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Endoscopic pituitary surgery

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https://www.readbyqxmd.com/read/28109490/risk-factors-for-cerebrospinal-fluid-leak-in-pediatric-patients-undergoing-endoscopic-endonasal-skull-base-surgery
#1
Amanda L Stapleton, Elizabeth C Tyler-Kabara, Paul A Gardner, Carl H Snyderman, Eric W Wang
OBJECTIVES: To determine the risk factors associated with cerebrospinal fluid (CSF) leak following endoscopic endonasal surgery (EES) for pediatric skull base lesions. METHODS: Retrospective chart review of pediatric patients (ages 1 month to 18 years) treated for skull base lesions with EES from 1999 to 2014. Five pathologies were reviewed: craniopharyngioma, clival chordoma, pituitary adenoma, pituitary carcinoma, and Rathke's cleft cyst. Fisher's exact tests were used to evaluate the different factors to determine which had a statistically higher risk of leading to a post-operative CSF leak...
February 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28104521/endoscopic-versus-microscopic-transsphenoidal-surgery-in-the-treatment-of-pituitary-adenoma-a-systematic-review-and-meta-analysis
#2
Aijun Li, Weisheng Liu, Peicheng Cao, Yuehua Zheng, Zhenfu Bu, Tao Zhou
BACKGROUND: Inconsistent findings have been reported regarding the efficacy and safety of endoscopic and microscopic transsphenoidal surgery for pituitary adenoma. This study aimed to assess the benefits and shortcomings of these surgical methods in patients with pituitary adenoma. METHODS: The electronic databases PubMed, EmBase, and the Cochrane Library were systematically searched, as well as proceedings of major meetings. Eligible studies with retrospective or prospective design that evaluated endoscopic versus microscopic methods in patients with pituitary adenoma were included...
January 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28072724/fatal-antiphospholipid-syndrome-following-endoscopic-transnasal-transsphenoidal-surgery-for-a-pituitary-tumor-a-case-report
#3
Chiao-Zhu Li, Chiao-Ching Li, Chih-Chuan Hsieh, Meng-Chi Lin, Dueng-Yuan Hueng, Feng-Chen Liu, Yuan-Hao Chen
INTRODUCTION: The fatal type of antiphospholipid syndrome is a rare but life-threating condition. It may be triggered by surgery or infection. Endoscopic transnasal-transsphenoidal surgery is a common procedure for pituitary tumor. We report a catastrophic case of a young woman died of fatal antiphospholipid syndrome following endoscopic transnasal-transsphenoidal surgery. METHODS AND RESULT: A 31-year-old woman of a history of stroke received endoscopic transnasal-transsphenoidal surgery for a pituitary tumor...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28057594/significant-improvement-in-chronic-persistent-headaches-caused-by-small-rathke-cleft-cysts-after-transsphenoidal-surgery
#4
Issei Fukui, Yasuhiko Hayashi, Daisuke Kita, Yasuo Sasagawa, Masahiro Oishi, Osamu Tachibana, Mitsutoshi Nakada
PURPOSE: Rathke cleft cysts (RCC) are usually asymptomatic and can be observed using conservative methods. However, some patients with RCCs have severe headaches even if they are small enough to be confined to the sella, and these small RCCs have seldom been discussed. This study presents an investigation into clinical characteristics of small RCCs associated with severe headaches, demonstrating efficacy and safety of endoscopic transsphenoidal surgery (ETSS) to relieve headaches. METHODS: In this study, 13 patients with small RCCs (maximum diameter < 10mm) who presented with headaches and were treated by ETSS at our institute from 2009 to 2014 were recruited...
January 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28024972/efficacy-and-complications-of-endoscopic-skull-base-surgery-for-giant-pituitary-adenomas
#5
Shigetoshi Yano, Takuichiro Hide, Naoki Shinojima
OBJECTIVE: Treatment of giant pituitary adenomas is challenging. Endoscopic endonasal skull base surgery (EES) was estimated the surgical results and complication for giant pituitary adenomas. METHODS: Thirty-four pituitary adenomas larger than 40 mm treated by EES between 2002 and 2015 were studied. Removal rates, symptoms, and complications were analyzed by direction of tumor extension. RESULTS: Average tumor size was 45.5 mm. Near-total resection (NTR) was achieved in 16 of 34 (47...
