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The purpose of this study was to audit a single center's data regarding outcomes of purely endoscopic endonasal transsphenoidal resection of pituitary adenomas in elderly patients and to compare them to the current literature.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A retrospective review of a prospectively acquired database of all endonasal endoscopic surgeries done by the senior authors was queried for patients aged 60\u201369 years and for those aged 70 years or older. Demographic and radiographic preoperative data were reviewed. Outcomes with respect to extent of resection and complications were examined and compared with appropriate statistical tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 135 patents were identified (81 aged 60\u201369 years and 54 aged 70 years or older [70+]). The average tumor diameter was slightly larger for the patients in the 70+ age group (mean [SD] 25.7 \u00b1 9.2 mm) than for patients aged 60\u201369 years (23.1 \u00b1 9.8 mm, p = 0.056). There was no significant difference in intraoperative blood loss (p &gt; 0.99), length of stay (p = 0.22), or duration of follow-up (p = 0.21) between the 2 groups. There was a 7.4% complication rate in patients aged 60\u201369 years (3 nasal and 3 medical complications) and an 18.5% complication rate in patients older than 70 years (4 cranial, 3 nasal, 1 visual, and 2 medical complications; p = 0.05 overall and 0.013 for cranial complications). Cranial complications in the 70+ age category included 2 postoperative hematomas, 1 pseudoaneurysm formation, and 1 case of symptomatic subdural hygromas.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Endonasal endoscopic surgery in elderly patients is safe, but there is a graded increase in complication rates with increasing age. The decision to operate on an asymptomatic or mildly symptomatic patient in these age groups should take this increasing complication rate into account. The use of a lumbar drain or lumbar punctures should be weighed against the risk of subdural hematoma in patients with preexisting atrophy.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.11.jns162286","type":"journal-article","created":{"date-parts":[[2017,4,7]],"date-time":"2017-04-07T14:03:49Z","timestamp":1491573829000},"page":"429-436","source":"Crossref","is-referenced-by-count":45,"title":["Endonasal endoscopic pituitary surgery in the elderly"],"prefix":"10.3171","volume":"128","author":[{"given":"Peter J.","family":"Wilson","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neurosurgery, Prince of Wales Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sacit B.","family":"Omay","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashutosh","family":"Kacker","sequence":"additional","affiliation":[{"name":"Otolaryngology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay K.","family":"Anand","sequence":"additional","affiliation":[{"name":"Otolaryngology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Otolaryngology, and"},{"name":"Neuroscience, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns162286","series-title":"Endocr J","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1507\/endocrj.K08E-117","article-title":"Treatment of elderly acromegalics","volume":"55","author":"Arita K,","year":"2008","unstructured":"Arita K, Hirano H, Yunoue S, Fujio S, Tominaga A, Sakoguchi T, : Treatment of elderly acromegalics. 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