====== Endoscopic sinus surgery ======

Inspired by an [[experience]] with endoscopic paranasal sinus surgery, an [[endoscope]] was applied in [[transsphenoidal]] [[pituitary surgery]]. This endoscopic transsphenoidal technique was used in 45 cases of [[pituitary neuroendocrine tumor]]s. Using a 4 mm rigid endoscope, the pituitary neuroendocrine tumor is removed through a [[nostril]]. A zero-degree endoscope is used for micro-adenomas. A combination of a 0-degree endoscope and a 30-degree endoscope is used for macro-adenomas that have extended to the suprasellar region. Although it is early in experience with a small number of patients, the short-term surgical results have been encouraging with patients' short [[hospital stay]] and minimum [[morbidity]]. The endoscopic technique that has evolved with Jho and Carrau experience is described with two cases of [[pituitary neuroendocrine tumor]]s
((Jho HD, Carrau RL. [[Endoscopy]] assisted [[transsphenoidal surgery]] for [[pituitary neuroendocrine tumor]]. Technical note. Acta Neurochir (Wien). [[1996]];138(12):1416-25. doi: 10.1007/BF01411120. PMID: 9030348.)).
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Intracranial [[complication]]s of [[sinusitis]] are rare but life threatening. 
Intracranial complications of [[sinusitis]] and [[acute otitis media]] are best managed in a specialist centre with multidisciplinary input. Concurrent ORL and neurosurgical intervention reduces [[abscess]] recurrence and requirement for revision neurosurgery in sinogenic complications and should represent the standard of care.  Endoscopic sinus surgery is the ORL modality of choice in experienced hands
((Sexton GP, Nae A, Cleere EF, O'Riordan I, O'Neill JP, Lacy PD, Amin M, Colreavy M, Caird J, Crimmins D. Concurrent management of suppurative intracranial complications of sinusitis and acute otitis media in children. Int J Pediatr Otorhinolaryngol. 2022 Mar 4;156:111093. doi: 10.1016/j.ijporl.2022.111093. Epub ahead of print. PMID: 35272257.)).