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Endoscopic pituitary surgery

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https://www.readbyqxmd.com/read/28922579/evaluating-real-time-effects-of-topical-1-1000-epinephrine-in-endoscopic-sinus-and-skull-base-surgery-on-hemodynamic-parameters-through-intraoperative-arterial-line-monitoring
#1
Michael T Yim, Omar G Ahmed, Masayoshi Takashima
BACKGROUND: Administration of topical 1:1000 epinephrine is commonly used in practice to achieve vasoconstriction during endoscopic sinus surgery and skull-base surgery; however, real-time effects on cardiovascular changes from systemic absorption have not been well studied. METHODS: Twenty-six patients undergoing endoscopic transsphenoidal resection of a pituitary lesion at a single institution were included into the study. Following arterial line placement by anesthesiology, 6 cottonoid pledgets soaked in 1:1000 epinephrine were placed into the bilateral nasal passages...
September 18, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28919622/incidence-of-diabetes-insipidus-in-postoperative-period-among-the-patients-undergoing-pituitary-tumour-surgery
#2
M L Kadir, M T Islam, M M Hossain, S Sultana, R Nasrin, M M Hossain
Post operative complications after pituitary tumour surgery vary according to procedure. There are several surgical procedures being done such as transcranial, transsphenoidal microsurgical and transsphenoidal endoscopic approaches. One of the commonest complications is diabetes insipidus (DI). Our main objective was to find out the incidence of diabetes insipidus in post operative period among patients undergoing surgical intervention for pituitary tumour in our institute. The presence of diabetes insipidus in the postoperative period was established by measuring serum Na+ concentration, hourly urine output and urinary specific gravity to find out the incidence of diabetes insipidus in postoperative period in relation to age, gender, tumour diameter, function of tumour (i...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28916976/preoperative-risk-factors-for-postoperative-complications-in-endoscopic-pituitary-surgery-a-systematic-review
#3
REVIEW
Daniel J Lobatto, Friso de Vries, Amir H Zamanipoor Najafabadi, Alberto M Pereira, Wilco C Peul, Thea P M Vliet Vlieland, Nienke R Biermasz, Wouter R van Furth
BACKGROUND: The ability to preoperatively predict postoperative complication risks is valuable for individual counseling and (post)operative planning, e.g. to select low-risk patients eligible for short stay surgery or those with higher risks requiring special attention. These risks however, are not well established in pituitary surgery. METHODS: We conducted a systematic review of associations between preoperative characteristics and postoperative complications of endoscopic transsphenoidal surgery according to the PRISMA guidelines...
September 15, 2017: Pituitary
https://www.readbyqxmd.com/read/28899832/radiological-predictors-for-extent-of-resection-in-pituitary-adenoma-surgery-a-single-center-study
#4
Jose L Sanmillán, Alberto Torres-Diaz, Juan José Sanchez-Fernández, Ruth Lau, Cristina Ciller, Paloma Puyalto, Andreu Gabarrós
BACKGROUND: Preoperative radiologic evaluation of pituitary adenomas is essential. Despite the efforts made to determine the achieved resection grade after pituitary adenoma surgery, there is a high level of disagreement among all the available classifications and measurement methods employed. Our study aimed to determine pituitary adenoma imaging features, easily obtained from preoperative magnetic resonance, which could be used as resection predictor variables. Secondly, we analyzed the usefulness of the ellipsoid method in pituitary adenoma volume determination...
