ArticleScientific reports2025
Endoscopic endonasal approach for pituitary neuroendocrine tumor with septal mucosa incision tailored to tumor extension intending unilateral septal mucosa preservation.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Determinants of sphenoid sinus ostium localization: implications for safer endoscopic sinus surgery.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- A case of carotid blowout syndrome following endoscopic endonasal surgery and proton beam therapy for chondrosarcoma: Considering the role of nasoseptal mucosal flap for minimizing bleeding.Surgical neurology international · 2026Article
- Endoscopic endonasal resection of transinfundibular craniopharyngiomas using a vertical infundibular split with subpial excavation: Case instruction and operative video.Surgical neurology international · 2026Article
- Postoperative weight gain following endoscopic endonasal surgery for craniopharyngiomas in children and adults: A retrospective cohort study.Pituitary · 2025Article
- Endoscopic Endonasal Transnasopharyngeal Approach for Ventral Craniovertebral Junction Lesions: A Technical Note.Neurospine · 2025Article
- A case of endoscopic endonasal surgery for a tuberculum sellae meningioma resected in the third trimester of pregnancy.Surgical neurology international · 2025Article
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9 authors.
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Abstract
Currently, the direct endonasal approach is widely used in endoscopic endonasal surgery (EES) for pituitary neuroendocrine tumor. However, a large posterior septal perforation is inevitable. We routinely utilize a modified para/transseptal approach using the combination of a Killian and a contralateral rescue flap incision (PTSA with K-R incision). Especially, rescue flap incision is used on ipsilateral side of the tumor extension to facilitate lateral expansion of the anterior sphenoidotomy and tumor resection. One hundred eighty-nine patients underwent EES using PTSA with K-R incision in Tsukuba university hospital. Gross total resection (GTR) was achieved in 146 (77.2%) patients. Even in cases of significant lateral tumor extension (Knosp 3 or 4), GTR was achieved in 56 of 90 (62.2%) patients. Among the 168 patients with available rhinological follow-up data, postoperative anterior and posterior septal perforation occurred in six (3.6%) and 18 (10.7%) patients, respectively. Surgical intervention was required in one (0.6%) patient with anterior septal perforation. Thus, PTSA with K-R incision was effective in preserving the nasal septal mucosa on one side and gaining a sufficient surgical corridor with lateral expansion of the anterior sphenoidotomy on the other side. Our strategy may be preferable to improve maneuverability of instruments during tumor resection.
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