Endoscopic Endonasal Transsphenoidal Surgery

  • E. de Divitiis
  • P. Cappabianca
Part of the Advances and Technical Standards in Neurosurgery book series (NEUROSURGERY, volume 27)


In the last century the microsurgical transsphenoidal approach has yelded excellent global results in the surgical treatment of pituitary lesions, with minor limits of the procedure itself and very good compliance by the patients, as compared to the transcranial option for the same condition. On the other side, the study, the research and the rapidly developing evolution of techniques and equipment in endoscopic intracranial surgery [88] and in the endoscopic treatment of paranasal sinuses diseases [59, 60, 81, 98, 106–108] have brought the endoscopes into the pituitary area, disclosing new possibilities and advantages [23, 32, 33, 35, 42–44, 46, 74, 92, 99–101, 119, 120].


Pituitary Adenoma Sphenoid Sinus Transsphenoidal Surgery Middle Turbinate Functional Endoscopic Sinus Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Abe T, Lüdecke DK (1999) Transnasal surgery for infradiaphragmatic craniopharyngiomas in pediatric patients. Neurosurgery 44: 957–966PubMedGoogle Scholar
  2. 2.
    Anon JB, Lipman SP, Guelcher RT (1991) Intraoperative use of the fluoroscopic C-arm during endoscopic intranasal sinus surgery. Oper Techn Otolaryngol Head Neck Surg 2: 266–268Google Scholar
  3. 3.
    Arita K, Kurisu K, Tominaga A, Kawamoto H, Iida K, Mizoue T, Pant B, Uozumi T (1998) Trans-sellar color doppler ultrasonography during transsphenoidal surgery. Neurosurgery 42: 81–86PubMedGoogle Scholar
  4. 4.
    Artico M, Pastore FS, Fraioli B, Giuffrè R (1998) The contribution of Davide Giordano (1864–1954) to pituitary surgery: the transglabellar-nasal approach. Neurosurgery 42: 909–912PubMedGoogle Scholar
  5. 5.
    Auer LM, Auer DP (1998) Virtual endoscopy for planning and simulation of minimally invasive neurosurgery. Neurosurgery 43: 529–548PubMedGoogle Scholar
  6. 6.
    Barrou Z, Abecassis JP, Guilhaume B, Thomopoulos P, Bertagna X, Derome P, Bonnin A, Luton JP (1997) Magnetic resonance imaging in Cushing disease. Prediction of surgical results. Press Med 26: 7–11Google Scholar
  7. 7.
    Baskin DS, Wilson CB (1984) Transsphenoidal treatment of non-neoplastic intrasellar cysts. A report of 38 cases. J Neurosurg 60: 8–13PubMedGoogle Scholar
  8. 8.
    Black PML, Zervas NT, Candia GL (1987) Incidence and management of complications of transsphenoidal operation for pituitary adenomas. Neurosurgery 20: 920–924PubMedGoogle Scholar
  9. 9.
    Cappabianca P, Alfieri A, Colao A, Cavallo LM, Fusco M, Peca C, Lombardi G, de Divitiis E (2000) Endoscopic endonasal transsphenoidal surgery in recurrent and residual pituitary adenomas. Technical note. Minim Invas Neurosurg 43: 38–43Google Scholar
  10. 10.
    Cappabianca P, Alfieri A, Colao A, Ferone D, Lombardi G, de Divitiis E (1999) Endoscopic endonasal transsphenoidal approach: an additional reason in support of surgery in the management of pituitary lesions. Skull Base Surg 9: 109–117PubMedGoogle Scholar
  11. 11.
    Cappabianca P, Alfieri A, de Divitiis E (1998) Endoscopic endonasal transsphenoidal approach to the sella: towards Functional Endoscopic Pituitary Surgery (FEPS). Minim Invas Neurosurg 41: 66–73Google Scholar
  12. 12.
    Cappabianca P, Alfieri A, Spaziante R, Fusco M, Cavallo LM, de Divitiis E (1999) Trattamento endoscopico endonasale di una sinusite sfenoidale in un paziente affetto da craniofaringioma. Rivista Italiana di Chirurgia Maxillo-Facciale 10: 1–4Google Scholar
  13. 13.
    Cappabianca P, Alfieri A, Thermes S, Buonamassa S, de Divitiis E (1999) Instruments for endoscopic endonasal transsphenoidal surgery. Neurosurgery 45: 392–396PubMedGoogle Scholar
  14. 14.
