The transseptal approaches to pituitary tumours: Technique, rhinologic functions and complications

Surgery for pituitary tumours at Kuala Lumpur Hospital was randomly performed by the sublabial or endonasal route as a joint rhino-surgical procedure by the otolaryngologists and neurosurgeons. The purpose of this study was to compare the techniques, rhinological functions, and complications of both these approaches. Seventy-one patients underwent transsphenoidal hypophysectomy from January 1990 to February 1997, of which 66 patients (33 males and females each) with adequate data and rhinological follow-ups were included in the study. The patients' ages ranged from 16 to 67 years (mean 40 years). Twenty patients were operated on by the sublabial and the remaining 46 by the endonasal route. The follow up period ranged from three months to 1.2 years (mean 4.6 months). There was no significant difference in the postoperative rhinological complaints except upper lip dysestesia on comparing the two approaches. The incidence of cerebrospinal fluid (CSF) leak was significantly higher in the sublabial route. One-third of the patients via the endonasal approach required alotomy, but the scar was not noticeable on followup. Therefore, due to the decreased complications, shorter operating time and hospitalization, the endonasal route is currently the procedure of choice at our center.