gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

The endoscopic surgical technique of pituitary adenomas preserves the hormonal function: a negative correlation to the microsurgical technique

Meeting Abstract

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  • Stefan Linsler - Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland
  • Christoph A. Tschan - Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland
  • Joachim Oertel - Klinik für Neurochirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMO.04.08

doi: 10.3205/13dgnc036, urn:nbn:de:0183-13dgnc0365

Published: May 21, 2013

© 2013 Linsler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: The endonasal endoscopic approach is currently under investigation for perisellar tumour surgery: a higher resection rate is to be expected and complications should be minimized. The authors report their technique of transnasal endoscopic neurosurgery and results of postoperative hormone insufficiency in comparison to microsurgical procedures.

Method: Between January 2011 and November 2012 45 patients received endoscopic endonasal transsphenoidal procedures for pituitary adenomas. All patients were followed up. A second group of 45 patients received microsurgical transsphenoidal procedures for pituitary adenomas in our neurosurgical department in the years before and were prospectively followed until November 2012. Special attention was paid to hormonal insufficiency and medical substitution.

Results: Eigthy percentage (36/45) of the patients who underwent microsurgical procedures showed a persisting pituitary insufficiency. In this patient group 16 patients had substitution of thyreotrophic, corticotrophic and gonadotrophic hormones. Twenty patients were substituted with thyroxine and hydrocortisone. In the 9 cases without any hormonal insufficiency after microsurgical procedures 5 patients (55%) showed remnant tumor in follow-up MRI. The patients who underwent endoscopic procedures for pituitary adenomas revealed significant (p<0.05) less persistent hormonal insufficiency with 8.8% of all cases (4/45). Thereby on follow-up MRI revealed radical tumour resection in 90%.

Conclusions: The endoscopic technique for sellar lesions has been shown to be safe and successful with a high radicality and only minor complications. This study seems to indicate that a better preservation of pituitary gland is possible in endoscopic pituitary adenoma surgery.