    Carrau RL, Jho HD, Ko Y (1996) Transnasal-transsphenoidal endoscopic surgery of the pituitary gland. Laryngoscope 106: 914–918PubMedGoogle Scholar
  15. 15.
    Chong VF, Fan YF, Lau D, Sethi DS (1998) Functional Endoscopic Sinus Surgery (FESS): what radiologists need to know. Clin Radiol 53: 650–658PubMedGoogle Scholar
  16. 16.
    Ciric IS, Cozzens JW (1980) Craniopharyngiomas: transsphenoidal method of approach- for the virtuoso only? Clin Neurosurg 27: 169–187PubMedGoogle Scholar
  17. 17.
    Ciric I, Ragin A, Baumgartner C, Pierce D (1997) Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery 40: 225–237PubMedGoogle Scholar
  18. 18.
    Cirillo S, Caranci F (1998) Regione sellare ed iuxtasellare. Diagnostica RM. Idelson-Gnocchi, Napoli, pp 137Google Scholar
  19. 19.
    Colao A, Cerbone G, Cappabianca P, Ferone D, Alfieri A, Di Salle F, Faggiano A, Merola B, de Divitiis E, Lombardi G (1998) Effects of surgery and radiotherapy on visual and endocrine function in nonfunctioning pituitary adenomas. J Endocrinol Invest 21: 284–290PubMedGoogle Scholar
  20. 20.
    Colao A, Ferone D, Cappabianca P, Del Basso, De Caro M, Marzullo P, Monticelli A, Alfieri A, Merola B, Cali A, Lombardi G, de Divitiis E (1997) Effect of octreotide pretreatment on surgical outcome in acromegaly. J Clin Endocrinol Metab 82: 3308–3314PubMedGoogle Scholar
  21. 21.
    Cooke RS, Jones RAC (1994) Experience with the direct transnasal approach to the pituitary fossa. Br J Neurosurg 8: 193–196PubMedGoogle Scholar
  22. 22.
    Cooper PR (1999) Comment to the article: Elias WJ, Chadduck JB, Alden TD, Laws ER Jr Frameless stereotaxy for transsphenoidal surgery. Neurosurgery 45: 276–277Google Scholar
  23. 23.
    Cusimano MD, Fenton RS (1996) A technique for endoscopic pituitary tumor removal. Neurosurgical Focus 1(1): 1–7Google Scholar
  24. 24.
    de Divitiis E, Spaziante R (1997) Osteplastic opening of the sellar floor in transsphenoidal surgery: technical note. Neurosurgery 20: 445–446Google Scholar
  25. 25.
    de Divitiis E, Spaziante R, Stella L (1981) Empty sella and benign intrasellar cysts. In: Krayenbühl, Brihaye J, Loew F, Logue V, Mingrino S, Pertuiset P, Symon L, Troupp H, Yasargil MG (eds) Advances and technical standards in neurosurgery. Springer, Wien New York, pp 3–74Google Scholar
  26. 26.
    de Herder WW, Uitterlinden P, Pieterman H, Tanghe HL, Kwekkeboom DJ, Pols HA, Singh R, van de Berge JH, Lamberts SW (1994) Pituitary tumour localization in patients with Cushing’s disease by magnetic resonance imaging. Is there a place for petrosal sinus sampling? Clin Endocrinol 40: 87–92Google Scholar
  27. 27.
    Doppman JL, Ram Z, Shawker TH, Oldfield EH (1994) Intraoperative US of the pituitary gland. Work in progress. Radiology 192: 111–115PubMedGoogle Scholar
  28. 28.
    Driber JS, Bolger WE, Robles HA, Cable B, Zinreich SJ (1998) The reliability of computerized tomographic detection of the Onodi (sphenoetmoid) cell. Am J Rhinol 12: 105–111Google Scholar
  29. 29.
    El-Hakim H, Mc Clymont L (1998) Target oriented computed tomography-scanning of the paranasal sinuses. Clin Otolaryngol 23: 77–81PubMedGoogle Scholar
  30. 30.
    Elias WJ, Chadduck JB, Alden TD, Laws ER Jr (1999) Frameless stereotaxy for transsphenoidal surgery. Neurosurgery 45: 271–277PubMedGoogle Scholar
  31. 31.
