뇌하수체선종에 대한 미세현미경 경접형동 수술과 내시경 경접형동 수술의 비교

Comparison between microscopic and endoscopic transsphenoidal surgery for pituitary adenoma

The recent advancement in the endoscopic skullbase surgery has made a paradigm shift on the surgical treatment for pituitary tumors. The endoscopic endonasal transsphenoidal approach (EETSA) has rapidly replaced the microscope-based transsphenoidal approach (MTSA). However, there is a still a debate on whether the EETSA is superior to the MTSA for pituitary adenomas or not. The use of the endoscope to visualize the sella via a direct endonasal approach offers the surgeons dramatically better visualization as well as improved range of motion compared to the operating microscope. On the other hand, the endonasal and bleeding complications are significantly higher in the EETSA compared with the MTSA. In Particular, patient discomfort, smell, and taste impairment are higher with the endoscopic method compared with microscopic ones. This paper will review on the basis of the data available in literature the pros and cons of the two methods, EETSA and MTSA.