December 23, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28009230/letter-to-the-editor-endoscopic-transsphenoidal-pituitary-surgery
#6
Chih-Chang Chang, Yu-Shu Yen, Tsung-Hsi Tu, Li-Yu Fay, Wen-Cheng Huang, Jau-Ching Wu
No abstract text is available yet for this article.
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28003168/endoscopic-endonasal-surgery-for-remission-of-cushing-disease-caused-by-ectopic-intracavernous-macroadenoma-case-report-and-literature-review
#7
Maria Koutourousiou, Welby I Winstead
BACKGROUND: Complete surgical resection of an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma is the gold standard of treatment of Cushing disease. Ectopic location of these adenomas is an extremely rare condition that may compromise the diagnosis and surgical success. We present the first case of an ectopic intracavernous ACTH-secreting macroadenoma totally resected with endoscopic endonasal surgery (EES). CASE DESCRIPTION: A 36-year-old woman presented with Cushing syndrome...
December 18, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28001090/recent-technological-advances-in-pediatric-brain-tumor-surgery
#8
Bassel Zebian, Francesco Vergani, José Pedro Lavrador, Soumya Mukherjee, William John Kitchen, Vita Stagno, Christos Chamilos, Benedetta Pettorini, Conor Mallucci
X-rays and ventriculograms were the first imaging modalities used to localize intracranial lesions including brain tumors as far back as the 1880s. Subsequent advances in preoperative radiological localization included computed tomography (CT; 1971) and MRI (1977). Since then, other imaging modalities have been developed for clinical application although none as pivotal as CT and MRI. Intraoperative technological advances include the microscope, which has allowed precise surgery under magnification and improved lighting, and the endoscope, which has improved the treatment of hydrocephalus and allowed biopsy and complete resection of intraventricular, pituitary and pineal region tumors through a minimally invasive approach...
December 21, 2016: CNS Oncology
https://www.readbyqxmd.com/read/27901326/tuberculuma-sellae-meningiomas-a-systematic-review-of-transcranial-approaches-in-the-endoscopic-era
#9
Mazda Turel, Georgios Tsermoulas, Abdulmounem Yasssin-Kassab, Deven Reddy, Hugo Andrade-Barazarte, Lior Gonen, Gelareh Zadeh, Fred Gentili
INTRODUCTION: With the advent of skull base endoscopy, tuberculum sellae meningiomas (TSMs) are currently operated both from the traditional transcranial (TC) route as well as the extended endonasal endoscopic trasnssphenoidal approach (EETS). The aim of this study was to conduct a systematic review of TSMs excised via the TC route in the modern era when the EETS excision is gaining popularity. EVIDENCE ACQUISITION: We performed a systematic review in the medical literature following the PRISMA guidelines...
November 30, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27899081/endoscopic-endonasal-pituitary-adenomas-surgery-the-surgical-experience-of-178-consecutive-patients-and-learning-curve-of-two-neurosurgeons
#10
Xuefei Shou, Ming Shen, Qilin Zhang, Yichao Zhang, Wenqiang He, Zengyi Ma, Yao Zhao, Shiqi Li, Yongfei Wang
BACKGROUND: We aim to study surgical technique and analyze the related factors affecting tumor total removal and postoperative endocrinological remission for endoscopic endonasal pituitary adenomas surgery. METHODS: We retrospectively analyzed 178 endoscopic endonasal pituitary adenomas surgery from March 2011 to May 2014. Endonasal approach included the routine transnasal-sphenoidal approach, transnasal- maxillary sinus approach in four cases and transnasal-clivus approach in one case...
