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Transsphenoidal approach anatomic

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https://www.readbyqxmd.com/read/29619106/an-analysis-of-anatomic-variations-of-the-sphenoid-sinus-and-its-relationship-to-the-internal-carotid-artery
#1
Myrian Marajó Dal Secchi, Ricardo Landini Lutaif Dolci, Reginaldo Teixeira, Paulo Roberto Lazarini
Introduction  The sphenoid sinus (SS) has a high variability; its anatomical relations and variations must be well understood prior to the expanded endoscopic surgery (EES) at the skull base via the endonasal transsphenoidal approach. A feared complication is injury to the internal carotid artery (ICA). Objective  To evaluate the anatomic variations of the SS and its relationship to the ICA using computed tomography (CT). Methods  Cross-sectional retrospective study. Analysis of 90 patients' CT scans on axial, coronal and sagittal planes with 1 mm slices, evaluating lateral and posterior extensions of pneumatization of the SS, deviation of the sphenoid septum, presence of septations and their relationship to the parasellar and paraclival segments of the internal carotid artery (psICA and pcICA, respectively)...
April 2018: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29574571/a-bony-defect-of-the-sphenoid-air-sinus-found-in-male-cadaver-a-case-report
#2
Asaad A A M Al-Shouk
The sphenoid sinus one of the posterior group of sinus, considered one of the most difficult sinuses due to its deep location in the skull. The interest in the understanding of the anatomy of the sphenoid sinus increased markedly during the last decades due to the development of endoscopic transsphenoidal approaches to the intracranial structures. The important anatomical relations of the sphenoid sinus make it one of the difficult and challenging structures for the surgeons. In this case report, we present one of the anatomical variations that was found during cadaveric dissection of the head...
May 2018: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29501633/reaching-the-sellar-region-endonasally-one-or-both-nostrils-a-pilot-study-in-body-donors
#3
Stefan Linsler, David Breuskin, Thomas Tschernig, Joachim Oertel
INTRODUCTION: The purpose of this study was to evaluate the effect of posterior septectomy size on surgical exposure and surgical freedom during the endoscopic transsphenoidal approach to the sellar and parasellar region. METHODS: A mononostril and binostril approach to the sellar region was performed on 4 formalin-fixed cadaveric heads. Predefined anatomical structures were identified. Additionally, a millimeter gauge was introduced into the surgical site and the extent of dorsal septectomy was analyzed for both approaches...
May 2018: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/29497027/preoperative-computed-tomography-ct-evaluation-of-anatomical-abnormalities-in-endonasal-transsphenoidal-approach-in-pituitary-adenoma
#4
Zhengyi Guo, Chunli Liu, Haifeng Hou, Ruiying Li, Jichun Su, Fuyong Zhang, Guoqiang Xing, Linlin Qian, Jianfeng Qiu, Yuanzhong Xie, Ningxi Zhu
BACKGROUND This study aimed to retrospectively analyze patient clinical data to investigate the effects of computed tomography (CT) reconstruction and the measurement of abnormal structures in the endonasal sphenoidal sinus approach on the operative effects in patients undergoing pituitary adenoma resection. MATERIAL AND METHODS The records of 53 patients who underwent pituitary adenoma resection via the endonasal transsphenoidal approach in the Neurosurgery Department of Tai'an City Central Hospital from December 2010 to June 2016 were analyzed retrospectively...
