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The table below demonstrates the effectiveness of the fully endoscopic endonasal approach, as compared to the complications of traditional surgery. These large studies involve hundreds of patients and the complete articles have been published in the distinguished peer reviewed journals, Minimally Invasive Neurosurgery and Neurosurgery Quarterly. Both articles, along with many others, are available for reading in their entirety in the Treatments section of this website.

Fully Endoscopic Endonasal vs. Transseptal-Transphenoidal (Postoperative Complications)

Complication %

Fully Endoscopic

Transseptal- a Transsphenoidal

Nasal Septum perforation

0.7

6.7

Postoperative epistaxis

1.3

10

Anterior Pituitary Insufficiency

2.7

19.4

Diabetes Insipidus

5.3 b

17.8

Loss of Vision

None

1.8

Carotid artery Injury

None

1.1

CNS Injury

None

1.3

Intrasellar Hemorrhage

0.7

2.9

Cerebrospinal Fluid Leak

1.7 (0.9) c

3.9

Meningitis

None

1.5

Death

None

0.9



a Results of a national survey (Ciric et al., 1997)

b 16/300 (5.3%) patients had postoperative DI, (12/16 had transient DI vs. 4/16 that developed permanent DI

c 3/5 CSF leaks occurred among the first 75 operations, while only 2 have occurred in  the last 225 operations for an incidence of 0.9%

Reference: Kabil MS, Eby JB, Shahinian HK: Fully Endoscopic Endonasal vs. Transseptal Transphenoidal Pituitary Surgery.  Minim Invasive Neurosurg. 2005 Dec; 48(6):348-54.

Reference: Kabil MS, Eby JB, Shahinian HK: Fully Endoscopic Transnasal vs.Transseptal Transphenoidal Pituitary Surgery. Neurosurg. Q 15(3):2005.




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