A COMPARATIVE STUDY BETWEEN ENDONASAL ENDOSCOPIC AND MICROSCOPIC TRANSSPHENOIDAL APPROACHES IN MANAGEMENT OF PITUITARY ADENOMAS

Background: Advances in the era of modern micro-neurosurgery enabled a reduction surgical invasiveness and brain retraction which has been defined as minimally invasive or keyhole surgery. Sinonasal endoscopy brought radical changes concepts pathophysiology treatment sinonasal diseases well techniques. Objective: Assessment patient outcomes regarding transsphenoidal endoscopic microscopic approaches pituitary adenomas. Patients methods: Our study included 40 cases adenomas, operated upon during 2 years, half them (group A; 20 cases) underwent endonasal adenoma resection, while remaining B; using standard transseptal resection. Results: The highest age incidence our was third fourth decades life, with male to female ratio nearly 1:1. Headache commonest presenting symptom series both groups; (60%& 70%) respectively followed by visual impairment; (55%& 60%). Although, loss libido most common endocrinopathies; (75%& 60%) respectively. In CT-sella coronal cuts initial radiographic investigation, performed all cases. It gave an idea about bony anatomy sella, sphenoid sinus, particularly important showing position sinus septum, crucial planning decision operation. study, improvement out-come higher group opposed (100% vs. 71% improved headache, 82% 58% 80% 55% total tumor removal ). Conclusion: Endoscopy offers very special wide visualization, close target inside anatomy. panoramic view provided endoscope, allowing identification landmarks around sella entire procedure, minimizes chance inaccurate orientation.