Pituitary tumors are one of the most common intracranial tumors and can be classified as prolactin, growth hormone, adrenocorticotropic hormone, etc. Depending on the type of endocrine, many pituitary tumors require surgery to solve the problem. With the continuous development of science and technology, the surgical approach of pituitary tumor has changed from open surgery to transoral nasopalatine sinus surgery to transnasopalatine sinus surgery, and the surgical technique has changed from traditional technique to microscopic technique to endoscopic technique.
Due to the small size of the nasal cavity and the irregular structure of the internal turbinates, the septum needs to be fractured and propped open with a spreader, and the operation can only be performed under a microscope, which causes more trauma; moreover, the postoperative nasal cavity needs to be filled on both sides to stop bleeding, and the patient can only breathe through the mouth and feels uncomfortable. Complications such as nasal septal perforation, nasal infection and mucosal atrophy often occur in the long term. Just as a gastroscope can be inserted into the stomach, a slim neuroendoscope can be inserted into the nasal cavity through a smaller nostril and directly reach the site where we need to operate for illumination and operation, maximizing the use of the natural cavity and reducing the damage to the normal structures of the nasal cavity, with minimal surgical trauma and quick recovery after surgery.
The advantage of neuroendoscopy lies not only in the minimally invasive effect on the nasal cavity, but also in the safety and thoroughness of the tumor removal process. In traditional microscopic surgery, the surgery can only be performed within a certain range of direct vision, thus the removal of tumor is often based on the feeling of hand. In contrast, the observation principle of neuroendoscope is similar to the ‘cat’s eye’ on the door of our house, and a wide-angle view can be obtained at a close distance. During the surgery, we place the endoscope as close as possible to the tumor and observe the tumor with a wide field of view at a close distance.
Due to the minimally invasive effect of neuroendoscopy, the hospitalization time of pituitary tumor patients is greatly shortened compared with traditional microscopic surgery, which greatly reduces the financial burden and pain of patients, and is no less than a blessing to patients in today’s economic crisis. In developed countries, the new technique of neuroendoscopic transnasal butterfly treatment of pituitary tumors has been commonly performed and has become one of the standard procedures for pituitary tumor surgery and is accepted by neurosurgeons and patients. Because this technique requires special training and research, only a few hospitals in China are able to perform it. After several years of unremitting efforts, the Department of Neurosurgery of Zhongshan Hospital of Fudan University has mastered the technique of neuroendoscopic transnasal butterfly surgery for pituitary tumors and has become the only hospital in China that can perform this technique. Through this technique, the number of postoperative hospital days, postoperative discomfort and cost of patients have been greatly reduced, while the total resection rate of tumors has been significantly improved. It is believed that with the promotion and popularization of this technology, this world-recognized latest surgical technique will continue to benefit the majority of pituitary tumor patients.