J Rhinol > Volume 26(1); 2019
Journal of Rhinology 2019;26(1):26-31.
Published online May 31, 2019.
DOI: https://doi.org/10.18787/jr.2019.26.1.26   
Clinical Usefulness of Trasseptal Transsphenoidal Approach for Pituitary Tumors with Septal Cartilage Removal and Replacement via Modified Killian Incision: Review of 42 Cases
So Yean Kim, Byoung Wook Yang, Yong Woo Lee, Kyung Chul Lee
Department of Otolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. fess0101@hanmail.net
뇌하수체 종양 수술에서 변형된 Killian 절개를 사용한 비중격 연골 제거 및 재위치 방식의 경비중격 경접형동 접근법의 임상적 유용성: 42예에 대한 분석
김소연, 양병욱, 이용우, 이경철
성균관대학교 의과대학 강북삼성병원 이비인후과학교실
Background and Objectives
The conventional transseptal transsphenoidal approach can inhibit visualization of the surgical field and may change the shape of external nose. We used the transseptal transsphenoidal technique to remove septal cartilage except the L strut via a modified Killian's incision and preserved the ‘key-stone area.’ The aim of this study was to verify the usefulness of this technique.
Retrospective analysis was carried out on 42 pituitary tumor patients who received this technique by a single otolaryngologist from March 2005 to March 2012 at Kangbuk Samsung Hospital.
The mean patient age at time of surgery was 52 years, and 41 cases were pituitary adenoma and 1 was Rathke's cleft cyst. Three patients had undergone prior surgery; of which 2 used a pterional approach and 1 a transsphenoidal approach. With regard to complication, there were 2 cases of CSF leakage and 5 cases of septal laceration. There were no cases of meningitis, deformity of external nose, septal perforation, anosmia, or sinusitis. In post operation follow up, 25 cases (59.5%) had no residual tumor, while 17 cases (40.5%) had residual tumor.
This study reveals that transseptal transsphenoidal surgery with septal cartilage removal and a replacement technique for a pituitary tumor are effective, allow easy exposure, and result in a low complication rate.
Key Words: Transsphenoidal approach;Pituitary adenoma;Killian incision

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