Outcomes of intraoperative ultrasound for endoscopic endonasal transsphenoidal pituitary surgery in adenomas with parasellar extension

Pituitary adenomas with parasellar extension present a technical challenge for adequate visualization and gross total resection (GTR). The endoscope improves identification of extension, however, additional intraoperative imaging adjuncts can further augment visualization. Intraoperative ultrasound (iUS) may provide viable cost-effective solution imaging. We sought to assess the ability predict extent on 3-month postoperative magnetic resonance (MRI) in pituitary extension. Twenty consecutive patients undergoing endoscopic endonasal transsphenoidal surgery assistance were prospectively collected. findings recorded during each case. MRI studies reviewed blinded fashion residual tumor compared findings. Median preoperative Knosp grade was 2. Cavernous sinus invasion encountered intraoperatively 3 patients, all whom preoperatively. operative time 152 min. Based iUS findings, 17 expected have GTR while underwent subtotal resection. 18 completed MRI. concordant 16 cases (88.9%) only two instances discordance. reliably as assessed by Image capture interpretation vary based operator experience. Ultrasound provides reliable immediate assessment resection, normal gland other important neurovascular structures.