    El-Mahdy W, Powell M (1998) Transsphenoidal management of 28 symptomatic Rathke’s cleft cysts, with special reference to visual and hormonal recovery. Neurosurgery 42: 7–17PubMedGoogle Scholar
  32. 32.
    Fahlbusch R, Heigl T, Huk W, Steinmeier R (1996) The role of endoscopy and intraoperative MRI in transsphenoidal pituitary surgery. In: Werder von K, Fahlbusch R (eds) Pituitary adenomas: from basic research to diagnosis and therapy. Elsevier, Amsterdam, pp 237–241Google Scholar
  33. 33.
    Fries G, Perneczky A (1998) Endoscope-assisted brain surgery: part 2 — Analysis of 380 procedures. Neurosurgery 42: 226–232PubMedGoogle Scholar
  34. 34.
    Fujii K, Chambers SM, Rhoton AL Jr (1979) Neurovascular relationship of the sphenoid sinus. A microsurgical study. J Neurosurg 50: 31–39PubMedGoogle Scholar
  35. 35.
    Gamea A, Fathi M, el-Guindi A (1994) The use of the rigid endoscope in transsphenoidal surgery. J Laryngol Otol 108: 19–22PubMedGoogle Scholar
  36. 36.
    Giordano D (1894) Manuale di Medicina Operativa. In: Duplay e Reclus (ed) Trattato di Chirurgia. Unione Tipografico-Editrice Torinese (UTET), Turin, pp 100–103Google Scholar
  37. 37.
    Griffith HB, Veerapen R (1987) A direct transnasal approach to the sphenoid sinus. Technical note. J Neurosurg 66: 140–142PubMedGoogle Scholar
  38. 38.
    Grotenhuis JA, Bartels RHMA, Tacl S (1997) Intraoperative dislocation of the distal lens of a neuroendoscope: a very rare complication: technical case report. Neurosurgery 41: 698–700PubMedGoogle Scholar
  39. 39.
    Grotenhuis JA, Bartels RHMA, Tacl S (1998) Intraoperative dislocation of the distal lens of a neuroendoscope: a very rare complication: technical case report. Neurosurgery 42: 949PubMedGoogle Scholar
  40. 40.
    Guiot G (1973) Transsphenoidal approach in surgical treatment of pituitary adenomas: general principles and indications in non-functioning adenomas. In: Kohler PO, Ross GT (eds) Diagnosis and treatment of pituitary adenomas. Excerpta Medica, Amsterdam, pp 159–178Google Scholar
  41. 41.
    Guiot G, Rougerie J, Fourestier M, Fournier A, Comoy C, Vulmiere J, Groux R (1963) Explorations endoscopiques intracrannienes. Press Med 71: 1225–1228PubMedGoogle Scholar
  42. 42.
    Hazan A, Roux FX, Levy D, Chevalier E, Pages JC, Peytral C (1998) Utilisation de l’endoscopie dans la chirurgie pituitaire. Neurochirurgie 44: 327–330PubMedGoogle Scholar
  43. 43.
    Heilman CB, Shucart WA, Rebeiz EE (1997) Endoscopic sphenoidotomy approach to the sella. Neurosurgery 41: 602–607PubMedGoogle Scholar
  44. 44.
    Helal MZ (1995) Combined micro-endoscopic trans-sphenoid excision of pituitary macroadenomas. Eur Arch Otorhinolaryngol 252: 186–189PubMedGoogle Scholar
  45. 45.
    Honegger J, Buchfelder M, Fahlbusch R, Däubler B, Dörr HG (1992) Transsphenoidal microsurgery for craniopharyngioma. Surg Neurol 37: 189–196PubMedGoogle Scholar
  46. 46.
    Jankowski R (1995) Endoscopic pituitary surgery. In: Stankiewicz JA (ed) Advanced endoscopic sinus surgery. Mosby, St. Louis, pp 95–102Google Scholar
  47. 47.
    Jankowski R, Auque J, Simon C, Marchai JC, Hepner H, Wayoff M (1992) Endoscopic pituitary tumor surgery. Laryngoscope 102: 198–202PubMedGoogle Scholar
  48. 48.
    Jho HD (1999) Endoscopy in skull base surgery. Proceedings of the 4th European Skull Base Congress, Nürnberg (Germany), May 19–22, 1999, Skull Base Surg 9 [Suppl] 2: 20–21Google Scholar
  49. 49.
