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https://www.readbyqxmd.com/read/28645926/nasopharyngeal-glial-heterotopia-with-delayed-postoperative-meningitis
#1
Kenichi Maeda, Kenji Furuno, Pin Fee Chong, Takato Morioka
A male infant, who underwent radical resection of a large glial heterotopia at the nasopharynx at 8 days, developed delayed postoperative bacterial meningitis at 9 months. Neuroradiological examination clearly demonstrated that meningitis had occurred because of the intracranial and extracranial connections, which were scarcely seen in the perioperative period. A transsphenoidal extension of hypothalamic hamartoma is possible because the connection started from the right optic nerve, running through the transsphenoidal canal in the sphenoid bone and terminating at the recurrent mass in the nasopharyngeal region...
June 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645320/acromegaly-discovered-during-a-routine-out-patient-surgical-procedure-a-case-report
#2
Chukwudi O Chiaghana, Julia M Bauerfeind, Cheri A Sulek, J Christopher Goldstein, Caleb A Awoniyi
BACKGROUND: Acromegaly is a rare syndrome in which there is unregulated hypersecretion of growth hormone. The anesthetic management of patients with this disorder is particularly challenging due to pre-existing cardiovascular and respiratory dysfunction, as well as recognized difficulties with airway management. Because of the insidious progression of the disease and the presence of nonspecific signs and symptoms, diagnosis is often made late when characteristic acromegalic features become apparent...
June 24, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28643208/visual-outcomes-after-endoscopic-endonasal-pituitary-adenoma-resection-a-systematic-review-and-meta-analysis
#3
REVIEW
Ivo S Muskens, Amir H Zamanipoor Najafabadi, Vanessa Briceno, Nayan Lamba, Joeky T Senders, Wouter R van Furth, Marco J T Verstegen, Timothy R S Smith, Rania A Mekary, Christine A E Eenhorst, Marike L D Broekman
PURPOSE: Patients with pituitary adenomas often present with visual deficits. While the aim of endoscopic endonasal transsphenoidal surgery (EETS) is to improve these deficits, permanent worsening is a possible outcome. The aim of this meta-analysis was to evaluate the effect of EETS for pituitary adenomas on visual outcomes. METHODS: A meta-analysis was conducted according to the PRISMA guidelines. Pooled prevalence was calculated for complete recovery, improvement, and deterioration of visual field deficits, visual acuity and unspecified visual function in fixed- and random-effect models, including assessment of heterogeneity (I(2)) and publication bias (Begg's test)...
June 22, 2017: Pituitary
https://www.readbyqxmd.com/read/28642181/surgery-outcome-of-growth-hormone-secreting-pituitary-adenoma-with-empty-sella-using-a-new-classification
#4
Qiang Wang, Xiaopeng Guo, Lu Gao, Zihao Wang, Kan Deng, Wei Lian, Renzhi Wang, Huijuan Zhu, Bing Xing
OBJECTIVE: To investigate the outcomes and identified risk factors for a cure and intraoperative cerebrospinal fluid leak following transsphenoidal surgery using a new classification for growth hormone-secreting pituitary adenoma associated with "empty sella". METHODS: This retrospective cohort study included 51 patients enrolled from January 2010 to June 2016. All subjects were categorized into three groups using a new classification scheme: Grade A, whole tumor occupation area beneath a horizontal line drawn along the lowest level of ES; Grade B, tumor occupation area that crossed the horizontal line on one side; and Grade C, tumor occupation area that crossed the horizontal line on two sides...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28621574/endovascular-plug-for-internal-carotid-artery-occlusion-in-the-management-of-a-cavernous-pseudoaneurysm-with-bifrontal-subdural-empyema-technical-note
#5
Sunil Manjila, Gagandeep Singh, Obinna Ndubuizu, Zoe Jones, Daniel P Hsu, Alan R Cohen
The authors demonstrate the use of an endovascular plug in securing a carotid artery pseudoaneurysm in an emergent setting requiring craniotomy for a concurrent subdural empyema. They describe the case of a 14-year-old boy with sinusitis and bifrontal subdural empyema who underwent transsphenoidal exploration at an outside hospital. An injury to the right cavernous segment of the ICA caused torrential epistaxis. Bleeding was successfully controlled by inflating a Foley balloon catheter within the sphenoid sinus, and the patient was transferred to the authors' institution...
