Front. Surg.

Sec. Neurosurgery

Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1439909

This article is part of the Research Topic Microsurgical Anatomy of the Central Nervous System and Skull Base Volume II View all 4 articles

Provisionally accepted

Xiao Liang Zhuoqun Li * Wenbo Gao * Mengyang Xing * Pengfei Liu * Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China

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Background The surgical treatment of pituitary adenomas (PAs) is aimed at achieving maximal tumor resection, relieving the compression, and correcting the disorders of pituitary hormones. Parasellar dural invasion is a primary factor in the failure of the surgery. By comparing the two operations of tumor excision combined with resection of the medial wall of the cavernous sinus (MW) and simple tumor excision, we further confirmed the clinical effectiveness and safety of the resection technique of the MW. Methods 41 patients with function pituitary adenoma (FPA) were divided into two groups according to the operation. The experimental group consisted of 20 patients who underwent tumor excision combined with resection of the MW via endonasal transsphenoidal approach and 21 patients who underwent simple pituitary tumor excision as the control group. Both groups were followed up for 12 months and matched for age, sex, BMI, tumor type, Knosp grade, maximum tumor diameter, hypertension, diabetes, and coronary disease. Perioperative-related indicators, biochemical remission rates, tumor recurrence rates, and complications were assessed.Results A total of 21 medial walls were removed in 20 patients, 17(71%) specimens had pathologically confirmed tumor invasion. Biochemical remission rates and average operative duration in the experimental group were more than in the control group (P 0.05).The technique of the MW removal via endonasal transsphenoidal approach for FPAs is safe and effective, with a high biochemical remission. The average operative duration for MW removal may be longer than that for simple tumor excision.

Keywords: Cavernous sins, Function pituitary adenoma, Aggressive pituitary adenoma, Outcome, Medial wall removal

Received: 28 May 2024; Accepted: 25 Nov 2024.

Copyright: © 2024 Liang, Li, Gao, Xing and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Zhuoqun Li, Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China
Wenbo Gao, Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China
Mengyang Xing, Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China
Pengfei Liu, Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China

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