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Pituitary surgery

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https://www.readbyqxmd.com/read/28230605/microscopic-transnasal-transsphenoidal-surgery-for-pediatric-pituitary-adenomas
#1
Wei Jiao, Yimin Huang, Wei Sun, Ting Lei
Microscopic transnasal transsphenoidal surgery (MTTS) has been a time-confirmed effective treatment for pituitary adenomas; however, the data supporting its use in pediatric patients is limited. In this study, the authors summarize the authors' 5-year experience of pituitary adenomectomy via MTTS in a pediatric population. The authors retrospectively reviewed the medical records of 35 patients aged ≤18 years who underwent microscopic transnasal transsphenoidal approach for pituitary adenomas between January 2011 and December 2015...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28225310/central-diabetes-insipidus-clinical-characteristics-and-long-term-course-in-a-large-cohort-of-adults
#2
Hiba Masri-Iraqi, Dania Hirsch, Dana Herzberg, Avner Lifshitz, Gloria Tsvetov, Carlos Benbassat, Ilan Shimon
Purpose Central diabetes insipidus (CDI) is a rare heterogeneous condition with various underlying causes. This study sought to increase the still-limited data on the clinical characteristics and long-term course in adults diagnosed with CDI. Methods Data on demographics, presentation, imaging findings, affected pituitary axes, treatment, and complications were collected retrospectively from the files of 70 adult patients with CDI followed at a referral endocrine clinic. Results 40 women and 30 men were included...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28219196/-treatment-effects-analysis-of-preoperative-long-acting-somatostatin-analogs-combined-trans-sphenoidal-endoscopic-surgery-for-patients-with-growth-hormone-secreting-pituitary-macroadenomas
#3
L Y Zhang, K Deng, Y Zhang, Y Yao, H J Zhu, Z M Jin, H Pan
Objective: To evaluate the treatment effects of preoperative long-acting somatostatin analogue (SSA) combined trans-sphenoidal endoscopic surgery for patients with growth hormone (GH)-secreting pituitary macroadenomas. Methods: Retrospective analysis was carried out on 20 patients with GH-secreting pituitary macroadenomas who were treated with preoperative SSA and trans-sphenoidal endoscopic surgery in our apartment from January 2010 to January 2016. We also selected 20 patients with only trans-sphenoidal endoscopic surgery treatment and 20 patients with preoperative SSA and non-trans-sphenoidal endoscopic surgery treatment...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28217395/the-impact-of-surgical-timing-on-visual-outcome-in-pituitary-apoplexy-literature-review-and-case-illustration
#4
REVIEW
Arif Abdulbaki, Imad Kanaan
BACKGROUND: Neuro-ophthalmologic signs are common clinical manifestations of pituitary apoplexy. Managing sudden visual loss is critical for achieving a good outcome. The timing of pituitary surgery remains controversial. In fact, various points of view have been reported in the literature. METHODS: We reviewed the impact of surgical intervention timing on visual outcome. The surgical intervention time was classified as urgent, early, intermediate, and late interventions based on the literature review...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28215426/the-impact-of-transsphenoidal-surgery-on-neurocognitive-function-a-systematic-review
#5
REVIEW
Adnan Alsumali, David J Cote, Quentin R Regestein, Erin Crocker, Abdulaziz Alzarea, Hasan A Zaidi, Wenya Linda Bi, Hassan Y Dawood, Marike L Broekman, Martine J E van Zandvoort, Rania A Mekary, Timothy R Smith
BACKGROUND: Cognitive impairment following transsphenoidal surgery (TSS) among patients with pituitary tumors has been intermittently reported and is not well established. We performed a systematic review to summarize the impact of TSS on cognitive function. METHODS: We conducted a systematic search of the literature using the PubMed, Cochrane, and Embase databases through October 2014. Studies were selected if they reported cognitive status after surgery and included at least 10 adult patients with pituitary tumors undergoing either endoscopic or microscopic TSS...
February 15, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28214641/posterior-reversible-encephalopathy-syndrome-causing-vision-loss-following-endoscopic-endonasal-resection-of-pituitary-adenoma-a-case-report
#6
Nicolas W Villelli, Daniel M Prevedello, Daniel S Ikeda, Alaa S Montaser, Bradley A Otto, Ricardo L Carrau
BACKGROUND: Posterior Reversible Encephalopathy Syndrome (PRES) is characterized by headache, altered mental status, visual changes, and seizure combined with brain imaging consistent with cerebral edema without infarction. To the best of our knowledge, we report the first case of PRES following an endoscopic endonasal resection of a pituitary macroadenoma. CASE DESCRIPTION: A 59-year-old female was diagnosed with a pituitary macroadenoma, for which she underwent endoscopic endonasal extracapsular resection...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28210908/updates-in-outcomes-of-stereotactic-radiation-therapy-in-acromegaly
#7
REVIEW
Monica Livia Gheorghiu
Purpose Treatment of acromegaly has undergone important progress in the last 20 years mainly due to the development of new medical options and advances in surgical techniques. Pituitary surgery is usually first-line therapy, and medical treatment is indicated for persistent disease, while radiation (RT) is often used as third-line therapy. The benefits of RT (tumor volume control and decreased hormonal secretion) are hampered by the long latency of the effect and the high risk of adverse effects. Stereotactic RT methods have been developed with the aim to provide more precise targeting of the tumor with better control of the radiation dose received by the adjacent brain structures...
