Das Outcome der endonasalen endoskopischen Eingriffe bei geringem Carotidenabstand

Endoscopic surgical techniques have been established as a method for transnasal

transsphenoidal approaches in the resection of sellar region pathologies. It has generally been

assumed that the transnasal transsphenoidal approach is unfavorable when the distance

between the internal carotid arteries (ICAD) is reduced. We aim in our study to

examine the influence of reduced ICAD on the outcome of these surgeries.

This is a retrospective study from January 2013 to January 2023. A total of 222

patients (mean age 54.63 ± 16.89 years) undergoing transnasal transsphenoidal endoscopic

surgery for resection of sellar region pathologies were included in this study. Patients were

categorized into subgroups based on ICAD, with n = 131 patients having an ICAD greater

than 15 mm and n = 91 patients having an ICAD of less than 15 mm. Follow-up

assessments were conducted up to 6 months post-surgery, involving magnetic resonance

imaging and collaboration with ophthalmologic and endocrinologic specialists.

The data revealed no significant correlation between reduced ICAD and the

occurrence of complications. Furthermore, tumor size was not a significant factor in total

resection when ICAD was reduced (p-value = 0.005). Although recurrence in cases of reduced

ICAD was not statistically significant (p-value = 0.036).

Our results suggest no association between reduced ICAD and the outcomes of

endoscopic procedures. Skilled surgeons can perform endoscopic procedures with

comparable outcomes even in cases of narrow ICAD.