Ultrasonography Imaging during Nasal Endoscopic Transsphenoidal Surgery

A 59-year-old Japanese woman presented with right visual impairment and tunnel vision. Pituitary gland tumor was diagnosed and nasal endoscopic transsphenoidal surgery was performed. Following partial removal of the posterior wall of the sphenoid sinus and extension of the ultrasonography probe to contact the dura mater, the bilateral carotid arteries and the pituitary gland tumor were clearly visualized. The ultrasonography image became clearer when the sphenoid sinus was filled with physiological saline. Histopathological analysis of the resected specimen revealed a pituitary adenoma. Ultrasonography was particularly useful in depicting the arteries, showing the tumor at the nasal endoscopic transsphenoidal surgery.