Neurology and Therapeutics

Biography

Biography: Kassem El-Shunnar

Abstract

Introduction: Advances in nasal endoscopy led to cooperation between neurosurgeons and ENT surgeons in Endoscopic trans-sphenoidal Pituitary surgery. This report discusses the cases treated by our team consisting of one neurosurgeon, one ENT surgeon, two endocrinologists and one neuro-ophthalmologist between March 2007 and December 2015. Methods: Forty-four patients (16 females and 28 males) presented to us between March 2007 and December 2015. Age range was 9-80 years. Most patients presented with visual failure. Pituitary apoplexy was the next most common presentation in our series. Hypopituitarism was present in only nine patients. Results: Most cases were non-functioning adenomas. There were 3 Carniopharyngiomas, 2 Rathke's Cleft cysts, 2 prolactinomas, 2 GH secreting tumors and one arachnoid cyst. Two cases had CSF leak requiring repair and 10 cases had transient Diabetes Insipidus. Vision improved in 90% of cases. There was no permanent added impairment to pituitary function. There was no mortality and 2 patients suffered postoperative complications. Conclusions: Endoscopic navigation guided trans-sphenoidal surgery is a safe and reliable procedure. We recommend working as a team of Neurosurgeon and ENT surgeon. We do not recommend preparing a mucosal flap as a routine for each case.