    Jho HD (1999) Endoscopic surgery of pituitary adenomas. In: Krisht AF, Tindall GT (eds) Comprehensive management of pituitary disorders. Lippincott Williams & Wilkins, Hagerstown, pp 389–403Google Scholar
  50. 50.
    Jho HD, Carrau RL (1996) Endoscopic endonasal transsphenoidal surgery: experience with 50 patients. Neurosurgical Focus 1(2): 1–10Google Scholar
  51. 51.
    Jho HD, Carrau RL (1997) Endoscopic endonasal transsphenoidal surgery: experience with 50 patients. J Neurosurg 87: 44–51PubMedGoogle Scholar
  52. 52.
    Jho HD, Carrau RL, Ko Y (1996) Endoscopic pituitary surgery. In Wilkins RH, Rengachary SS (eds) Neurosurgical Operative Atlas. American Association of Neurological Surgeons, Park Ridge, Ill 5, pp 1–12Google Scholar
  53. 53.
    Jho HD, Carrau RL, Ko Y, Daly MA (1997) Endoscopic pituitary surgery: an early experience. Surg Neurol 47: 213–223PubMedGoogle Scholar
  54. 54.
    Jho HD, Carrau RL, Mc Laughlin ML, Somaza SC (1996) Endoscopic transsphenoidal resection of a large chordoma in the posterior fossa. Neurosurg Focus 1(3): 1–7, 1996Google Scholar
  55. 55.
    Johnson DM, Hopkins RJ, Hanafee WN, Fisk JD (1985) The unprotected parasphenoidal carotid artery studied by high resolution computed tomography. Radiology 155: 137–141PubMedGoogle Scholar
  56. 56.
    Kalushar SK (1997) Pre and post operative mucociliary clearance in functional endoscopic sinus surgery. Ear Nose Throath J 76: 884–886Google Scholar
  57. 57.
    Kato T, Sawamura J, Abe H, Nagashima M (1998) Transsphenoidal-transtuberculum sellae approach for supradiaphragmatic tumours: technical note. Acta Neurochir (Wien) 140: 715–719Google Scholar
  58. 58.
    Kelley TF, Stankiewicz JA, Chow JM, Origitano TC, Shea J (1996) Endoscopic closure of postsurgical anterior cranial fossa cerebrospinal fluid leaks. Neurosurgery 39: 743–746PubMedGoogle Scholar
  59. 59.
    Kennedy DW (1985) Functional endoscopic sinus surgery. Technique. Arch Otolaryngol 111: 643–649Google Scholar
  60. 60.
    Kennedy DW, Zinreich SJ, Rosenbaum AE, Johns ME (1985) Functional endoscopic sinus surgery. Theory and diagnostic evaluation. Arch Otolaryngol 111:576–582PubMedGoogle Scholar
  61. 61.
    Kennedy DW, Zinreich SJ, Hassab MH (1990) The internal carotid artery as it relates to endonasal sphenoethmoidectomy. Am J Rhinol 4: 7–12Google Scholar
  62. 62.
    Kim J, Choe I, Bak K, Kim C, Kim N, Yang Y (2000) Transsphenoidal supradiaphragmatic intradural approach: technical note. Minim Invas Neurosurg 43: 33–37Google Scholar
  63. 63.
    Kouri JG, Chen MY, Watson JC, Odfield EH (2000) Resection of suprasellar tumors by using a modified transsphenoidal approach. J Neurosurg 92: 1028–1035PubMedGoogle Scholar
  64. 64.
    Laine FJ, Smoker WR (1992) The ostiomeatal unit and endoscopic surgery: anatomy, variations, and imaging findings in inflammatory diseases. AJR 159: 846–857Google Scholar
  65. 65.
    Landolt AM (1999) Comment to the article: Abe T, Lüdecke DK Transnasal surgery for infradiaphragmatic craniopharyngiomas in pediatric patients. Neurosurgery 44: 964–965Google Scholar
  66. 66.
    Landolt AM, Zachmann M (1991) Results of transsphenoidal extirpation of craniopharyngiomas and Rathke’s cysts. Neurosurgery 28: 410–415PubMedGoogle Scholar
  67. 67.
    Landolt AM, Strebel P (1980) Technique of transsphenoidal operation for pituitary adenomas. In: Krayenbühl, Brihaye J, Loew F, Logue V, Mingrino S, Pertuiset P, Symon L, Troupp H, Yasargil MG (eds) Advances and Technical standards in neurosurgery. Springer, Wien New York, pp 119–177Google Scholar
  68. 68.
