COMPLICATIONS AFTER ENDOSCOPIC ENDONASAL TRANSPHENOIDAL REMOVAL OF PITUITARY ADENOMAS

Abstract

The use of endoscopic techniques has significantly expanded the indications for operations performed via transsphenoidal access. Currently, more than 90% of pituitary adenomas are operated transsphenoidally. Transnasal removal of giant pituitary adenomas has become possible. The frequency and structure of postoperative complications have changed due to the transition to endoscopic endonasal access in the removal of pituitary adenomas. An analysis of possible complications after endoscopic endonasal transsphenoidal removal of pituitary adenomas has been conducted. These include complications of the access itself (nosebleeds, nasal septum perforation, olfactory dysfunction, atrophic rhinitis, synechiae, mucoperiosteal flap necrosis, external nasal deformities), infectious complications (meningitis, intracranial abscesses), cerebrovascular accidents (subarachnoid hemorrhage, cerebral vasospasm, injury to large vessels, intracranial hematomas), neuro-ophthalmological complications (visual and oculomotor disorders), endocrine (hypopituitarism, diabetes insipidus, hyponatremia), somatic complications and nasal cerebrospinal fluid rhinorrhea. In conclusion, it should be noted that despite the constant improvement of the endonasal endoscopic removal technique for pituitary adenomas, there remains a risk of quite serious complications, the development of methods for their prevention is still relevant today.