September 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28887283/endoscopic-transsphenoidal-approach-for-acromegaly-remission-rates-in-401-patients-2010-consensus-criteria
#5
Ihsan Anik, Burak Cabuk, Aykut Gokbel, Alev Selek, Berrin Cetinarslan, Yonca Anik, Savas Ceylan
BACKGROUND: Transsphenoidal surgery is the first choice treatment for acromegaly. Postoperative remission is an important predictor of outcome. Various factors have been described as markers of remission preoperative mean growth hormone (GH) and insulin-like growth factor-1 levels, cavernous sinus invasion, tumor size, extra pseudocapsule resection, and experience of the surgeon. MATERIALS AND METHODS: A total of 401 patients underwent 432 endoscopic transsphenoidal surgeries between August1997 and June 2016 at Pituitary Research Centre of Kocaeli University...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28872159/cerebrospinal-fluid-rhinorrhoea-following-transsphenoidal-surgery-for-pituitary-adenoma-experience-in-a-chinese-centre
#6
C Zhang, X Ding, Y Lu, L Hu, G Hu
The aim of this study was to elucidate the risk factors for cerebrospinal fluid (CSF) rhinorrhoea following transsphenoidal surgery and discuss its prevention and treatments. We retrospectively reviewed 474 consecutive cases of pituitary adenoma treated with 485 transsphenoidal surgical procedures from January 2008 to December 2011 in our department. We analysed the incidence of intra- and post-operative CSF leakage and outcomes of various repair strategies. Intra-operative CSF leakage was encountered in 85 cases (17...
August 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28869375/treatment-strategies-for-craniopharyngiomas
#7
Malte Ottenhausen, Kavelin Rumalla, Emanuele LA Corte, Andrew Alalade, Prakash Nair, Jonathan Forbes, Atef Ben Nsir, Theodore H Schwartz
Craniopharyniomas arise from the sellar region and are particularly challenging because of their close proximity to critical neurovascular structures, including cranial nerves, brainstem, internal carotid arteries, posterior cerebral arteries, hypothalamus, and the pituitary gland. The tumors are benign on histology but can cause serious symptoms by compression of surrounding vital structures. While radical surgery and gross total resection (GTR) remains the first line treatment, choosing the optimal surgical approach is critical for the minimization of complications and post-operative morbidity...
September 4, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28867316/endoscopic-endonasal-surgery-for-treatment-of-pituitary-apoplexy-16-years-of-experience-in-a-specialized-pituitary-center-endoscopic-surgery-for-pituitary-apoplexy
#8
Jackson A Gondim, Lucas Alverne F de Albuquerque, Joao Paulo Almeida, Tania Bulcao, Erica Gomes, Michele Schops, Raquel Vasconcelos, Flora da Paz, Sergio Botelho Guimarães
OBJECTIVE: Symptomatic pituitary apoplexy is a rare but life-threatening condition caused by sudden hemorrhage or infarction of a pituitary adenoma. In the current study, we aim to evaluate the clinical presentation, management and clinical outcomes in a cohort of patients who were treated for this condition in our center in the last 16 years. METHODS: We performed a retrospective analysis of all patients who underwent endoscopic endonasal surgery for treatment of symptomatic pituitary apoplexy between 2001 and 2016 in our center...
August 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28862552/cavernous-sinus-compartments-from-the-endoscopic-endonasal-approach-anatomical-considerations-and-surgical-relevance-to-adenoma-surgery
#9
Juan C Fernandez-Miranda, Nathan T Zwagerman, Kumar Abhinav, Stefan Lieber, Eric W Wang, Carl H Snyderman, Paul A Gardner
OBJECTIVE Tumors with cavernous sinus (CS) invasion represent a neurosurgical challenge. Increasing application of the endoscopic endonasal approach (EEA) requires a thorough understanding of the CS anatomy from an endonasal perspective. In this study, the authors aimed to develop a surgical anatomy-based classification of the CS and establish its utility for preoperative surgical planning and intraoperative guidance in adenoma surgery. METHODS Twenty-five colored silicon-injected human head specimens were used for endonasal and transcranial dissections of the CS...
September 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28862548/reoperation-for-growth-hormone-secreting-pituitary-adenomas-report-on-an-endonasal-endoscopic-series-with-a-systematic-review-and-meta-analysis-of-the-literature
#10
João Paulo Almeida, Armando S Ruiz-Treviño, Buqing Liang, Sacit B Omay, Sathwik R Shetty, Yu-Ning Chen, Vijay K Anand, Kartikey Grover, Paul Christos, Theodore H Schwartz
OBJECTIVE Surgery is generally the first-line therapy for acromegaly. For patients with residual or recurrent tumors, several treatment options exist, including repeat surgery, medical therapy, and radiation. Reoperation for recurrent acromegaly has been associated with poor results, with hormonal control usually achieved in fewer than 50% of cases. Extended endonasal endoscopic approaches (EEAs) may potentially improve the results of reoperation for acromegaly by providing increased visibility and maneuverability in parasellar areas...
