Nasal Evaluation in the Surgical Approach of Sellar Diseases

Abstract

Introduction: Since its beginnings, the surgical approach to the hypophysis has experienced an important development; from the transcranial to the transsphenoidal approach. The latter has evolved into the first line treatment method for sellar diseases. Aim: To report the surgical experience in nasal septum management during sellar approach at the Instituto de Neurocirugía Dr. Alfonso Asenjo (INCA). Material and Method: This study is a descriptive and transversal analysis of patients who underwent trans-septosphenoidal surgery at INCA, from January 1^s, 2007 to March, 31^st, 2008. The otorhinolaryngologic experience in the transsphenoidal approach is also presented. Results: Average age of patients was 42.26 years, 52,4% of the cases were female and 47,6% male. 61% of the surgeries corresponded to a first intervention, which explains why nearly 40% of surgeries were performed in a septum that was previously manipulated. Nasal packing was removed within a median of 4 days. No prophylactic antibiotics were used. Discussion and Conclusions: The current surgical technique used is the Cottle approach. Repositioning of the posterior septum allows surgical reinterventions using the same approach, even up to four times, in variable periods of time, without nasal lesions. No infections were reported in this study.