November 30, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27876186/randomized-trial-for-superiority-of-high-field-strength-intra-operative-magnetic-resonance-imaging-guided-resection-in-pituitary-surgery
#11
Vivek Tandon, Amol Raheja, Ashish Suri, P Sarat Chandra, Shashank S Kale, Rajinder Kumar, Ajay Garg, Mani Kalaivani, Ravindra M Pandey, Bhawani S Sharma
Till date there are no randomized trials to suggest the superiority of intra-operative magnetic resonance imaging (IOMRI) guided trans-sphenoidal pituitary resection over two dimensional fluoroscopic (2D-F) guided resections. We conducted this trial to establish the superiority of IOMRI in pituitary surgery. Primary objective was to compare extent of tumor resection between the two study arms. It was a prospective, randomized, outcome assessor and statistician blinded, two arm (A: IOMRI, n=25 and B: 2D-F, n=25), parallel group clinical trial...
November 18, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27875509/osseous-repair-in-minimally-invasive-reconstruction-of-anterior-skull-base-defects
#12
Vijay R Ramakrishnan, Adam M Terella, Seerat Poonia, Alexander G Chiu, James N Palmer
Management of anterior skull base defects is an area of continued innovation for skull base surgeons. Various grafting materials have been advocated for the repair of skull base defects depending on needs, availability, harvest site morbidity, and surgeon preference. Spontaneous bony closure of small skull defects is known to occur in animal models without bone grafts, but this phenomenon has been unexplored in the human skull base. The objective of this study was to evaluate osseous skull base closure in patients undergoing endoscopic repair of skull base defects...
January 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27872697/co-occurrence-of-pituitary-adenoma-with-suprasellar-and-olfactory-groove-meningiomas
#13
Kai-Zheong Lim, Tony Goldschlager, Ronil V Chandra, Jonathan Hall, Brent Uren, Michael Pullar
INTRODUCTION: The co-existence of pituitary adenoma and meningioma is extremely rare. It is even rarer in patients with no previous known risk factors for either tumour. Here, we present a case of synchronous non-functioning pituitary adenoma with suprasellar and olfactory groove meningiomas in a patient without previous irradiation. METHODS: The tumours were diagnosed on MRI in the 65-year-old patient who presented with patchy visual deficits. The decision was made to undergo surgery for resection of the suprasellar meningioma and the pituitary adenoma, leaving the small olfactory groove meningioma intact...
October 2016: Basic and Clinical Neuroscience
https://www.readbyqxmd.com/read/27857869/endoscopic-transmaxillary-transposition-of-temporalis-flap-for-recurrent-cerebrospinal-fluid-leak-closure
#14
Regi Thomas, Shabari Girishan, Ari George Chacko
Objective To describe the technique of endoscopic transmaxillary temporalis muscle flap transposition for the repair of a persistent postoperative sphenoidal cerebrospinal fluid leak. Design The repair of a recurrent cerebrospinal fluid leak for a patient who had undergone endoscopic transsphenoidal excision of an invasive silent corticotroph Hardy C and Knosp Grade IV pituitary adenoma was undertaken. The patient had completed postoperative radiotherapy for the residual tumor and presented with cerebrospinal fluid leak, 1 year later...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27847570/parasellar-extension-grades-and-surgical-extent-in-endoscopic-endonasal-transsphenoidal-surgery-for-pituitary-adenomas-a-single-surgeon-s-consecutive-series-with-the-aspects-of-reliability-and-clinical-validity
#15
Sang-Hyo Lee, Jae-Sung Park, Song Lee, Sung-Won Kim, Yong-Kil Hong
OBJECTIVE: The inter-rater reliability of the modified Knosp's classification was measured before the analysis. The clinical validity of the parasellar extension grading system was evaluated by investigating the extents of resection and complication rates among the grades in the endoscopic endonasal transsphenoidal surgery (EETS) for pituitary adenomas. METHODS: From November 2008 to August 2015, of the 286 patients who underwent EETS by the senior author, 208 were pituitary adenoma cases (146 non-functioning pituitary adenomas, 10 adrenocorticotropic hormone-secreting adenomas, 31 growth hormone-secreting adenomas, 17 prolactin-secreting adenomas, and 4 thyroid-stimulating hormone-secreting adenomas; 23 microadenomas, 174 macroadenomas, and 11 giant adenomas)...