September 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28860094/qol-and-work-capacity-is-unrelated-to-approach-or-complications-after-pituitary-surgery
#11
Erik Uvelius, Nazia Castelo, Babar Kahlon, Christer Svensson, Anders Cervin, Peter Höglund, Stig Valdemarsson, Peter Siesjö
OBJECTIVE: Endoscopic pituitary surgery has shown favorable clinical outcomes. Less is known about the impact of surgical approaches on health related quality of life (HRQoL) and work capacity. The present study was undertaken to compare transsphenoidal microscope-assisted surgery to endoscopic transsphenoidal surgery regarding preoperative and surgical factors for the final outcome of HRQoL and work capacity. METHODS: In a retrospective study on patients operated for pituitary adenoma, outcome was compared between those operated before and after transition to endoscopic surgery at our department...
August 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28859712/long-term-olfactory-outcome-after-nasoseptal-flap-reconstructions-in-midline-skull-base-surgery
#12
Michael B Soyka, Carlo Serra, Luca Regli, Eva Meier, David Holzmann
BACKGROUND: The nasoseptal flap (NSF) is a universally used surgical technique to cover defects of the skull base after extended sinonasal surgery. Long-term follow-up of complications, sequelae, and smell function is largely unknown. OBJECTIVE: The main objective of this study was to investigate monorhinal olfaction after transsphenoidal skull base surgery. METHODS: Patients who underwent skull base surgery for midline lesions (craniopharyngioma and pituitary tumors) by using a NSF, also referred to as the Haddad flap, were assessed for their long-term outcome...
September 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28859453/comparison-of-complications-trends-and-costs-in-endoscopic-vs-microscopic-pituitary-surgery-analysis-from-a-us-health-claims-database
#13
Anthony O Asemota, Masaru Ishii, Henry Brem, Gary L Gallia
BACKGROUND: Microsurgical and endoscopic techniques are commonly utilized surgical approaches to pituitary pathologies. There are limited data comparing these 2 procedures. OBJECTIVE: To evaluate postoperative complications, associated costs, and national and regional trends of microscopic and endoscopic techniques in the United States employing a nationwide database. METHODS: The Truven MarketScan database 2010 to 2014 was queried and Current Procedural Terminology codes identified patients that underwent microscopic and/or endoscopic transsphenoidal pituitary surgery...
September 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28844919/guidewire-breakage-during-cavernous-sinus-sampling-a-rare-complication-and-its-treatment
#14
Necmettin Tanriover, Baris Kucukyuruk, Saffet Tuzgen, Nil Comunoglu, Osman Kizilkilic, Nurperi Gazioglu
BACKGROUND: Venous sampling methods are valuable tools for the diagnosis of pituitary adenomas. However, these interventions also have their complications, which may complicate the treatment process. CASE DESCRIPTION: A forty-nine year old female pituitary adenoma patient with preliminary diagnosis of Cushing's disease underwent cavernous sinus sampling (CSS) to delineate the adenoma. The micro guidewire broke during the procedure and the distal part of the micro guidewire had to be left within the right cavernous sinus...
August 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28841122/folate-receptor-overexpression-can-be-visualized-in-real-time-during-pituitary-adenoma-endoscopic-transsphenoidal-surgery-with-near-infrared-imaging
#15
John Y K Lee, Steve S Cho, Ryan Zeh, John T Pierce, Maria Martinez-Lage, Nithin D Adappa, James N Palmer, Jason G Newman, Kim O Learned, Caitlin White, Julia Kharlip, Peter Snyder, Philip S Low, Sunil Singhal, M Sean Grady
OBJECTIVE Pituitary adenomas account for approximately 10% of intracranial tumors and have an estimated prevalence of 15%-20% in the general US population. Resection is the primary treatment for pituitary adenomas, and the transsphenoidal approach remains the most common. The greatest challenge with pituitary adenomas is that 20% of patients develop tumor recurrence. Current approaches to reduce recurrence, such as intraoperative MRI, are costly, associated with high false-positive rates, and not recommended...
