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Endoscopic pituitary surgery

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https://www.readbyqxmd.com/read/29770288/infrasellar-endoscopic-endonasal-approach-for-a-pituitary-adenoma-extending-into-the-third-ventricle-with-anterior-displacement-of-the-pituitary-gland
#1
Georgios A Zenonos, Eric W Wang, Juan Carlos Fernandez-Miranda
Objectives  The current video presents the nuances of the infrasellar endoscopic endonasal approach for a pituitary adenoma extending into the third ventricle, with anterior displacement of the pituitary gland. Design  The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting  The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon at a teaching academic institution...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29767319/endoscopic-vs-microscopic-transsphenoidal-surgery-for-cushing-s-disease-a-systematic-review-and-meta-analysis
#2
Leonie H A Broersen, Nienke R Biermasz, Wouter R van Furth, Friso de Vries, Marco J T Verstegen, Olaf M Dekkers, Alberto M Pereira
PURPOSE: Systematic review and meta-analysis comparing endoscopic and microscopic transsphenoidal surgery for Cushing's disease regarding surgical outcomes (remission, recurrence, and mortality) and complication rates. To stratify the results by tumor size. METHODS: Nine electronic databases were searched in February 2017 to identify potentially relevant articles. Cohort studies assessing surgical outcomes or complication rates after endoscopic or microscopic transsphenoidal surgery for Cushing's disease were eligible...
May 16, 2018: Pituitary
https://www.readbyqxmd.com/read/29765831/quality-of-life-before-and-after-endoscopic-pituitary-surgery-as-measured-by-the-short-form-36
#3
Edward C Kuan, Frederick Yoo, Jennifer Chyu, Angela Oh, Marvin Bergsneider, Marilene B Wang
Objectives/Hypotheses  To assess quality of life (QOL) after transnasal, endoscopic pituitary surgery using the 36-item short form (SF-36) instrument. Design  Retrospective review was used for this study. Setting  The study was conducted in a tertiary academic medical center. Participants  Patients who underwent endoscopic, transnasal, transsphenoidal surgery for pituitary adenomas between January 1, 2007 and July 1, 2016 and completed preoperative and postoperative SF-36 surveys. Main Outcome Measures  SF-36 survey data as measured by its eight domains (physical functioning, physical role functioning, emotional role functioning, energy/fatigue, emotional well-being, social functioning, pain, and general health)...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29749920/evolution-of-the-graded-repair-of-csf-leaks-and-skull-base-defects-in-endonasal-endoscopic-tumor-surgery-trends-in-repair-failure-and-meningitis-rates-in-509-patients
#4
Andrew Conger, Fan Zhao, Xiaowen Wang, Amalia Eisenberg, Chester Griffiths, Felice Esposito, Ricardo L Carrau, Garni Barkhoudarian, Daniel F Kelly
OBJECTIVE The authors previously described a graded approach to skull base repair following endonasal microscopic or endoscope-assisted tumor surgery. In this paper they review their experience with skull base reconstruction in the endoscopic era. METHODS A retrospective review of a single-institution endonasal endoscopic patient database (April 2010-April 2017) was undertaken. Intraoperative CSF leaks were graded based on size (grade 0 [no leak], 1, 2, or 3), and repair technique was documented across grades...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29712519/systematic-review-of-health-economic-studies-in-cranial-neurosurgery
#5
Won Hyung A Ryu, Michael M H Yang, Sandeep Muram, W Bradley Jacobs, Steven Casha, Jay Riva-Cambrin
OBJECTIVE As the cost of health care continues to increase, there is a growing emphasis on evaluating the relative economic value of treatment options to guide resource allocation. The objective of this systematic review was to evaluate the current evidence regarding the cost-effectiveness of cranial neurosurgery procedures. METHODS The authors performed a systematic review of the literature using PubMed, EMBASE, and the Cochrane Library, focusing on themes of economic evaluation and cranial neurosurgery following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29694715/evolution-of-pituitary-surgery-in-a-tertiary-centre
#6
Katherine J McNamara, Thomas F C Saunders, Adnan Darr, Sonia Kumar, Simon Shaw, Natarajan Saravanappa
BACKGROUND: Endoscopic trans-sphenoidal hypophysectomy is now widely recognised as being the chosen method of resecting pituitary gland tumours. There have been a number of advances both in technology and management of this group of patients over the years from the introduction of a multi disciplinary team (MDT) to the use of computed tomography (CT) navigation system for operative guidance. OBJECTIVE OF REVIEW: This study reviews one UK centre's experience of pituitary tumour resection over a period of 26 years and identifies how management of these cases has changed over this time...
