectomy + MMA 1 Figure 3.
A bifrontal craniotomy was performed by the neurosurgery team and bilateral maxillary antrostomy, ethmoidectomy, and sphenoidotomy
were performed by otolaryngology along with resection of the tumor under endoscopic guidance.
Complete resection of the mass was achieved through a posterior septectomy and bilateral sphenoidotomy
with tissue removal.
Right posterior ethmoidectomy, sphenoidotomy
, and draining the content in the Onodi cell (Figure 3) were performed and found whitish bloody mucoid discharge in the Onodi cell with dehiscence of the superior wall exposing the right optic nerve.
Bilateral ethmoidectomy and sphenoidotomy
was done using a microdebrider to achieve control of the posterior most extent of the tumor.
Endoscopic transnasal sphenoidotomy
requires good hemostasis in the operative field.
Surgery was done by the following techniques: Uncinectomy (100%), Middle meatal antrostomy (100%), Anterior ethmoidectomy (86.5%), Posterior ethmoidectomy (67.3%), Sphenoidotomy
(34.6%) Frontal recess surgery (42.3%) and Reduction of middle turbinate (34.6%).
was performed but there was no discharge or mucosal swelling in the oncediseased sinus on MRI.
The patient was submitted to endonasal endoscopic approach with large sphenoidotomy
, marsupialization, and bilateral posterior ethmoidectomy.