Complications of endoscopic endonasal transsphenoidal surgery

Endoscopie endonasal transsphenoidal surgery can be nowadays considered a standard technique in the treatment of lesions of the sellar and parasellar areas, routinely employed in many neurosurgical centers. In spite of the excellent view of the anatomical details it allows, easier treatment of recurrences and very good compliance by the patients, the morbidity is not negligible and complications still occur. We divided the complications into different groups,1 according to the anatomical structures and the systems involved (naso-facial, sphenoid sinus, sella turcica, supra and parasellar and endocrinologie complications), and the respective figures were compared to the same in course of the microsurgical transsphenoidal operation. The most remarkable feature that seems to come out from the analysis of the first 148 patients operated on by this approach from 1997 to 2000, is the overall reduced amount of complications, that are even lower in respect to those that occurred to experienced microneurosurgeons with more than 200 transsphenoidal procedures,2 even though the present series has to take into consideration the sharp learning curve of this new technique.