March 2, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29404250/extended-endoscopic-endonasal-approach-for-craniopharyngioma-removal
#5
Mahmoud Messerer, Rodolfo Maduri, Roy Thomas Daniel
Objective  Endoscopic transsphenoidal extended endoscopic approach (EEA) represents a valid alternative to microsurgery for craniopharyngiomas removal, especially for retrochiasmatic lesions without large parasellar extension. The present video illustrates the salient surgical steps of the EEA for craniopahryngioma removal. Patient  A 52-year-old man presented with a bitemporal hemianopia and a bilateral decreased visual acuity. MRI showed a Kassam type III cystic craniopharyngioma with a solid component ( Fig...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29351688/three-hand-endoscopic-endonasal-transsphenoidal-surgery-experience-with-an-anatomy-preserving-mononostril-approach-technique
#6
Chikezie I Eseonu, Karim ReFaey, Eva Pamias-Portalatin, Javier Asensio, Oscar Garcia, Kofi D Boahene, Alfredo Quiñones-Hinojosa
BACKGROUND: Variations on the endoscopic transsphenoidal approach present unique surgical techniques that have unique effects on surgical outcomes, extent of resection (EOR), and anatomical complications. OBJECTIVE: To analyze the learning curve and perioperative outcomes of the 3-hand endoscopic endonasal mononostril transsphenoidal technique. METHODS: Prospective case series and retrospective data analysis of patients who were treated with the 3-hand transsphenoidal technique between January 2007 and May 2015 by a single neurosurgeon...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29325947/usefulness-of-oblique-coronal-computed-tomography-and-magnetic-resonance-imaging-in-the-endoscopic-endonasal-approach-to-treat-skull-base-lesions
#7
Shigetoshi Yano, Naoki Shinojima, Mika Kitajima, Hiroyuki Uetani, Takuichiro Hide, Akitake Mukasa
OBJECTIVE: This report examines the usefulness of the preoperative image to orient the surgeon in the sphenoid sinus during endoscopic endonasal transsphenoidal surgery (ETSS). METHODS: ETSS was performed in 100 cases of sellar lesion and used to classify the sphenoid sinus septum shape. Preoperative computed tomography and magnetic resonance imaging were performed for 2 types of coronal imaging: conventional and oblique. Expected sphenoid sinus septum shape was compared with those from ETSS to estimate concordance...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29027644/treatment-of-empty-sella-associated-with-visual-impairment-a-systematic-review-of-chiasmapexy-techniques
#8
REVIEW
Lina Raffaella Barzaghi, Carmine Antonio Donofrio, Pietro Panni, Marco Losa, Pietro Mortini
PURPOSE: Chiasmapexy is a poorly described surgical procedure adopted to correct the downward displacement of suprasellar visual system (SVS) into an empty sella (ES) causing visual worsening. The aim of our study is to define the indications for extradural and intradural chiasmapexy. METHODS: A systematic literature review has been performed on MEDLINE database (US National Library of Medicine), including only articles that depicted cases of surgically treated patients affected by ES and progressive delayed visual worsening...
February 2018: Pituitary
https://www.readbyqxmd.com/read/28989046/modular-classification-of-endoscopic-endonasal-transsphenoidal-approaches-to-sellar-region-anatomic-quantitative-study
#9
Francesco Belotti, Francesco Doglietto, Alberto Schreiber, Marco Ravanelli, Marco Ferrari, Davide Lancini, Vittorio Rampinelli, Lena Hirtler, Barbara Buffoli, Andrea Bolzoni Villaret, Roberto Maroldi, Luigi Fabrizio Rodella, Piero Nicolai, Marco Maria Fontanella
BACKGROUND: Endoscopic visualization does not necessarily correspond to an adequate working space. The need for balancing invasiveness and adequacy of sellar tumor exposure has recently led to the description of multiple endoscopic endonasal transsphenoidal approaches. Comparative anatomic data on these variants are lacking. OBJECT: We sought to quantitatively compare endoscopic endonasal transsphenoidal approaches to the sella and parasellar region, using the concept of "surgical pyramid...
January 2018: World Neurosurgery
https://www.readbyqxmd.com/read/28887284/quantitative-comparison-of-three-endoscopic-approaches-to-the-parasellar-region-laboratory-investigation
#10
Evgenii Belykh, Kaan Yağmurlu, Yuan Hong, Michael A Mooney, Baran Bozkurt, Vadim A Byvaltsev, Peter Nakaji, Mark C Preul
BACKGROUND: Endoscopic endonasal transsphenoidal and contralateral sublabial transmaxillary approaches are used for approaching parasellar lesions. The aim of this anatomical study was to compare endoscopic endonasal uninostril and binostril (contralateral) and contralateral sublabial transmaxillary approaches via a quantitative analysis of exposure limits and instrument working avenues. METHODS: Six formalin-fixed silicone-injected adult cadaveric heads (12 sides) were studied...
