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https://www.readbyqxmd.com/read/28106514/endonasal-management-of-pediatric-congenital-transsphenoidal-encephaloceles-nuances-of-a-modified-reconstruction-technique-technical-note-and-report-of-3-cases
#1
Mehdi Zeinalizadeh, Seyed Mousa Sadrehosseini, Zohreh Habibi, Farideh Nejat, Harley Brito da Silva, Harminder Singh
OBJECTIVE Congenital transsphenoidal encephaloceles are rare malformations, and their surgical treatment remains challenging. This paper reports 3 cases of transsphenoidal encephalocele in 8- to 24-month-old infants, who presented mainly with airway obstruction, respiratory distress, and failure to thrive. METHODS The authors discuss the surgical management of these lesions via a minimally invasive endoscopic endonasal approach, as compared with the traditional transcranial and transpalatal approaches. A unique endonasal management algorithm for these lesions is outlined...
January 20, 2017: Journal of Neurosurgery. Pediatrics
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/28098212/different-volumetric-measurement-methods-for-pituitary-adenomas-and-their-crucial-clinical-significance
#3
Chi-Cheng Chuang, Shinn-Yn Lin, Ping-Ching Pai, Jiun-Lin Yan, Cheng-Hong Toh, Shih-Tseng Lee, Kuo-Chen Wei, Zhuo-Hao Liu, Chung-Ming Chen, Yu-Chi Wang, Cheng-Chi Lee
Confirming the status of residual tumors is crucial. In stationary or spontaneous regression cases, early treatments are inappropriate. The long-used geometric calculation formula is 1/2 (length × width × height). However, it yields only rough estimates and is particularly unreliable for irregularly shaped masses. In our study, we attempted to propose a more accurate method. Between 2004 and 2014, 94 patients with pituitary tumors were enrolled in this retrospective study. All patients underwent transsphenoidal surgery and received magnetic resonance imaging (MRI)...
January 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28093347/a-novel-invasive-related-biomarker-in-three-subtypes-of-non-functioning-pituitary-adenomas
#4
Yong Chen, Hong-Li Chuan, Sheng-Yuan Yu, Chu-Zhong Li, Zhe-Bao Wu, Gui-Lin Li, Ya-Zhuo Zhang
OBJECTIVES: To identify biomarkers key to invasiveness of the three subtypes of non-functioning pituitary adenomas (NFPAs) and provide a guidance for therapeutic decision-making and identification of potential adjuvant drugs. METHODS: Fifty NFPAs tumor tissues obtained from transsphenoidal surgery were used in the study. Three invasive NFPAs and four non-invasive NFPAs were used for gene expression microarray analyses; Additionally, there are five invasive NFPAs and four non-invasive NFPAs used for proteomic analyses...
January 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089836/delayed-csf-rhinorrhea-after-gamma-knife-radiosurgery-with-or-without-preceding-transsphenoidal-resection-for-pituitary-pathology
#5
Avital Perry, Christopher S Graffeo, William R Copeland, Kathryn M Van Abel, Matthew L Carlson, Bruce E Pollock, Michael J Link
BACKGROUND: Skull base cerebrospinal fluid (CSF) leak after gamma knife radiosurgery (GKRS) is a very rare complication. In patients who were treated with both GKRS and transsphenoidal resection (TSR) for pituitary lesions, early CSF leak occurs at a comparable rate to the general TSR population (4%). Delayed CSF leak occurring more than a year after TSR, GKRS, or dual therapy, is exceedingly rare. METHODS: Retrospective chart review and review of the literature RESULTS: We present two cases of delayed CSF leak following GKRS to treat pituitary adenoma...
January 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28079350/transcranial-approach-in-giant-pituitary-adenomas-results-and-outcome-in-a-modern-series
#6
Thomas Graillon, Frédéric Castinetti, Stéphane Fuentes, Regis Gras, Thierry Brue, Henry Dufour
BACKGROUND: Today, transcranial (TC) approach indications are particularly rare in pituitary adenomas (PA), representing 1.1% of all PA surgeries in our experience. In these rare and selected cases, the complications, advantages, and disadvantages of TC approach were also analyzed. METHODS: 19 cases of giant PA (≥40 mm) operated via TC approach alone or combined with transsphenoidal (TS) approach between 2000 and 2016 were selected. RESULTS: The most frequently observed symptom was visual disturbance...