February 16, 2017: Pituitary
https://www.readbyqxmd.com/read/28204898/surgical-treatment-and-outcome-of-tsh-producing-pituitary-adenomas
#8
Roman Rotermund, Nina Riedel, Till Burkhardt, Jakob Matschke, Nils-Ole Schmidt, Jens Aberle, Jörg Flitsch
BACKGROUND: Thyrotropin-producing adenomas (TSHomas) account for approximately 1-2% of all pituitary tumors. Recently, there has been debate on primary treatment as some studies suggest a high rate of hypopituitarism after transsphenoidal surgery and therefore suggest primary use of somatostatin analogs (SSA) instead. We would like to challenge this assumption by presenting our single-center experience with transsphenoidal surgery for TSHoma. METHODS: Fifteen patients treated consecutively between May 2010 and December 2016 were analyzed for long-term postoperative remission and pituitary function...
February 15, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28203372/diagnostic-challenges-and-management-of-a-patient-with-acromegaly-due-to-ectopic-growth-hormone-releasing-hormone-secretion-from-a-bronchial-carcinoid-tumour
#9
Nikolaos Kyriakakis, Jacqueline Trouillas, Mary N Dang, Julie Lynch, Paul Belchetz, Márta Korbonits, Robert D Murray
: A male patient presented at the age of 30 with classic clinical features of acromegaly and was found to have elevated growth hormone levels, not suppressing during an oral glucose tolerance test. His acromegaly was originally considered to be of pituitary origin, based on a CT scan, which was interpreted as showing a pituitary macroadenoma. Despite two trans-sphenoidal surgeries, cranial radiotherapy and periods of treatment with bromocriptine and octreotide, his acromegaly remained active clinically and biochemically...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28203025/-trigemino-cardiac-reflex-in-skull-base-surgery
#10
H Z Duan, Y Zhang, L Li, J Y Zhang, Z Q Yi, S D Bao
OBJECTIVE: To explore the mechanism, clinical features, and prognosis of Trigemino-cardiac reflex (TCR) during skull base operations. METHODS: A retrospective analysis was performed on 291 patients with skull base disease from Jan. 2009 to Oct. 2015 in Peking University First Hospital. By reviewing the patients' operative data and anaesthetic electrical record, and we picked out all the patients who suffered from TCR during the operation and analyzed their surgical procedures, clinical features, influence factors, and prognosis...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28202834/-a-case-of-lymphocytic-adenohypophysitis-presenting-visual-disturbance-in-the-third-trimester-of-pregnancy
#11
Ryo Yaoita, Miiko Ito, Kenichiro Matsuda, Yasuaki Kokubo, Shinya Sato, Yukihiko Sonoda
Lymphocytic hypophysitis(LH)has first been described as an autoimmune endocrinopathy by Goudie in 1962. In particular, lymphocytic adenohypophysitis(LAH)is usually associated with pregnancy and hypopituitarism due to insufficient endocrine of ACTH. However, several cases of LAH in pregnant patients showing only visual disturbances have recently been documented. We treated a patient with LAH presenting only the chiasma syndrome in the third trimester without hypopituitarism. A 27-year-old woman unexpectedly experienced visual disturbance starting in the 28th week of pregnancy...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28201827/hypogonadotropic-hypogonadism-in-non-functioning-pituitary-adenomas-impact-of-intervention
#12
Diana Margarida Monteiro, Paula Freitas, Romana Vieira, Davide Carvalho
To determine the prevalence of hypogonadotropic hypogonadism (HH) among patients with non-functioning pituitary adenomas (NFPA) and the post-surgery outcome on pituitary gonadotropins secretion (PGS); to determine the prevalence of erectile dysfunction (ED) on male patients with NFPA, to evaluate the impact of testosterone replacement therapy (TRT) in those with HH. Retrospective evaluation of gonadal function in 109 NFPA patients (45 males), with a mean age of 51.8 years, diagnosed on the last 10 years. ED questionnaire applied to 34 male patients...
February 15, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28197813/t2-weighted-mri-signal-intensity-as-a-predictor-of-hormonal-and-tumoral-responses-to-somatostatin-receptor-ligands-in-acromegaly-a-perspective
#13
REVIEW
Iulia Potorac, Albert Beckers, Jean-François Bonneville
T2-weighted MRI signal intensity of GH-secreting pituitary adenomas is gaining recognition as a marker of disease characteristics and may be a predictor of response to treatment of acromegaly. Adenomas that are T2-hypointense are more common, are smaller and are less likely to invade the cavernous sinus compared to the T2-iso and hyperintense tumors. T2-hypointense tumors are also accompanied by higher IGF1 values at baseline. When presurgical somatostatin receptor ligand (SRL) therapy is administered, T2-hypointense adenomas have better hormonal responses and have greater tumor shrinkage...