    Laws ER Jr (1980) Transsphenoidal microsurgery in the management of craniopharyngioma. J Neurosurg 52: 661–666PubMedGoogle Scholar
  69. 69.
    Laws ER Jr (1994) Transsphenoidal removal of craniopharyngioma. Pediatr Neurosurg 21 [Suppl] 1: 57–63PubMedGoogle Scholar
  70. 70.
    Laws ERJr (1996) Comment to the article: Rodziewicz GS, Kelley RT, Kellman RM, Smith MV Transnasal endoscopic surgery of the pituitary gland: technical note. Neurosurgery 39: 193Google Scholar
  71. 71.
    Laws ER Jr, Kern EB (1976) Complications of transsphenoidal surgery. Clin Neurosurg 23: 401–416PubMedGoogle Scholar
  72. 72.
    Laws ER Jr, Kern EB (1982) Complications of transsphenoidal surgery. In Laws ER Jr, Randall RV, Kern EB, Abboud CF (eds) Management of pituitary adenomas and related lesions. Appleton Century Croft, New York, pp 329–346Google Scholar
  73. 73.
    Lillehei KO, Kirschman DL, Kleinschmidt-DeMasters BK, Chester Ridgway EC (1998) Reassessment of the role of radiation therapy in the treatment of endocrine-inactive pituitary macroadenomas. Neurosurgery 43: 432–439PubMedGoogle Scholar
  74. 74.
    Liston SL, Siegel LG, Thienprasit P, Gregory R (1987) Nasal endoscopes in hypophysectomy. J Neurosurg 66: 155 (letter)PubMedGoogle Scholar
  75. 75.
    Mafee MF, Chow JM, Meyers R (1993) Functional endoscopic sinus surgery: screening, indications, and complications. AJR 160: 735–744PubMedGoogle Scholar
  76. 76.
    Marino R (1999) Comment to the article: Abe T, Lüdecke DK Transnasal surgery for infradiaphragmatic craniopharyngiomas in pediatric patients. Neurosurgery 44: 965Google Scholar
  77. 77.
    Mason JD, James NS, Pres RJH, Holland IM (1998) A sistematic approach to the interpretation of computed tomography scans prior to the endoscopic sinus surgery. J Laringol Otol 112: 986–990Google Scholar
  78. 78.
    Mason RB, Nieman LK, Doppman JL, Oldfield EH (1997) Selective excision of adenomas originating in or extending into the pituitary stalk with preservation of pituitary function. J Neurosurg 87: 343–351PubMedGoogle Scholar
  79. 79.
    Mc Ginn GJ, Mc Clarty BM (1997) The posttherapeutic pituitary gland. In: Jinkins JR (ed) Posttherapeutic neurodiagnostic imaging. Lippincott-Raven Publishers, Philadelphia, pp 69–87Google Scholar
  80. 80.
    Melhem ER, Oliverio PJ, Benson ML, Leopold DA, Zinreich SJ (1996) Optimal CT evaluation for functional endoscopic sinus surgery. Am J Neuroradiol 17: 181–188PubMedGoogle Scholar
  81. 81.
    Messerklinger W (1994) Background and evolution of endoscopic sinus surgery. Ear Nose Throat J 73: 449–450PubMedGoogle Scholar
  82. 82.
    Moussa R, Roux FX, Nataf F, Devaux B, Obreja C, Page P, Turak B (1998) Controverses dans la prise en charge des résidus de macro-adénomes hypophysaire opérés. Neurochirurgie 44: 352–359PubMedGoogle Scholar
  83. 83.
    Nadas S, Duvoisin B, Landry M, Schnyder P (1995) Concha bullosa frequency and appearances on CT and correlations with sinus disease in 308 patients with chronic sinusitis. Neuroradiology 37: 234–237PubMedGoogle Scholar
  84. 84.
    Nakasu Y, Itoh R, Nakasu S, Nioka H, Kidooka M, Handa J (1998) Postoperative sella: evaluation with fast spin echo T2-weighted high-resolution imaging. Neurosurgery 43: 440–447PubMedGoogle Scholar
  85. 85.
    Newfield P, Albin MS, Chestnut JS, Maroon J (1978) Air embolism during transsphenoidal pituitary operations. Neurosurgery 2: 39–42PubMedGoogle Scholar
  86. 86.