December 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28602884/autostereoscopic-three-dimensional-neuronavigation-to-the-sella-technical-note
#11
A Nimer Amr, Jens Conrad, Sven Kantelhardt, Alf Giese
BACKGROUND: A drawback of conventional neuronavigation is the necessity of focusing on two-dimensional images in 3 planes at the same time to determine one's position in the operating field. A solution would be to merge the images into a single three-dimensional (3D) image that mirrors the actual anatomy. The introduction of holographic glassless 3D monitors paved the way to 3D navigation. We present our experience with 3D neuronavigation as exemplified by navigation to and within the sella...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28516968/preliminary-experience-with-4k-ultra-high-definition-endoscope-analysis-of-pros-and-cons-in-skull-base-surgery
#12
M Rigante, G La Rocca, L Lauretti, G Q D'Alessandris, A Mangiola, C Anile, A Olivi, G Paludetti
During the last two decades endoscopic skull base surgery observed a continuous technical and technological development 3D endoscopy and ultra High Definition (HD) endoscopy have provided great advances in terms of visualisation and spatial resolution. Ultra-high definition (UHD) 4K systems, recently introduced in the clinical practice, will shape next steps forward especially in skull base surgery field. Patients were operated on through transnasal transsphenoidal endoscopic approaches performed using Olympus NBI 4K UHD endoscope with a 4 mm 0° Ultra Telescope, 300 W xenon lamp (CLV-S400) predisposed for narrow band imaging (NBI) technology connected through a camera head to a high-quality control unit (OTV-S400 - VISERA 4K UHD) (Olympus Corporation, Tokyo, Japan)...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28474189/transsphenoidal-and-infralabyrinthine-approach-of-the-petrous-apex-cholesterol-granuloma
#13
Karl-Ludwig Bruchhage, Barbara Wollenberg, Anke Leichtle
Space-demanding or destructive changes in the petrous bone are often challenging differential diagnosis. Cholesterol granulomas of the petrous apex can clinically present in a combination of hearing loss, vertigo, tinnitus, chronic cephalgia, impairment of facial nerve function, neuralgic pain of the nervus trigeminus, or manifest diplopia by the nerve palsy of the nervus abducens. CT-morphologically cholesterol granulomas appear as soft-tissue density masses, which may display a discrete rim after intravenous administration of a contrast agent...
July 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28470359/is-endoscopic-endonasal-transsphenoidal-surgery-increases-the-susceptibility-to-rhinosinusitis
#14
Muhammet Fatih Topuz, Murat Sarı, Adem Binnetoglu, Ramazan Dogrul, Onur Bugdaycı, Aşkın Şeker
The aim of the study was to analyze whether the measurement of changes in the anatomical position and volume of middle concha, the volume changes in the area between the middle concha and lamina papyracea, the evaluation of opacification in major paranasal sinuses, and osteomeatal complex occlusion in cases with middle concha by out-fracture technique during endoscopic endonasal transsphenoidal approach is a minimally invasive surgery, and also to find out whether these changes lead to the development of tendency to rhinosinusitis...
