Endoscopic endonasal surgery for pituitary adenomas extending to the oculomotor cistern

Head Neck. 2018 Mar;40(3):536-543. doi: 10.1002/hed.24999. Epub 2017 Nov 9.

Abstract

Background: Extension of a pituitary adenoma to the oculomotor cistern harbors the risk of oculomotor nerve impairment and further extension into the interpeduncular cistern. The role of endoscopic endonasal surgery for those lesions was investigated.

Methods: The medical records were retrospectively analyzed. Attention was paid to the oculomotor nerve function and removal rate of the tumor within the oculomotor and interpeduncular cisterns.

Results: Six patients were eligible for the study, including 2 with oculomotor nerve palsy. The tumor from the oculomotor and interpeduncular cistern was removed in all except on one side of the case with bilateral tumor extension. The oculomotor nerve palsy demonstrated partial recovery in both cases during the 3-month follow-up.

Conclusion: The pituitary adenoma extending to the oculomotor cistern can be removed under the endoscope. Improvement of oculomotor nerve palsy can be achieved, and further tumor extension into the interpeduncular cistern can be prevented.

Keywords: endoscopic endonasal surgery; lateral recess of the interpeduncular cistern; oculomotor cistern; oculomotor nerve palsy; pituitary adenoma.

MeSH terms

  • Adenoma / pathology
  • Adenoma / surgery*
  • Adult
  • Aged
  • Cavernous Sinus / pathology*
  • Cavernous Sinus / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Natural Orifice Endoscopic Surgery / methods*
  • Neoplasm Recurrence, Local / surgery
  • Nose / surgery
  • Oculomotor Nerve / pathology
  • Oculomotor Nerve / surgery
  • Oculomotor Nerve Diseases / etiology
  • Oculomotor Nerve Diseases / surgery*
  • Pituitary Neoplasms / pathology
  • Pituitary Neoplasms / surgery*
  • Retrospective Studies
  • Treatment Outcome