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Transsphenoidal approach anatomic

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https://www.readbyqxmd.com/read/29404250/extended-endoscopic-endonasal-approach-for-craniopharyngioma-removal
#1
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
#2
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-ct-and-mri-imaging-in-the-endoscopic-endonasal-approach-to-treat-skull-base-lesions
#3
Shigetoshi Yano, Naoki Shinojima, Mika Kitajima, Hiroyuki Uetani, Takuichiro Hide, Akitake Mukasa
OBJECTIVE: This report examines the utility of the preoperative image to orientate the surgeon in the sphenoid sinus during an endoscopic endonasal transsphenoidal approach (ETSS). METHODS: ETSS was performed in 100 cases of sellar lesion and used to classify the sphenoid sinus septum shape. Preoperative CT and MRI scans were taken for two types of coronal imaging: conventional and oblique. Expected sphenoid sinus septum shape was compared with those from ETSS to estimate concordance...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29027644/treatment-of-empty-sella-associated-with-visual-impairment-a-systematic-review-of-chiasmapexy-techniques
#4
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...
October 13, 2017: Pituitary
https://www.readbyqxmd.com/read/28989046/modular-classification-of-endoscopic-endonasal-transsphenoidal-approaches-to-the-sellar-region-anatomical-quantitative-study
#5
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 of balancing invasiveness and adequacy of sellar tumor exposure has recently led to the description of multiple endoscopic endonasal transsphenoidal approaches. Comparative anatomical data on these variants are lacking. OBJECT: To quantitatively compare endoscopic endonasal transsphenoidal approaches to the sella and parasellar region, using the concept of "surgical pyramid"...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28887284/quantitative-comparison-of-three-endoscopic-approaches-to-the-parasellar-region-laboratory-investigation
#6
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 using a quantitative analysis of exposure limits and instrument working avenues. METHODS: Six formalin-fixed silicone-injected adult cadaveric heads (12 sides) were studied...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28602884/autostereoscopic-three-dimensional-neuronavigation-to-the-sella-technical-note
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/27857875/dual-endoscopic-endonasal-transsphenoidal-and-precaruncular-transorbital-approaches-for-clipping-of-the-cavernous-carotid-artery-a-cadaveric-simulation
#17
Jeremy Ciporen, Brandon Lucke-Wold, Aclan Dogan, Justin S Cetas, William E Cameron
Background Endoscopic skull base approaches are being used to address complicated neurovascular pathology. These approaches are safest when proximal vascular control of the cavernous carotid artery (CavCA) can be obtained. Methods We present a cadaver-based anatomic simulation study showing the feasibility of clip placement for the CavCA as it courses through the cavernous sinus. The arterial vessels were injected with red microfil (Flow Tech, Carver, Massachusetts) to enhance visibility. The endoscope was directed through a precaruncular transorbital approach and instrumentation was managed through an endonasal transsphenoidal approach...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27500775/-endoscopic-transsphenoidal-resection-of-pituitary-adenomas-invading-the-cavernous-sinus
#18
P L Kalinin, O I Sharipov, I N Pronin, M A Kutin, D V Fomichev, B A Kadashev, A N Shkarubo, S N Alekseev, L I Astaf'eva, O F Tropinskaya, G F Dobrovol'skiy, E I Shul'ts, D N Andreev, I A Voronina, A B Kurnosov
INTRODUCTION: Pituitary adenomas are benign growths that invade the cavernous sinus (CS) in 10-15% of cases. There are different types of microsurgical and endoscopic approaches enabling resection of tumors from the CS cavity that is a relatively small and hard to reach anatomical structure comprising eloquent neurovascular structures. MATERIAL AND METHODS: A study group included 97 patients with pituitary adenomas (PAs) invading the CS. PAs were resected using an endoscopic technique: adenomas were resected from the CS cavity through a standard endoscopic endonasal transsphenoidal approach in 62 cases; a lateral extended transsphenoidal endoscopic approach was used in 35 cases...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/27431342/transalar-transsphenoidal-meningoencephalocele-presenting-in-the-form-of-recurrent-meningitis-report-of-two-cases-and-discussion-of-the-diagnosis-and-treatment
#19
A Zoghlami, N Bon Mardion, F Callonnec, D Dehesdin, F Proust, J-P Marie
INTRODUCTION: Skull base meningoencephaloceles are rare congenital malformations. The two cases of transalar transsphenoidal malformation reported here differ from the classical transsphenoidal meningoencephalocele. CASE REPORTS: Case 1 was a three-and-a-half-year-old boy and case 2 was a 36-year-old man. Both cases presented with clinical features of recurrent meningitis. Surgical management of case 1 was performed via an intradural infratemporal fossa craniotomy with reoperation 2years later...
December 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/27168320/primary-lymphomas-of-the-skull-base-from-a-neurosurgical-perspective-review-of-the-literature-and-personal-experience
#20
REVIEW
Alessandro Pesce, Michele Acqui, Marco Cimatti, Riccardo Caruso, Venceslao Wierzbicki, Antonino Raco
Primary lymphomas of the skull base are exceedingly rare and thus not commonly dealt with in everyday clinical practice. Primary diffuse large B cell lymphoma is the most commonly found (30-40% of primary non-Hodgkin lymphomas of the bone). This article reports a case of primary lymphoma of the skull base and reviews all the relevant literature in the PubMed, National Institutes of Health Library, and Google Scholar databases to outline the clinical, diagnostic, and surgical traits of this yet widely unexplored pathology...
January 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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