    Oldfield EH, Doppman JL, Nieman LK, Chrousos GP, Miller DL, Katz DA, Cutler GB Jr, Loriaux DL (1991) Petrosal sinus sampling with and without corticotropin-releasing hormone for the differential diagnosis of Cushing’s syndrome. New Engl J Med 325: 897–905PubMedGoogle Scholar
  87. 87.
    Page RB (1994) Craniopharyngioma: indications for transsphenoidal surgery. Curr Ther Endocrinol Metab 5: 33–34PubMedGoogle Scholar
  88. 88.
    Perneczky A, Fries G (1998) Endoscope-assisted brain surgery: part 1 — evolution, basic concept, and current technique. Neurosurgery 42: 219–225PubMedGoogle Scholar
  89. 89.
    Ram Z, Shawker TH, Bradford MH, Doppman JL, Oldfield EH (1995) Intraoperative ultrasound-directed resection of pituitary tumors. J Neurosurg 83: 225–230PubMedGoogle Scholar
  90. 90.
    Renn WH, Rhoton Jr AL (1975) Microsurgical anatomy of the sellar region. J Neurosurg 43: 288–298PubMedGoogle Scholar
  91. 91.
    Resch KDM, Perneczky A (1998) Intraoperative sonography for neuro-endoscopic procedures. Minim Invas Neurosurg 41: 122–123Google Scholar
  92. 92.
    Rodziewicz GS, Kelley RT, Kellman RM, Smith MV (1996) Transnasal endoscopic surgery of the pituitary gland: technical note. Neurosurgery 39: 189–193PubMedGoogle Scholar
  93. 93.
    Rogalla P, Nischwitz A, Gottschalk S, Huitema A, Kaschke O, Hamm B (1998) Virtual endoscopy of the nose and paranasal sinuses. Eur Radiol 8: 946–950PubMedGoogle Scholar
  94. 94.
    Ross DA, Norman D, Wilson CB (1992) Radiologic characteristics and results of surgical management of Rathke’s cysts in 43 patients. Neurosurgery 30: 173–179PubMedGoogle Scholar
  95. 95.
    Sandeman D, Moufid A (1998) Interactive image-guided pituitary surgery. An experience of 101 procedures. Neurochirurgie 44: 331–338PubMedGoogle Scholar
  96. 96.
    Saito K, Kuwayama A, Yamamoto N, Sugita K (1995) The transsphenoidal removal of non functioning pituitary adenomas with suprasellar extension: the open sella method and intentionally staged operation. Neurosurgery 36: 668–676PubMedGoogle Scholar
  97. 97.
    Scotti G, Anzalone N, Triulzi F, Pieralli S, Parazzini C, Bozzi M (1991) MR evaluation of post-surgical changes in transsphenoidal surgery for pituitary adenomas. Riv Neuroradiol 4 [Suppl] 1: 57–61Google Scholar
  98. 98.
    Senior BA, Kennedy DW, Tanabodee J, Kroger H, Hassab M, Lanza D (1998) Long-term results of functional endoscopic sinus surgery. Laryngoscope 108: 151–157PubMedGoogle Scholar
  99. 99.
    Sethi DS, Pillay PK (1995) Endoscopic management of lesions of the sella turcica. J Laryngol Otol 109: 956–962PubMedGoogle Scholar
  100. 100.
    Sethi DS, Pillay PK (1996) Endoscopic surgery for pituitary tumors. Op Tech Otolaryngol Head Neck Surg 7: 264–268Google Scholar
  101. 101.
    Shikani AH, Kelly JH (1993) Endoscopic debulking of a pituitary tumor. Am J Otolaryngol 14: 254–256PubMedGoogle Scholar
  102. 102.
    Spaziante R, de Divitiis E (1997) Drainage techniques for cystic craniopharyngiomas. Neurosurg Qu 7: 183–208Google Scholar
  103. 103.
    Spaziante R, de Divitiis E, Cappabianca P (1985) Reconstruction of the pituitary fossa in transsphenoidal surgery: an experience of 140 cases. Neurosurgery 17: 453–458PubMedGoogle Scholar
  104. 104.
    Spaziante R, de Divitiis E, Cappabianca P (2000) Repair of the sella after transsphenoidal surgery. In: Schmidek HH (ed) Operative neurosurgical techniques. Indications, methods and results. W.B. Saunders Company, Philadelphia, pp 398–415Google Scholar
  105. 105.