August 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28434957/amygdalohippocampectomy-via-the-lateral-extended-transsphenoidal-endoscopic-approach-through-the-pterygopalatine-fossa-an-anatomic-study
#15
Pavel Kalinin, Oleg Sharipov, Maxim Kutin, Dmitry Fomichev, Andreis Gavrjushin, Georgiy Polev, Yevgeny Shults, Klementina Avdeeva
BACKGROUND: The lateral extended transsphenoidal endoscopic approach (LETEA) is used to remove tumors located lateral to the cavernous segment of the internal carotid artery under direct visual control and provides access to Meckel cave, pterygopalatine fossa, medial part of the middle cranial fossa, and orbit. We describe an extended transsphenoidal approach to the amygdalohippocampectomy through the pterygopalatine fossa. METHODS: The LETEA to the middle cranial fossa through the pterygopalatine fossa was studied on 3 injected human cadavers at the Burdenko Neurosurgery Institute in Moscow, Russia...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28321371/anatomic-variations-in-pituitary-endocrinopathies-implications-for-the-surgical-corridor
#16
Edward C Kuan, Frederick Yoo, Won Kim, Karam W Badran, Thomas E Heineman, Ali R Sepahdari, Marvin Bergsneider, Marilene B Wang
Objectives/Hypotheses  Functioning pituitary adenomas may produce endocrinopathies such as acromegaly and Cushing syndrome. Both conditions lead to characteristic anatomic variations as a result of hormonally induced abnormal soft tissue deposition. We evaluate the anatomic differences between acromegalics and Cushing disease patients and compare these dimensions to controls. Design  Radiographic review of preoperative magnetic resonance images (MRI) of the pituitary gland. Setting  Tertiary academic medical center...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28239067/recent-evolution-of-endoscopic-endonasal-surgery-for-treatment-of-pituitary-adenomas
#17
Hiroshi Nishioka
For the treatment of pituitary tumors, microscopic transsphenoidal surgery has been considered the "gold standard" since the late 1960s. Over the last two decades, however, a worldwide shift towards endoscopic endonasal surgery is in progress for many reasons. These include a wide panoramic view, improved illumination, an ability to look around anatomical corners using angled tip and, in addition, application to the extended approaches for parasellar tumors. Both endoscopic and microscopic approaches appear equally effective for nonfunctioning adenomas without significant suprasellar or lateral extensions, whereas the endoscopic approach may improve outcomes associated with the extent of resection and postoperative complications for larger tumors...
April 15, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28065874/is-complex-sphenoidal-sinus-anatomy-a-contraindication-to-a-transsphenoidal-approach-for-resection-of-sellar-lesions-case-series-and-review-of-the-literature
#18
REVIEW
Marco Locatelli, Andrea Di Cristofori, Riccardo Draghi, Giulio Bertani, Claudio Guastella, Lorenzo Pignataro, Giovanna Mantovani, Paolo Rampini, Giorgio Carrabba
BACKGROUND: The transsphenoidal approach is considered the gold standard for resection of pituitary adenomas and other sellar region lesions. This approach is guided by a few fundamental anatomic landmarks that conduct the surgeon toward the sellar floor. Some anatomic structures may vary a lot (e.g., intrasphenoidal septa, intercarotid distance) and may be difficult to identify. Pneumatization and conformation of the sphenoidal sinus (SS) plays a key role in accessing the floor of the sella and other skull base structures...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28009229/transoral-robotic-surgery-for-sellar-tumors-first-clinical-study
#19
Dorian Chauvet, Stéphane Hans, Antoine Missistrano, Celeste Rebours, Wissame El Bakkouri, Guillaume Lot
OBJECTIVE The aim of this study was to confirm the feasibility of an innovative transoral robotic surgery (TORS), using the da Vinci Surgical System, for patients with sellar tumors. This technique was designed to offer a new minimally invasive approach, without soft-palate splitting, that avoids the rhinological side effects of classic endonasal approaches. METHODS The authors performed a prospective study of TORS in patients with symptomatic sellar tumors. Specific anatomical features were required for inclusion in the study and were determined on the basis of preoperative open-mouth CT scans of the brain...
October 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903115/aggressive-surgery-based-on-an-anatomical-subclassification-of-craniopharyngiomas
#20
Hiroki Morisako, Takeo Goto, Hiroyuki Goto, Christian Aisse Bohoun, Samantha Tamrakar, Kenji Ohata
OBJECTIVE Craniopharyngiomas remain a particularly formidable challenge in the neurosurgical field. Because these lesions involve the hypothalamus and ophthalmological systems, their resection is associated with either higher rates of mortality and recurrence or a lower rate of radical resection. The authors report the outcomes of aggressive surgeries based on an anatomical subclassification of craniopharyngiomas. METHODS Clinical and ophthalmological examinations, imaging studies, endocrinological studies, neuropsychological function, and surgical complications in all patients who had undergone microsurgical resection for craniopharyngioma at Osaka City University hospital between January 2000 and December 2014 were retrospectively reviewed through the medical records...
December 2016: Neurosurgical Focus
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