Pituitary tumors are one of the most common intracranial tumors, and can be classified into prolactin, growth hormone, and adrenocorticotropic hormone types according to different endocrine types, and further classified into microadenoma and macroadenoma according to different sizes, and surgery is one of the main methods of pituitary tumor treatment. The emergence of neuroendoscopy has not only reduced the trauma of the traditional transnasal butterfly approach to a very low level, but also made it possible to perform endoscopic transnasal butterfly procedures that could only be performed under a microscope in the past, bringing a blessing to patients.
Due to the small size of the nasal cavity and the irregular structure of the internal turbinates, the traditional method requires the use of a spreader to fracture the nasal septum and open it up for surgery under the microscope, which causes more trauma and requires bilateral nasal plugs to stop bleeding after surgery. It is also easy to cause rebleeding of the nasal cavity when removing the stuffing, and complications such as nasal septal perforation, nasal infection and mucosal atrophy often occur in the long term. The charm and advantage of neuroendoscopy is that it can use the natural channels of the nasal cavity, like a fish roaming in water, to reach the surgical area smoothly and naturally for surgery, avoiding to the greatest extent possible the nuisance to the structures in the nasal cavity. The patient’s postoperative discomfort is greatly reduced, recovery time is shorter, and minimally invasive is truly achieved.
The charm and advantage of neuroendoscopy also lies in the close observation of the surgical area under good illumination. When a conventional microscope is used for pituitary tumor surgery via the nasal butterfly, the illumination principle determines that it can only “look across the shore” and there are many dead spots for observation, and the surgery depends more on the surgeon’s hand. The neuroendoscope, however, can directly observe the surgical area “behind the enemy’s back”, and with its unique wide-angle field of view similar to the “cat’s eye”, the tumor features can be clearly seen, and the tumors hidden in the corners can be revealed, thus ensuring complete, minimally invasive and safe tumor removal. This ensures complete, minimally invasive and safe resection of tumors.
The advent of neuroendoscopy and the maturation of neuroendoscopic technology have also brought about a revolutionary change in concept. Some huge invasive pituitary tumors and other tumors developing in the suprasellar and triple ventricles, such as craniopharyngioma and meningioma in the saddle area, which could only be operated craniotomically in the past, can now be operated via nasal butterfly using neuroendoscopic technology, avoiding the risk of craniotomy, shortening the postoperative hospital recovery time, and reducing the financial burden of patients.