    Stamm A, Bordasch A, Vellutini E, Pahl F (1998) Transnasal micro-endoscopic surgery for pituitary surgery. Proceedings of the E.R.S. and I.S.I.A.N. Meeting-Vienna 1998, Monduzzi Ed, Bologna, pp 341–347Google Scholar
  106. 106.
    Stammberger H (1986) Endoscopic endonasal surgery: concepts in treatment of recurring rhinosinusitis, part I: anatomic and pathologic considerations. Otolaryngol Head Neck Surg 94: 143–146PubMedGoogle Scholar
  107. 107.
    Stammberger H (1986) Endoscopic endonasal surgery: concepts in treatment of recurring rhinosinusitis, part II: surgical technique. Otolaryngol Head Neck Surg 94: 147–156PubMedGoogle Scholar
  108. 108.
    Stammberger H, Posawetz W (1990) Functional Endoscopic Sinus Surgery. Concepts, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol 247: 63–76PubMedGoogle Scholar
  109. 109.
    Stankiewicz JA (1987) Complications of endoscopic intranasal ethmoidectomy. Laringoscope 97: 1270–1273Google Scholar
  110. 110.
    Stankiewicz JA (1991) CSF fistula and endoscopic sinus surgery. Laringoscope 101: 250–256Google Scholar
  111. 111.
    Steiner E, Math G, Knosp E, Mostbeck G, Kramer J, Herold CJ (1995) MR appearance of the pituitary gland before and after resection of pituitary macroadenomas. Clin Radiol 49: 524–530Google Scholar
  112. 112.
    Steinmeier R, Fahlbusch R, Ganslandt O, Nimsky C, Buchfelder M, Kaus M, Heigl T, Lenz G, Kuth R, Huk W (1998) Intraoperative magnetic resonance imaging with the magnetom open scanner: concepts, neurosurgical indications, and procedures: a preliminary report. Neurosurgery 43: 739–748PubMedGoogle Scholar
  113. 113.
    Suojanen JN, Regan F (1995) Spiral CT scanning of the paranasal sinuses. Am J Neuroradiol 16: 787–789PubMedGoogle Scholar
  114. 114.
    Vincentelli F, Grisoli F, Bartoli JF, Leclerc T, de Smedt E, Salamon G (1982) Anatomicoradiologic basis of sellar surgery and its nasoseptal approach. J Neuroradiol 9: 284–303PubMedGoogle Scholar
  115. 115.
    Watson JC, Shawker TH, Nieman LK, DeVroom HL, Doppman JL, Oldfield EH (1998) Localization of pituitary adenomas by using intraoperative ultrasound in patients with Cushing’s disease and no demonstrable pituitary tumor on magnetic resonance imaging. J Neurosurg 89: 927–932PubMedGoogle Scholar
  116. 116.
    Wigand ME (1981) Transnasal ethmoidectomy under endoscopic control. Rhinology 19: 7–15PubMedGoogle Scholar
  117. 117.
    Wigand ME, Steiner W, Jaumann MP (1978) Endonasal sinus surgery with endoscopic control: from radical operation to rehabilitation of the mucosa. Endoscopy 10: 255–260PubMedGoogle Scholar
  118. 118.
    Wilson CB (1990) Role of surgery in the management of pituitary tumors. Neurosurg Clin N Am 1: 139–159PubMedGoogle Scholar
  119. 119.
    Wurster CF, Smith DE (1994) The endoscopic approach to the pituitary gland. Arch Otolaryngol Head Neck Surg 120: 674 (letter)PubMedGoogle Scholar
  120. 120.
    Yaniv E, Rappaport ZH (1997) Endoscopic transseptal transsphenoidal surgery for pituitary tumors. Neurosurgery 40: 944–946PubMedGoogle Scholar
  121. 121.
    Zinreich SJ, Kennedy DW, Rosenbaum AE, Gayler BW, Kumar AJ, Stammberger H (1987) Paranasal sinuses: CT imaging requirements for endoscopic surgery. Radiology 163: 769–775PubMedGoogle Scholar

Copyright information

© Springer-Verlag/Wien 2002

Authors and Affiliations

  • E. de Divitiis
    • 1
  • P. Cappabianca
    • 1
  1. 1.Department of Neurological SurgeryFederico II UniversityNaplesItaly

Personalised recommendations