The authors have no funding, financial relationships, or conflicts of interest to disclose.
Microscopic versus endoscopic pituitary surgery: A systematic review†
Article first published online: 26 APR 2010
Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 120, Issue 7, pages 1292–1297, July 2010
How to Cite
Rotenberg, B., Tam, S., Ryu, W. H. A. and Duggal, N. (2010), Microscopic versus endoscopic pituitary surgery: A systematic review. The Laryngoscope, 120: 1292–1297. doi: 10.1002/lary.20949
- Issue published online: 25 JUN 2010
- Article first published online: 26 APR 2010
- Manuscript Accepted: 18 MAR 2010
- Manuscript Revised: 23 FEB 2010
- Manuscript Received: 26 JAN 2010
- Pituitary adenoma;
- endoscopic surgery;
- minimally invasive surgery;
- Level of Evidence: 2a
To critically review current literature comparing microscopic versus endoscopic surgery in the treatment of pituitary adenomas.
Systematic review of the literature.
All English language literature published between January 1989 and June 2009 on PubMed were eligible for inclusion. Inclusion criteria were: direct comparison between microscopic and fully endoscopic approaches and surgery performed with the intent to treat a pituitary adenoma. Endoscopic-assisted comparisons and studies comparing outcomes with previous literature were excluded. Technical notes, case reports, letters, and comments were also excluded. Included studies were categorized according to level of evidence and evaluated for quality using a modified Downs and Black scale. Data was extracted and compared between studies.
Of the 3,586 studies retrieved from the search strategy, 11 studies met the inclusion and exclusion criteria. Various outcomes measures were used including: operating time, extent of tumor resection, postoperative normalization of hormone levels, incidence of complications, length of hospital stay, and patient pain and discomfort. The endoscopic approach decreased operating time, lumbar drains, immediate postoperative diabetes insipidus, some rhinologic complications, length of hospital stay, and patient pain and discomfort. Other outcome measures were comparable between the two approaches.
The literature comparing endoscopic and microscopic pituitary surgery favors the endoscopic approach for pituitary surgery. Major outcome measures (extent of tumor resection, changes in hormone levels) do not differ between the two approaches. Complications, time in the operating room and hospital, and patient discomfort are significantly less with the endoscopic approach. Laryngoscope, 2010