April 25, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29686164/-treatment-of-rathke-s-cleft-cyst-technical-note-for-preservation-of-pituitary-function
#7
Miiko Ito, Kenichiro Matsuda, Atsushi Kuge, Shinya Sato, Takamasa Kayama, Yukihiko Sonoda
Pituitary dysfunction, such as panhypopituitarism or diabetes insipidus(DI), is often found in patients with Rathke's cleft cyst. Patients were treated with transsphenoidal microscopic surgery; however, pituitary dysfunction did not usually recover. Recently, endoscopic transsphenoidal surgery(eTSS)has enabled minimally invasive surgery for patients with Rathke's cleft cyst. In this study, we analyzed 22 consecutive patients with Rathke's cleft cyst who underwent eTSS to determine if pituitary dysfunction recovered...
April 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29682011/endoscopic-versus-microscopic-pituitary-adenoma-surgery-an-institutional-experience
#8
Hanuman Prasad Prajapati, Shashi Kant Jain, Virendra D Sinha
Aim: The aim of this study was to compare the efficacy of endoscopic versus microscopic excision of pituitary adenoma, and to evaluate the merits and demerits of each approach. Materials and Methods: Prospective data were collected and patients were surgically treated for pituitary adenoma at SMS Hospital, Jaipur, Rajasthan, India. Patients consent was obtained. Age, sex, presenting symptoms, length of hospital stay, pre- and post-operative hormone status, extent of resections of tumors, and intra- and post-operative complication were noted...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29595045/the-endoscopic-surgical-resection-of-intrasellar-lesions-conserves-the-hormonal-function-a-negative-correlation-to-the-microsurgical-technique
#9
Stefan Linsler, Sebastian Senger, Renate Hero-Gross, Wolf-Ingo Steudel, Joachim Oertel
BACKGROUND: The endonasal endoscopic approach is still currently under investigation for sellar tumour surgery: a higher resection rate is to be expected and complications should be minimized. The authors report their surgical results of endonasal endoscopic neurosurgery with special focus on postoperative hypopituitarism in comparison to microsurgical procedures. METHODS: Sixty patients received endoscopic endonasal transsphenoidal procedures for sellar pathologies...
March 28, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29593947/angioplasty-is-an-effective-treatment-for-vasospasm-following-pituitary-apoplexy-and-tumor-resection
#10
Diana G Douleh, Peter J Morone, Bret Mobley, Matthew R Fusco, Lola B Chambless
Pituitary apoplexy is a clinical syndrome characterized by acute headache, visual changes, and decreased consciousness occurring in association with hemorrhage or infarct of an existing pituitary adenoma. Surgical management involves tumor resection and decompression of surrounding structures including the optic apparatus. Vasospasm is a rare but potentially devastating complication of pituitary apoplexy. We present a case of pituitary apoplexy in a 28-year-old male treated with emergent endoscopic transsphenoidal resection...
January 26, 2018: Curēus
https://www.readbyqxmd.com/read/29588906/complications-of-extended-endoscopic-endonasal-surgery-in-elderly-patients
#11
Tyler J Kenning, Carlos D Pinheiro-Neto
Extended endoscopic endonasal procedures are not unique among surgical interventions in carrying increased risk in the elderly population. There are, however, components of the procedure, namely high-flow cerebrospinal fluid leaks, that do result in the potential for increased perioperative morbidity for these patients. We present the case of a 77-year-old male with a large invasive pituitary macroadenoma resected through a transplanum-transtuberculum-transsellar endonasal approach. A gross total resection was obtained with resolution of the patient's preoperative ophthalmologic deficits...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588905/endoscopic-endonasal-resection-of-a-suprasellar-pituitary-adenoma-mimicking-tuberculum-sellae-meningioma-in-a-patient-with-an-intrasellar-persistent-trigeminal-artery
#12
Alaa S Montaser, Alexandre B Todeschini, Juan M Revuelta Barbero, Mostafa Shahein, E Antonio Chiocca, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
A 50-year-old female with an incidentally diagnosed suprasellar lesion was initially managed conservatively due to the presence of an intrasellar persistent trigeminal artery going through the dorsum sellae and fundamentally forming the blood supply of the entire posterior circulation. Serial follow-up brain magnetic resonance imaging (MRI) revealed progressive enlargement of the suprasellar lesion over 4 years period. Surgery was indicated after the initial tumor growth; however, the patient refused surgery for fear of complications related to the persistent trigeminal artery...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588903/endoscopic-endonasal-transoculomotor-triangle-approach-for-the-resection-of-a-pituitary-adenoma-with-ambient-cistern-extension
#13
Georgios Andrea Zenonos, Eric Wesley Wang, Juan C Fernandez-Miranda
Objectives  The current video presents the nuances of the endoscopic endonasal transoculomotor triangle approach for the resection of a pituitary adenoma with extension into the ambient cistern. Design  The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting  The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon at a teaching academic institution...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588901/endoscopic-endonasal-transtuberculum-sellae-approach-for-the-resection-of-suprasellar-intrainfundibular-epidermoid-cyst
#14