February 14, 2017: Pituitary
https://www.readbyqxmd.com/read/28192266/risk-factors-and-management-of-intraoperative-cerebrospinal-fluid-leaks-in-endoscopic-treatment-of-pituitary-adenoma-analysis-of-492-patients
#14
Qiangyi Zhou, Zhijun Yang, Xingchao Wang, Zhenmin Wang, Chi Zhao, Shun Zhang, Peng Li, Shiwei Li, Pinan Liu
OBJECTIVES: To determine risk factors and management of intraoperative cerebrospinal fluid (CSF) leakage in endoscopic endonasal transsphenoidal pituitary adenoma surgery. METHODS: we conducted a retrospective review of 492 patients who, between April 2012 and August 2015, underwent endoscopic endonasal transsphenoidal surgeries for resection of pituitary adenoma. A multivariate statistical analysis was performed to investigate the association of some risk factors with intraoperative CSF leakage...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28185972/optimizing-sellar-reconstruction-after-pituitary-surgery-with-free-mucosal-graft-results-in-the-first-50-consecutive-patients
#15
Maria Peris-Celda, Mark Chaskes, Daniel D Lee, Tyler J Kenning, Carlos D Pinheiro-Neto
BACKGROUND: Postoperative CSF leak after endoscopic pituitary surgery ranges from 1.9-10% in different series. Vascularized flaps have reduced the incidence of leak, however it carries nasal morbidity. This paper presents a technique for sellar reconstruction with free mucosal graft from the nasal cavity floor including inferior meatus mucosa. This technique aims to standardize sellar reconstruction without the use of the nasoseptal flap and keeping the advantage of mucosal coverage of the defect in all cases...
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28185971/endoscopic-endonasal-versus-microscopic-transsphenoidal-surgery-for-recurrent-and-or-residual-pituitary-adenomas
#16
REVIEW
Yoshua Esquenazi, Walid I Essayed, Harminder Singh, Elizabeth Mauer, Mudassir Ahmed, Paul J Christos, Theodore H Schwartz
No abstract text is available yet for this article.
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28175384/151%C3%A2-race-and-insurance-status-are-associated-with-higher-charges-in-patients-having-pituitary-tumor-surgery-in-new-york-state
#17
Edward Vates, Amy Lalonde, Charles Lee, Kristopher T Kimmell, Laura Calvi, Tanzy Love, Matthew C Miller
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28170483/diagnosis-and-treatment-of-pituitary-adenomas-a-review
#18
Mark E Molitch
Importance: Pituitary adenomas may hypersecrete hormones or cause mass effects. Therefore, early diagnosis and treatment are important. Observations: Prevalence of pituitary adenomas ranges from 1 in 865 adults to 1 in 2688 adults. Approximately 50% are microadenomas (<10 mm); the remainder are macroadenomas (≥10 mm). Mass effects cause headache, hypopituitarism, and visual field defects. Treatments include transsphenoidal surgery, medical therapies, and radiotherapy...
February 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28154960/radiological-features-for-the-approach-in-trans-sphenoidal-pituitary-surgery
#19
Victoria Twigg, Simon D Carr, Ramkishan Balakumar, Saurabh Sinha, Showkat Mirza
INTRODUCTION: In order to perform trans-sphenoidal endoscopic pituitary surgery safely and efficiently it is important to identify anatomical and pituitary disease features on the pre-operative CT and MRI scans; thereby minimising the risk to surrounding structures and optimising outcomes. We aim to create a checklist to streamline pre-operative planning. METHODS: We retrospectively reviewed pre-operative CT and MRI scans of 100 adults undergoing trans-sphenoidal endoscopic pituitary surgery...
February 2, 2017: Pituitary
https://www.readbyqxmd.com/read/28153622/case-report-of-a-primary-pituitary-abscess-and-systematic-literature-review-of-pituitary-abscess-with-a-focus-on-patient-outcomes
#20
REVIEW
Justice O Agyei, Lindsay J Lipinski, Jody Leonardo
BACKGROUND: Pituitary abscess is a rare but potentially life-threatening condition with an incidence of 0.2-1.1% of operative pituitary lesions. Diagnosis can be challenging, as this disorder shares many similarities with other pituitary lesions in terms of symptomatology and radiographic findings. Most pituitary abscesses are categorized as secondary, arising from pre-existing pituitary lesions or in conjunction with transsphenoidal surgery, sepsis, meningitis, or sinusitis. To date, there have been only a handful of reports of primary pituitary abscess, which occurs without any of the aforementioned risk factors...
January 30, 2017: World Neurosurgery
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