August 25, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28841120/endoscopic-extradural-supraorbital-approach-to-the-temporal-pole-and-adjacent-area-technical-note
#16
Fuminari Komatsu, Masaaki Imai, Hideaki Shigematsu, Rie Aoki, Shinri Oda, Masami Shimoda, Mitsunori Matsumae
The authors' initial experience with the endoscopic extradural supraorbital approach to the temporal pole and adjacent area is reported. Fully endoscopic surgery using the extradural space via a supraorbital keyhole was performed for tumors in or around the temporal pole, including temporal pole cavernous angioma, sphenoid ridge meningioma, and cavernous sinus pituitary adenoma, mainly using 4-mm, 0° and 30° endoscopes and single-shaft instruments. After making a supraorbital keyhole, a 4-mm, 30° endoscope was advanced into the extradural space of the anterior cranial fossa during lifting of the dura mater...
August 25, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28826711/surgical-management-of-rathke-s-cleft-cysts
#17
Vishwaraj Ratha, Subodh Patil, Vikram S Karmarkar, Nishit J Shah, Chandrashekhar E Deopujari
BACKGROUND: The diagnosis of Rathke's Cleft cysts (RCC) have increased in recent times due to improvements in imaging techniques; however symptomatic cases are uncommon and accurate preoperative diagnosis may sometimes be difficult. The indications of surgical management protocol are evolving. We aim to provide a comprehensive review of clinical, imaging, and histopathological features with operative management strategies along with outcome and prognosis in RCC. METHODS: A retrospective analysis (2003-2015)of 58 consecutive cases of RCC seen in a surgical unit...
August 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28820308/resection-of-pituitary-macroadenomas-via-the-pseudocapsule-along-the-posterior-tumor-margin-a-cohort-study-and-technical-note
#18
Davis G Taylor, John A Jane, Edward H Oldfield
OBJECTIVE Extracapsular resection of pituitary microadenomas improves remission rates, but the application of pseudocapsular techniques for macroadenomas has not been well described. In larger tumors, the extremely thin, compressed normal gland or its complete absence along the tumor's anterior surface limits the application of the traditional pseudocapsular technique that can be used for microadenomas. However, in the authors' experience, the interface between the pseudocapsule at the posterior margin of the adenoma and the compressed normal gland behind it is universally present, providing a surgical dissection plane...
August 18, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28780404/the-likelihood-of-remnant-non-functioning-pituitary-adenomas-shrinking-is-associated-with-the-lesion-s-blood-supply-pattern
#19
Miiko Ito, Atushi Kuge, Ken-Ichiro Matsuda, Shinya Sato, Takamasa Kayama, Yukihiko Sonoda
OBJECTIVE: Non-functioning pituitary adenomas (NFPA) often shrink after transsphenoidal surgery. However, little is known about the predictors of spontaneous NFPA regression. The aim of this study was to determine whether the blood supply pattern of remnant NFPA lesions was associated with the likelihood of such lesions shrinking. METHODS: A total of 37 remnant tumors in 31 patients that were treated at the Department of Neurosurgery, Yamagata University Hospital, were included in this study...
August 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28765065/reconstructive-outcome-of-intraoperative-cerebrospinal-fluid-leak-after-endoscopic-endonasal-surgery-for-tumors-involving-skull-base
#20
Chi-Man Jeon, Sang Duk Hong, Ho Jun Seol, Jung-Il Lee, Do-Hyun Nam, Yoon Jung Hwang, Doo-Sik Kong
Endoscopic transnasal surgery for tumors located at the base of the skull has a high incidence of postoperative cerebrospinal fluid (CSF) leaks. Here, we assessed the repair outcomes for high-flow CSF leaks based upon the tumor location, and analyzed the reasons for repair failure after transnasal endoscopic surgery solely for tumors involving the base of the skull. From Feb. 2009 to Dec. 2014 we performed endoscopic endonasal surgery for a variety of skull base lesions in 788 patients at our institution. Among them, 95 patients with intradural skull base tumors underwent endoscopic transnasal surgery...
July 29, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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