Alaa S Montaser, Juan M Revuelta Barbero, Mostafa Shahein, Alexandre B Todeschini, Bradley A Otto, Ricardo L Carrau, Daniel M Prevedello
A 49-year-old female presented with intense headaches of 3 months duration. Brain magnetic resonance imaging (MRI) was performed and showed a sellar-suprasellar lesion extending into the third ventricle. A presumptive diagnosis of a craniopharyngioma was made. Since the patient did not have any visual deficits, she opted for conservative management. Four months later, she started to have progressive deterioration of vision; thus, surgery was indicated. The patient underwent endoscopic endonasal resection of the lesion through a transtuberculum sellae approach...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29588894/surgery-of-tuberculum-sellae-meningioma-a-technical-purview-on-pterional-approach
#15
Anil Nanda, Devi Prasad Patra, Amey Rajan Savardekar, Nasser Mohammed, Vinayak Narayan, Shyamal C Bir
Objective  Amidst the raging debate between transnasal and transcranial approaches, the critical factor that dictates success lies in the meticulous dissection of the tumor from the optic apparatus, anterior communicating artery complex, and the pituitary stalk. In this surgical video, we describe the resection of a tuberculum sellae meningioma through the pterional approach highlighting dissection through the appropriate arachnoidal plane. Case Description  The patient is a 75-year-old female who presented with optic nerve compression with bitemporal hemianopia and endocrine function abnormalities...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29581739/investigating-the-application-of-diving-endoscopic-technique-in-determining-the-extent-of-pituitary-adenoma-resection-via-the-trans-nasal-sphenoidal-approach
#16
Hai-Bin Gao, Li-Qing Wang, Jian-Yun Zhou, Wei Sun
The aim of the present study was to investigate the advantages and disadvantages of the diving endoscopic technique in pituitary adenoma surgery, and the application value in determining the extent of tumor resection. A total of 37 patients with pituitary adenoma initially underwent tumor resection under an endoscope-assisted microscope via standard trans-nasal-sphenoidal approach, and tumor cavity structure was observed by applying the diving endoscopic technique. Surgery was subsequently performed again under a microscope or endoscope...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29581015/suprasellar-hemangioblastoma-with-reversible-edema-like-change-along-the-optic-tract-a-case-report
#17
Yujiro Hattori, Shigeyuki Tahara, Osamu Yamada, Masahiro Yamaguchi, Eitaro Ishisaka, Akio Morita
BACKGROUND: Hemangioblastomas usually occur in the cerebellum, and are often a component of the von Hippel-Lindau disease. Edema-like changes along the optic tract are commonly observed in association with tumors in the sellar and suprasellar regions, such as craniopharyngiomas and pituitary adenomas. Here, we describe a case of sporadic suprasellar hemangioblastoma with edema-like changes along the optic tract that completely resolved after surgery CASE DESCRIPTION: The patient was a 28-year-old woman with failing vision and a bitemporal hemianopia...
March 23, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29580720/endonasal-endoscopic-surgery-in-pituitary-adenomas-surgical-results-in-a-series-of-86-consecutive-patients
#18
R López-García, J Abarca-Olivas, I Monjas-Cánovas, A M Picó Alfonso, P Moreno-López, J R Gras-Albert
INTRODUCTION: The endoscopic endonasal approach has become the gold standard for the surgical treatment of pituitary adenomas. OBJECTIVES: The aim of this study is to present the results obtained in our hospital in purely endoscopic surgery of pituitary adenomas. METHODS: From February 2011 to August 2016, we conducted a prospective study on a series of 86 patients with pituitary adenoma, all of whom underwent surgery with a purely endoscopic endonasal approach...
March 23, 2018: Neurocirugía
https://www.readbyqxmd.com/read/29554412/incidence-of-epistaxis-after-endoscopic-pituitary-surgery-proposed-treatment-algorithm
#19
Lee A Zimmer, Norberto Andaluz
Endoscopic transsphenoidal surgery for pituitary tumors is an increasingly common practice. Little has been reported on the incidence and treatment of postoperative epistaxis in this population. The aim of this study was to analyze the incidence of postoperative epistaxis and formulate a treatment algorithm based on our experience. We performed a case series with chart review. A total of 434 consecutive patients who had endoscopic transsphenoidal pituitary surgery were identified between April 2006 and November 2013...
March 2018: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29527390/the-posterior-nasoseptal-flap-a-novel-technique-for-closure-after-endoscopic-transsphenoidal-resection-of-pituitary-adenomas
#20
James Barger, Matthew Siow, Michael Kader, Katherine Phillips, Girish Fatterpekar, David Kleinberg, David Zagzag, Chandranath Sen, John G Golfinos, Richard Lebowitz, Dimitris G Placantonakis
Background: While effective for the repair of large skull base defects, the Hadad-Bassagasteguy nasoseptal flap increases operative time and can result in a several-week period of postoperative crusting during re-mucosalization of the denuded nasal septum. Endoscopic transsphenoidal surgery for pituitary adenoma resection is generally not associated with large dural defects and high-flow cerebrospinal fluid (CSF) leaks requiring extensive reconstruction. Here, we present the posterior nasoseptal flap as a novel technique for closure of skull defects following endoscopic resection of pituitary adenomas...
2018: Surgical Neurology International
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