June 16, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28616673/contribution-of-sellar-dura-integrity-to-symptom-manifestation-in-pituitary-adenomas-with-intratumoral-hemorrhage
#6
Yasuhiko Hayashi, Yasuo Sasagawa, Daisuke Kita, Issei Fukui, Masahiro Oishi, Osamu Tachibana, Fumiaki Ueda, Mitsutoshi Nakada
PURPOSE: Although hemorrhage within pituitary adenomas frequently exacerbates the symptoms, there are many grades of severity. Moreover, the contributing factors for symptom severity are still controversial. METHODS: This retrospective study included 82 patients who underwent transsphenoidal surgery for pituitary adenomas with intratumoral hemorrhage. The grades of preoperative symptoms were classified into group A, asymptomatic or minor symptoms; group B, moderate symptoms sufficient for complain; and group C, severe symptoms disturbing daily life...
June 14, 2017: Pituitary
https://www.readbyqxmd.com/read/28602884/autostereoscopic-3d-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 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/28602880/intraoperative-scoring-system-to-predict-postoperative-remission-in-endoscopic-endonasal-transsphenoidal-surgery-for-growth-hormone-secreting-pituitary-adenomas
#8
Shigetoshi Yano, Naoki Shinojima, Junji Kawashima, Tatsuya Kondo, Takuichiro Hide
OBJECTIVE: This study aimed to determine the predictive factors for endocrinological remission of patients with growth hormone (GH)-secreting pituitary adenomas. METHODS: In 47 patients with GH-secreting pituitary adenomas who underwent endoscopic endonasal transsphenoidal surgery with intraoperative GH measurements from 2002 to 2011, the relationship between the intraoperative GH levels and postoperative remission was analyzed, and two items that predicted remission (GH half-life obtained 30 min or less after removal and a minimum surgical GH level less than 2...
June 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28593114/transient-exacerbation-of-nasal-symptoms-following-endoscopic-transsphenoidal-surgery-for-pituitary-tumors-a-prospective-study
#9
Benjamin M Davies, Erica Tirr, Yi Yuen Wang, Kanna K Gnanalingham
Object  Endoscopic transsphenoidal surgery is the commonest approach to pituitary tumors. One disadvantage of this approach is the development of early postoperative nasal symptoms. Our aim was to clarify the peak onset of these symptoms and their temporal evolution. Methods  The General Nasal Patient Inventory (GNPI) was administered to 56 patients undergoing endoscopic transsphenoidal surgery for pituitary tumors preoperatively and at 1 day, 3 days, 2 weeks, 3 months, and 6 to 12 months postoperatively...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28591390/long-term-follow-up-of-growth-hormone-secreting-pituitary-adenomas-submitted-to-endoscopic-endonasal-surgery
#10
Caroline Martins Dos Santos Leopoldo, Felippe Martins Dos Santos Leopoldo, Américo Rubens Leite Dos Santos, José Carlos Esteves Veiga, José Viana Lima, Nilza Maria Scalissi, Paulo Roberto Lazarini, Ricardo Landini Lutaif Dolci
Objective: The aim of this study was to evaluate the results of the endoscopic transsphenoidal technique for growth hormone (GH)-secreting adenomas. Methods: A retrospective analysis based on medical records of 23 acromegalic patients submitted to endoscopic transsphenoidal surgery. Biochemical control was defined as basal GH < 1ng/ml, nadir GH < 0.4ng/ml after glucose load and age-adjusted IGF-1 normal at the last follow-up. Results: The overall endocrinological remission rate was 39...
