Objective: To explore the effects of extended transsphenoidal approach, a new approach for removing giant tumors in sellar and clival area.
Methods: Twenty-eight patients, 19 males and 9 females, aged 17 - 67 with a mean age of 47.8, with a mean history of 6.2 years, 13 with invasive giant pituitary adenoma, 10 with chordoma, 2 with giant cell tumor of bone, 2 with pituitary metastatic tumor, and 1 with pituitary endocrinal carcinoma underwent operation by extended transsphenoidal approach. The tumors were 3.0 - 5.5 cm in size. In 2 cases the tumor extended to the base of the frontal lobe, 7 tumors involved the cavernous sinus, and 19 extended to clivus.
Results: The tumor was totally removed in 19 patients, removed subtotally in 6 patients, and removed partially in 3 patients. Postoperative follow-up was performed for 6 months to 4 years. No recurrence occurred except for enlargement of 2 pituitary metastatic tumors and 1 chordoma.
Conclusion: Extended transsphenoidal approach satisfactorily reaches and helps remove the giant tumors in sellar and clival area without severe complication.