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Transsphenoidal approach anatomic

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https://www.readbyqxmd.com/read/28602884/autostereoscopic-3d-neuronavigation-to-the-sella-technical-note
#1
A Nimer Amr, Jens Conrad, Sven Kantelhardt, Alf Giese
BACKGROUND: A drawback of conventional neuronavigation is the necessity of focusing on 2D-images in three planes at the same time to determine one's position in the operation field. A solution would be to merge the images into a single 3D-image that mirrors the actual anatomy. This solution has hitherto been hindered by technical limitations. The introduction of holographic-glassless 3D-monitors paved the way to 3D-navigation. OBJECTIVE: We present our experience with 3D-neuronavigation as exemplified by navigation to and within the sella...
June 5, 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
#2
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
#3
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...
May 4, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28470359/is-endoscopic-endonasal-transsphenoidal-surgery-increases-the-susceptibility-to-rhinosinusitis
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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...
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903115/aggressive-surgery-based-on-an-anatomical-subclassification-of-craniopharyngiomas
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27101471/critical-analysis-of-anatomical-landmarks-within-the-sphenoid-sinus-for-transsphenoidal-surgery
#15
Yahya Ahmadipour, Elias Lemonas, Homajoun Maslehaty, Sophia Goericke, Boris A Stuck, Nicolai El Hindy, Ulrich Sure, Oliver Mueller
The transsphenoidal approach to the sellar region has been introduced more than a 100 years ago. It is the accepted standard operative corridor to pathologies of the pituitary gland and surrounding structures. There are anatomical landmarks within the sphenoid sinus that are used for orientation directing to the sella floor or the cavernous sinus. Yet, little data can be found on the consistency of these landmarks. It is the aim of this study to evaluate the reliability of these anatomical landmarks for the surgeon's orientation...
November 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27070254/-the-use-of-intraoperative-doppler-ultrasound-in-endoscopic-transsphenoidal-surgery
#16
O I Sharipov, M A Kutin, P L Kalinin, D V Fomichev, V A Lukshin, A B Kurnosov
INTRODUCTION: Doppler ultrasound (DUS) has been widely used in neurosurgical practice to diagnose various cerebrovascular diseases. This technique is used in transsphenoidal surgery to identify the localization of intracranial arteries when making an approach or during tumor resection. MATERIAL AND METHODS: To identify the cavernous segment of the internal carotid artery (ICA) and/or basilar artery during endoscopic transsphenoidal surgery, we used a combined device on the basis of a click line curette («Karl Storz») and a 16 MHz Doppler probe (Lassamed)...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/26991390/endosphenoidal-coil-for-intraoperative-magnetic-resonance-imaging-of-the-pituitary-gland-during-transsphenoidal-surgery
#17
Prashant Chittiboina, S Lalith Talagala, Hellmut Merkle, Joelle E Sarlls, Blake K Montgomery, Martin G Piazza, Gretchen Scott, Abhik Ray-Chaudhury, Russell R Lonser, Edward H Oldfield, Alan P Koretsky, John A Butman
OBJECTIVE Pituitary MR imaging fails to detect over 50% of microadenomas in Cushing's disease and nearly 80% of cases of dural microinvasion. Surface coils can generate exceptionally high-resolution images of the immediately adjacent tissues. To improve imaging of the pituitary gland, a receive-only surface coil that can be placed within the sphenoid sinus (the endosphenoidal coil [ESC]) during transsphenoidal surgery (TSS) was developed and assessed. METHODS Five cadaver heads were used for preclinical testing of the ESC...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/26932956/anatomic-changes-caused-by-endoscopic-endonasal-transsphenoidal-surgery-and-their-effects-on-nasal-functions
#18
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Yong Jin Park, Soo Whan Kim, Jin Hee Cho, Boo Young Kim, Sungwoo Han, Young Hoon Jung, Yong Joo Lee, Sung Won Kim
OBJECTIVE: We evaluated postoperative changes in nasal cavity dimensions and their effects on nasal functions and symptoms. STUDY DESIGN: Case series with chart review. SETTING: Tertiary referral center. SUBJECTS AND METHODS: We studied patients who underwent binostril, 4-hand endoscopic endonasal transsphenoidal approach surgery with the bilateral modified nasoseptal rescue flap technique. Pre- and postoperative paranasal computed tomography scans were used to assess nasal cavity dimensional changes at 4 levels...
June 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/26679957/morphometric-analysis-of-the-medial-opticocarotid-recess-and-its-anatomical-relations-relevant-to-the-transsphenoidal-endoscopic-endonasal-approaches
#19
Cristian Ferrareze Nunes, Daniel Monte-Serrat Prevedello, Ricardo Luis Carrau, Clóvis Orlando Pereira da Fonseca, José Alberto Landeiro
BACKGROUND: The medial opticocarotid recess (MOCR) is located in the posterior wall of the sphenoid sinus, medial to the junction of the optic canal (OC) and the carotid prominence (CP). There is controversy in the literature in relation to the presence of the MOCR and its constancy, which is relevant when approaching the skull base through an endoscopic route. METHODS: The morphometric relations of the MOCR with the surrounding structures were studied in 18 cadaveric specimens after endoscopic endonasal approach (EEA)...
February 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/26658152/vascular-complications-of-intercavernous-sinuses-during-transsphenoidal-surgery-an-anatomical-analysis-based-on-autopsy-and-magnetic-resonance-venography
#20
Xuefei Deng, Shijun Chen, Ya Bai, Wen Song, Yongchao Chen, Dongxue Li, Hui Han, Bin Liu
PURPOSE: Vascular complications induced by intercavernous sinus injury during dural opening in the transsphenoidal surgery may contribute to incomplete tumour resections. Preoperative neuro-imaging is of crucial importance in planning surgical approach. The aim of this study is to correlate the microanatomy of intercavernous sinuses with its contrast-enhanced magnetic resonance venography (CE-MRV). METHODS: Eighteen human adult cadavers and 24 patients were examined based on autopsy and CE-MRV...
2015: PloS One
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