May 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28586933/a-case-of-pituitary-carcinoma-initially-diagnosed-as-an-ectopic-growth-hormone-producing-pituitary-adenoma-with-a-high-ki-67-labeling-index
#11
Toshiki Endo, Yoshikazu Ogawa, Mika Watanabe, Teiji Tominaga
We report a case of a 66-year-old woman with a malignant transformation of a growth hormone (GH)-producing pituitary adenoma that was mainly located in the clivus. The patient originally presented with left oculomotor and abducens nerve palsies. Magnetic resonance imaging revealed a clival tumor separated from the normal pituitary gland, and the patient subsequently underwent transsphenoidal surgery. Analysis of the resected clival tissue revealed proliferation of tumor cells with slightly irregular nuclei but no mitosis...
June 6, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28584351/the-effects-of-dexmedetomidine-and-magnesium-sulphate-in-adult-patients-undergoing-endoscopic-transnasal-transsphenoidal-resection-of-pituitary-adenoma-a-double-blind-randomised-study
#12
Rabie Soliman, Eman Fouad
BACKGROUND AND AIM: Transnasal transsphenoidal resection of pituitary tumours is associated with blood loss and wide fluctuations in haemodynamic parameters. The aim of the present study was to compare the effect of dexmedetomidine and magnesium sulphate during the transsphenoidal resection of pituitary tumours. METHODS: The study was a double-blind, randomised study and included 152 patients classified randomly into two groups: Group D: Dexmedetomidine was given as a loading dose 1 μg/kg over 10 min before induction followed by an infusion at 0...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28583458/xanthomatous-hypophysitis-presenting-with-diabetes-insipidus-completely-cured-through-transsphenoidal-surgery-a-case-report-and-literature-review
#13
Wei Lin, Lu Gao, Xiaopeng Guo, Wenze Wang, Bing Xing
BACKGROUND: Xanthomatous hypophysitis (XH) is extremely rare. Only 27 cases have been reported in the literature. No XH patient presenting with diabetes insipidus (DI) has been completely cured through surgery. Here, we describe the first XH case of a DI patient whose pituitary function was normalized postoperatively, without hormone replacement therapy. CASE DESCRIPTION: A 41-year-old woman suffered from polydipsia, DI, headache and breast discharge. Laboratory investigation revealed hyperprolactinemia...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28583452/factors-affecting-the-visual-outcome-of-pituitary-adenoma-patients-treated-with-endoscopic-transsphenoidal-surgery
#14
Tuomas Luomaranta, Antti Raappana, Ville Saarela, M Johanna Liinamaa
OBJECTIVE: To evaluate visual acuity (VA) and visual fields (VF) quantitatively before and after endoscopic transsphenoidal surgery (ETS), with special attention to prognostic factors such as the pituitary adenomas' (PAs') suprasellar extension (SSE), volume and the patients' age. METHODS: Medical records of 47 PA patients operated with ETS were evaluated. VA, VF and visual impairment score (VIS) were determined pre- (VISpre) and postoperatively (VISpost). The PA's SSE, volume and chiasmal contact and their correlation with visual function was pre- and postoperatively assessed...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28583451/assessment-of-cost-drivers-in-transsphenoidal-approaches-for-resection-of-pituitary-tumors-using-the-value-driven-outcome-database
#15
Michael Karsy, Andrea A Brock, Jian Guan, Erica F Bisson, William T Couldwell
INTRODUCTION: Reducing healthcare costs while improving quality of care has become imperative in neurosurgical care. The Value-Driven Outcome (VDO) database at the University of Utah is one approach that identifies cost drivers and tracks changes over time. METHODS: A retrospective review by was performed for transsphenoidal resections of pituitary adenomas from July 2012 to September 2016. Total cost, subcategory costs, and potential cost drivers were evaluated...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28582956/endoscopic-endonasal-transsphenoidal-approach-from-the-surgeon-point-of-view
#16
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Jae-Sung Park, Dong-Jun Lim, Soo Whan Kim, Jin Hee Cho, Yong Jin Park, YulGyun Kim, Sung Won Kim
OBJECTIVE: In February 2009, the authors' center formed a team of neurosurgeons, otolaryngologists, endocrinologists, and radiologists to perform pituitary surgery using the endoscopic endonasal transsphenoidal approach (EETSA). This paper reviews the authors' experience with the technique, pathological outcomes, hormone profiles, and postoperative complications. METHODS: Between February 2009 and December 2015, 535 patients underwent the EETSA with 2-nostrils/4-hands surgery...
