Fig 1.
One-hand (A) and two-hand (B) technique surgical views. (A) The one-hand/mono-nostril operation for treatment of pituitary tumors was performed through the right nostril with one hand holding the endoscope (filled triangle) and the other hand using the surgical instruments. (B) The two-hand/one-and-half nostril surgery was assisted by an endoscope holder (arrow). All techniques employed in two-surgeon endoscopic surgery are incorporated into this approach.
Fig 2.
Illustration of surgical approach.
(A) The one-hand operation was done through the right nostril with one hand holding the endoscope and the other hand using the surgical instruments. The middle turbinate was pushed laterally to expose the ostium of the sphenoid sinus. A naso-septal flap was created before the sphenoidectomy in selected cases. The sphenoidectomy was performed by widening the ostium with partial removal of the vomer bone. (B) The two-hand/one-and half nostril approach shared a similar surgical approach. After the exposure of the sphenoid sinus, the distal end of the nasal septum was opened for the contralateral nostril approach. The endoscope was then held by the holder, and the opening of the sellar floor and the removal of the tumor was performed by two-hand manipulation. The images were copied from website (https://www.kenhub.com/en/start/medial-wall-of-nasal-cavity) and further modified.
Table 1.
Demographic and clinical characteristics of patients undergoing endoscopic transsphenoidal operation for large pituitary tumors.
Table 2.
Postoperative outcomes and complications of patients with large tumor receiving transsphenoidal operation using mono-nostril or one-and-half nostril approaches.