{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:14:37Z","timestamp":1791285277242,"version":"4.1.0"},"reference-count":6,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The evidence supporting endoscopic transsphenoidal pituitary adenoma resection (TSPR) is predominantly from skull base centers in high\u2010resource settings (HRSs). This study is the first comparative analysis of TSPR performed at a low\u2010resource setting (LRS), Korle Bu Teaching Hospital (KBTH), a public hospital in Accra, Ghana, versus HRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary skull base surgery centers in Ghana, the United States, Canada, and Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent TSPR at KBTH from 2021 to 2023 were compared to a multi\u2010institutional cohort of TSPR patients from skull base centers in the United States, Canada, and Australia. Univariate and multivariate analyses were performed controlling for available demographic characteristics and medical history.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The KBTH cohort included 93 patients, and the HRS cohort included 1112 patients of similar age. The HRS cohort had higher incidences of diabetes (<jats:italic>P<\/jats:italic>\u2009=\u2009.013) and cancer history (<jats:italic>P<\/jats:italic>\u2009=\u2009.012). There were two deaths in the KBTH cohort (one intracranial bleed, one meningitis) versus five in the HRS cohort (odds ratio [OR]\u2009=\u20098.07, 95% CI 1.28, 50.98). There were no differences in rates of other postoperative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These findings demonstrate the capacity of LRSs to perform endoscopic pituitary surgery and highlight the need for building rhinologic and skull base surgery capacity around the world. This study was unable to control for important factors including tumor size, postoperative access to health care resources, availability of adjuvant treatments such as neuro\u2010interventional radiology and stereotactic radiation therapy, and others.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1263","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T02:21:01Z","timestamp":1744338061000},"page":"2111-2115","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Endoscopic Pituitary Surgery in High\u2010Resource Settings Versus a Public Hospital in Ghana"],"prefix":"10.1002","volume":"172","author":[{"given":"Katherine Y.","family":"Tai","sequence":"first","affiliation":[{"name":"Columbia University Irving Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel B.","family":"Spielman","sequence":"additional","affiliation":[{"name":"MedStar Georgetown University Hospital Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren H.","family":"Tucker","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kafui","family":"Searyoh","sequence":"additional","affiliation":[{"name":"Korle Bu Teaching Hospital (KBTH) Accra Ghana"},{"name":"ENT Unit, Department of Surgery, University of Ghana Medical School, College of Health Sciences University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loius","family":"Armooh","sequence":"additional","affiliation":[{"name":"Korle Bu Teaching Hospital (KBTH) Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Confidence K.","family":"Nai","sequence":"additional","affiliation":[{"name":"Korle Bu Teaching Hospital (KBTH) Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Quarshie","sequence":"additional","affiliation":[{"name":"Korle Bu Teaching Hospital (KBTH) Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divine A.","family":"Kwami","sequence":"additional","affiliation":[{"name":"Korle Bu Teaching Hospital (KBTH) Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome K.","family":"Boatey","sequence":"additional","affiliation":[{"name":"Korle Bu Teaching Hospital (KBTH) Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Bankah","sequence":"additional","affiliation":[{"name":"Korle Bu Teaching Hospital (KBTH) Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George K.","family":"Wepeba","sequence":"additional","affiliation":[{"name":"Korle Bu Teaching Hospital (KBTH) Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney J.","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan B.","family":"Overdevest","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1938-9349","authenticated-orcid":false,"given":"David A.","family":"Gudis","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2217\/cns.15.21"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-023-02136-8"},{"issue":"6","key":"e_1_2_8_4_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-005190","article-title":"Unravelling \u201clow\u2010resource settings\u201d: a systematic scoping review with qualitative content analysis","volume":"6","author":"Zyl C","year":"2021","journal-title":"BMJ Glob Health"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21622"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20107"},{"key":"e_1_2_8_7_1","volume-title":"Cancer Control Opportunities in Low\u2010 and Middle\u2010Income Countries","author":"Institute of Medicine (US) Committee on Cancer Control in Low\u2010 and Middle\u2010Income 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