June 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28567295/stubborn-hiccups-as-a-sign-of-massive-apoplexy-in-a-naive-acromegaly-patient-with-pituitary-macroadenoma
#17
Gulay Simsek Bagir, Soner Civi, Ozgur Kardes, Fazilet Kayaselcuk, Melek Eda Ertorer
Pituitary apoplexy (PA) may very rarely present with hiccups. A 32-year-old man with classical acromegaloid features was admitted with headache, nausea, vomiting and stubborn hiccups. Pituitary magnetic resonance imaging (MRI) demonstrated apoplexy of a macroadenoma with suprasellar extension abutting the optic chiasm. Plasma growth hormone (GH) levels exhibited suppression (below <1 ng/mL) at all time points during GH suppression test with 75 g oral glucose. After treatment with corticosteroid agents, he underwent transsphenoidal pituitary surgery and hiccups disappeared postoperatively...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28560099/a-retrospective-analysis-of-postoperative-hypokalemia-in-pituitary-adenomas-after-transsphenoidal-surgery
#18
Lili You, Wenpeng Li, Tang Chen, Dongfang Tang, Jinliang You, Xianfeng Zhang
BACKGROUND: Pituitary adenoma is one of the most common intracranial neoplasms, and its primary treatment is endoscopic endonasal transsphenoidal tumorectomy. Postoperative hypokalemia in these patients is a common complication, and is associated with morbidity and mortality. This study aimed to analyze the etiopathology of postoperative hypokalemia in pituitary adenomas after endoscopic transsphenoidal surgery. METHODS AND MATERIALS: This retrospective study included 181 pituitary adenomas confirmed by histopathology...
2017: PeerJ
https://www.readbyqxmd.com/read/28559065/primary-pituitary-fibrosarcoma-with-prior-adenoma-a-case-report-of-a-rare-disease
#19
Ahmed Bayoumi, Jenny X Chen, Peter R Swiatek, Yosef Laviv, Ekkehard M Kasper
BACKGROUND: Pituitary sarcomas are rare clinical entities most often encountered as secondary neoplasms representing late sequelae of radiation therapy to the sellar region. Primary pituitary fibrosarcomas (PPFS) on the other hand are exceptionally rare tumors with very few cases described in the literature thus far. Herein, we present a case of PFFS and describe it in the context of the existing literature. CASE DESCRIPTION: A 39 year old female presented with two months of headaches and rapidly progressive vision loss...
May 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28535639/-curative-effect-analysis-of-two-surgical-methods-for-removal-of-pituitary-adenoma-via-endonasal-transsphenoidal-approach
#20
Y Han, Z Q Jiang, X L Zheng, L Li, F Y Lou, S J Zhang
Objective: To compare the efficacy of endoscopic endonasal transsphenoidal surgery and microsurgery for pituitary adenomas. Methods: One hundred and ten patients with pituitary adenoma who were treated by single nostril transsphenoidal surgery in the department of neurosurgery of the First Affiliated Hospital of Bengbu Medical College from June 2014 to December 2016 were enrolled.These cases were randomly divided into endoscopic group 53 cases (including 36 cases of functional pituitary adenoma and 17 cases of non-functional pituitary adenoma) and microscope group 57 cases (including 34 cases of pituitary adenoma and 23 cases of non-functional pituitary adenomas), with no significant difference in preoperative clinical data about gender, age, tumor size and endocrine function (P>0...
May 23, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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