{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T11:16:55Z","timestamp":1793272615098,"version":"4.5.0"},"reference-count":29,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Pituitary adenomas rank third among adult intracranial tumors, with an incidence of 3.9\u2013 7.4 cases\/per 100,000 annually. Transsphenoidal surgery has evolved to include endoscopic endonasal surgery (EEA) in many centers due to technological and surgical advancements over the past two decades. We aim to analyze a 12-year cohort of pituitary adenomas operated through EEA, highlighting the evolution of surgical techniques and outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A retrospective review of patients undergoing EEA was conducted. A team of an otolaryngologist and neurosurgeon performed surgeries. The cohort was divided into three groups: Phase 1 (P1, 2012\u20132015), Phase 2 (P2, 2016\u20132019), and Phase 3 (P3, 2020\u20132023). Patient demographics, clinical data, and outcomes were collected from electronic medical records and compared over time.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The mean age was 54.2 years, with 53.5% being female. The gross total resection rate was 75.6%, increasing from 62.3% in P1 to 76.3% in P3 (\n P<\/jats:italic>\n = 0.003). The mean operative duration was 274.61 min, with no significant correlation to case number. Complication rates, excluding cerebrospinal fluid (CSF) leaks, were similar between the groups, with no statistically significant differences observed for complications such as visual deficit, cranial nerve palsy, and epistaxis. However, meningitis decreased significantly from 3.8% to 0.3% (\n P<\/jats:italic>\n < 0.001). Intraoperative CSF leaks decreased from 65.1% to 55% (\n P<\/jats:italic>\n = 0.003). The need for revision surgery was lower in P3 (8.5% vs. 5.4% vs. 2.1,\n P<\/jats:italic>\n < 0.001). Length of hospitalization decreased from 5.3 days to 3.9 days (\n P<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Our experience with EEA for pituitary adenomas shows significant improvements in surgical outcomes, reduced complications, and better postoperative management, underscoring the importance of experience, technical refinement, and a multidisciplinary approach.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_750_2024","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T00:30:13Z","timestamp":1731025813000},"page":"407","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The learning curve and outcomes of 1038 endoscopic endonasal transsphenoidal pituitary tumor surgeries \u2013 A single surgical team experience"],"prefix":"10.25259","volume":"15","author":[{"given":"Muhammet Enes","family":"Gurses","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"G\u00f6kalp","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery,University of Southern California, Los Angeles, CA, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neslihan Nisa","family":"Gecici","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khushi Hemendra","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie Rose","family":"Baboun","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany Alyssa","family":"Eatz","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mynor Mendez","family":"Valdez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith Claire","family":"Costello","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caleigh Samantha","family":"Roach","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin A.","family":"Merenzon","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor M.","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish H.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E.","family":"Ivan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoukaa","family":"Sargi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo J.","family":"Komotar","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami, Miller School of Medicine, Lois Pope Life Center, Miami, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2024,11,8]]},"reference":[{"key":"10.25259\/SNI_750_2024\/ref-1","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1002\/lary.30496","article-title":"Hajek and Hirsch: Otolaryngology pioneers of endonasal transsphenoidal pituitary surgery","volume":"133","author":"Ben-Shlomo","year":"2023","journal-title":"Laryngoscope"},{"key":"10.25259\/SNI_750_2024\/ref-2","doi-asserted-by":"crossref","first-page":"959440","DOI":"10.3389\/fsurg.2022.959440","article-title":"Endoscopic transsphenoidal surgery for non-functioning pituitary adenoma: Learning curve and surgical results in a prospective series during initial experience","volume":"9","author":"Boetto","year":"2022","journal-title":"Front Surg"},{"key":"10.25259\/SNI_750_2024\/ref-3","doi-asserted-by":"crossref","first-page":"861","DOI":"10.3171\/2017.11.JNS172141","article-title":"Evolution of the graded repair of CSF leaks and skull base defects in endonasal endoscopic tumor surgery: Trends in repair failure and meningitis rates in 509 patients","volume":"130","author":"Conger","year":"2019","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_750_2024\/ref-4","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.ecl.2020.04.002","article-title":"The epidemiology of pituitary adenomas","volume":"49","author":"Daly","year":"2020","journal-title":"Endocrinol Metab Clin North Am"},{"key":"10.25259\/SNI_750_2024\/ref-5","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s11102-024-01396-x","article-title":"Repeat endoscopic endonasal transsphenoidal surgery for residual or recurrent Cushing\u2019s disease: Safety, feasibility, and success","volume":"27","author":"Hanalioglu","year":"2024","journal-title":"Pituitary"},{"key":"10.25259\/SNI_750_2024\/ref-6","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1288\/00005537-199202000-00016","article-title":"Endoscopic 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craniopharyngiomas","volume":"77","author":"Komotar","year":"2012","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_750_2024\/ref-13","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1007\/s11102-011-0359-3","article-title":"Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of giant pituitary adenomas","volume":"15","author":"Komotar","year":"2012","journal-title":"Pituitary"},{"key":"10.25259\/SNI_750_2024\/ref-14","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1227\/NEU.0b013e31825ea3e0","article-title":"Endoscopic endonasal approach for resection of cranial base chordomas: Outcomes and learning curve","volume":"71","author":"Koutourousiou","year":"2012","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_750_2024\/ref-15","doi-asserted-by":"crossref","first-page":"464","DOI":"10.3171\/2014.10.JNS131919","article-title":"Marching beyond the sella: Gerard Guiot and his contributions to 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surgery","volume":"33","author":"Schmidt","year":"2012","journal-title":"Neurosurg Focus"},{"key":"10.25259\/SNI_750_2024\/ref-28","doi-asserted-by":"crossref","first-page":"337","DOI":"10.3171\/2018.10.JNS182154","article-title":"Lessons learned in the evolution of endoscopic skull base surgery","volume":"130","author":"Schwartz","year":"2019","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_750_2024\/ref-29","doi-asserted-by":"crossref","first-page":"750","DOI":"10.3171\/2019.12.JNS192600","article-title":"How long is the tail end of the learning curve? Results from 1000 consecutive endoscopic endonasal skull base cases following the initial 200 cases","volume":"134","author":"Younus","year":"2021","journal-title":"J Neurosurg"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/the-learning-curve-and-outcomes-of-1038-endoscopic-endonasal-transsphenoidal-pituitary-tumor-surgeries-a-single-surgical-team-experience\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/the-learning-curve-and-outcomes-of-1038-endoscopic-endonasal-transsphenoidal-pituitary-tumor-surgeries-a-single-surgical-team-experience\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,30]],"date-time":"2024-11-30T18:37:36Z","timestamp":1732991856000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/the-learning-curve-and-outcomes-of-1038-endoscopic-endonasal-transsphenoidal-pituitary-tumor-surgeries-a-single-surgical-team-experience\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,8]]},"references-count":29,"alternative-id":["10.25259\/SNI_750_2024"],"URL":"https:\/\/doi.org\/10.25259\/sni_750_2024","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2024,11,8]]},"article-number":"407"}}