November 2016: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/27846864/one-and-a-half-nostril-endoscopic-transsphenoidal-approach-for-pituitary-adenomas-a-technical-report
#16
Guodao Wen, Chao Tang, Chunyu Zhong, Junyang Li, Zixiang Cong, Yuan Zhou, Kaidong Liu, Yong Zhang, Mamatemin Tohti, Chiyuan Ma
BACKGROUND: Binostril endoscopic transsphenoidal approach (BETA) provides sufficient manipulation space and wide endoscopic vision, although it increases the trauma of nose. Mononostril endoscopic transsphenoidal approach (META) has minimal trauma of nose, at the expense of space within the operation. We describe a one-and-a-half nostril endoscopic transsphenoidal approach (OETA) that combines the advantages of BETA and META. METHODS: We introduced OETA for pituitary adenomas with a detailed technical description...
November 15, 2016: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27812603/transsphenoidal-pituitary-surgery-by-microscopic-or-endoscopic-approach-the-still-unsolved-question-of-superiority
#17
EDITORIAL
Eduardo de Arnaldo S Vellutini
No abstract text is available yet for this article.
October 2016: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27791524/reoperative-endoscopic-endonasal-surgery-for-residual-or-recurrent-pituitary-adenomas
#18
Hazem M Negm, Rafid Al-Mahfoudh, Manish Pai, Harminder Singh, Salomon Cohen, Sivashanmugam Dhandapani, Vijay K Anand, Theodore H Schwartz
OBJECTIVE Regrowth of the lesion after surgical removal of pituitary adenomas is uncommon unless subtotal resection was originally achieved in the first surgery. Treatment for recurrent tumor can involve surgery or radiotherapy. Locations of residual tumor may vary based on the original approach. The authors evaluated the specific sites of residual or recurrent tumor after different transsphenoidal approaches and describe the surgical outcome of endoscopic endonasal transsphenoidal reoperation. METHODS The authors analyzed a prospectively collected database of a consecutive series of patients who had undergone endoscopic endonasal surgeries for residual or recurrent pituitary adenomas after an original transsphenoidal microscopic or endoscopic surgery...
October 28, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27766473/endoscopic-transnasal-skull-base-surgery-pushing-the-boundaries
#19
Nathan T Zwagerman, Georgios Zenonos, Stefan Lieber, Wei-Hsin Wang, Eric W Wang, Juan C Fernandez-Miranda, Carl H Snyderman, Paul A Gardner
The endoscopic endonasal approach (EEA) has significantly evolved since its initial uses in pituitary and sinonasal surgery. The literature is filled with reports and case series demonstrating efficacy and advantages for the entire ventral skull base. With competence in 'minimally invasive' parasellar approaches, larger and more complex approaches were developed to utilize the endonasal corridor to create maximally invasive endoscopic skull base procedures. The challenges of these more complex endoscopic procedures include a long learning curve and navigating in a narrow corridor; reconstruction of defects presented new challenges and early experience revealed a significantly higher risk of cerebrospinal fluid leak...
October 20, 2016: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/27763976/transseptal-subperichondrial-endoscopic-hypophysectomy-with-preservation-of-vital-nasal-structures
#20
Hasmet Yazici, Sedat Doğan, Mehmet Akif Sönmez, Olcay Eser
INTRODUCTION: Pituitary surgery involving different techniques is often applied to the excision of benign adenomas. Operative interventions involved various approaches and techniques. Endoscopic transsphenoidal approach is the less traumatic route to the sella turcica, avoiding brain retraction, and also permitting good visualization, with lower rates of morbidity and mortality. Although mortality of pituitary surgery decreased by advances in surgical techniques morbidities such as synechiae formation, anosmia, bleeding, nasal septal perforations, drying, and incrustation due to traumatization of the nasal structures such as septum, nasal mucosa, and middle concha are the current problems in pituitary surgery...
October 2016: Journal of Craniofacial Surgery
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