January 12, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28074324/how-to-deal-with-giant-pituitary-adenomas-transsphenoidal-or-transcranial-simultaneous-or-two-staged
#7
Sheng Han, Wei Gao, Zhitao Jing, Yunjie Wang, Anhua Wu
Giant pituitary adenomas (diameter >4 cm) are a challenge to treat, and there is no consensus on the optimal surgical strategy. We report here our experience in surgical management of these lesions. Adult patients with giant pituitary adenomas (n = 62; 54 non-functioning and eight hormone-secreting adenomas) who underwent surgical resection at our hospital from 2009 to 2015 were retrospectively reviewed. Surgical and clinical outcomes were analyzed. Single transsphenoidal and transcranial approaches were used in 43 (69...
January 11, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28072724/fatal-antiphospholipid-syndrome-following-endoscopic-transnasal-transsphenoidal-surgery-for-a-pituitary-tumor-a-case-report
#8
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/28069358/pneumococcal-polysaccharide-vaccination-administered-early-after-neurotrauma-or-neurosurgery
#9
Anna Ljunghill Hedberg, Karlis Pauksens, Per Enblad, Jessika Söderberg, Björn Johansson, Helena Käyhty, Jan Sjölin
OBJECTIVES: Pneumococcal vaccination is recommended to lower the risk of posttraumatic meningitis, and early vaccination may be of importance. After both trauma and central nervous system injury, immune-suppression may occur, which could affect T-cell function and the response to T-cell dependent vaccines. We therefore aimed to investigate the response to early vaccination with a T-cell independent pneumococcal polysaccharide vaccine (PPSV). METHODS: Thirty-three patients with basilar skull fracture and 23 patients undergoing transsphenoidal pituitary gland surgery were vaccinated with PPSV within 10days after neurotrauma or neurosurgery...
January 6, 2017: Vaccine
https://www.readbyqxmd.com/read/28065874/is-complex-sphenoidal-sinus-anatomy-a-contraindication-to-a-transsphenoidal-approach-for-resection-of-sellar-lesions-presentation-of-a-case-series-and-review-of-the-literature
#10
Marco Locatelli, Andrea Di Cristofori, Riccardo Draghi, Giulio Bertani, Claudio Guastella, Lorenzo Pignataro, Giovanna Mantovani, Paolo Rampini, Giorgio Carrabba
BACKGROUND: The transsphenoidal approach (TNS) is considered the gold standard for resection of pituitary adenomas and other sellar region lesions. This approach is guided by few fundamental anatomical landmarks that conduct the surgeon toward the sellar floor. Some anatomical structures may vary a lot (e.g. intrasphenoidal septa, intercarotid distance) and may be difficult to identify. Among those structures, the pneumatization and conformation of the sphenoidal sinus (SS) plays a key role for accessing the floor of the sella and other skull base structures...
January 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28057594/significant-improvement-in-chronic-persistent-headaches-caused-by-small-rathke-cleft-cysts-after-transsphenoidal-surgery
#11
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/28057099/-the-surgery-of-thyrotropin-secreting-pituitary-adenomas-and-the-significance-of-thyroid-stimulating-hormone-level-in-follow-up
#12
Y Y Yang, H Liu, A Hu, Y Zou, B Xing, Y Yao, R Z Wang, W Lian
Objective: To explore the clinical characteristics of thyrotropin-secreting pituitary adenomas and the effect of the transsphenoidal approach of procedure with/without drug treatment for thyrotropin-secreting pituitary adenomas, and to investigate the correlation between the prognosis of thyrotropin-secreting pituitary adenomas and the postoperative level of thyroid stimulating hormone (TSH). Methods: A total of 45 patients with thyrotropin-secreting pituitary adenoma who hospitalized in Peking Union Medical College Hospital from 2000 to 2015 were enrolled in the study...
December 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28045816/risk-factors-predicting-nasoseptal-flap-failure-in-the-endoscopic-endonasal-transsphenoidal-approach
#13
Boo-Young Kim, Ji Hyeon Shin, Sung Won Kim, Yong Kil Hong, Sin-Soo Jeun, Soo Whan Kim, Jin Hee Cho, Yong Jin Park
OBJECTIVE: Reconstruction of the skull base using a pedicled nasoseptal flap (NSF) seems to be advantageous after the endoscopic endonasal transsphenoidal approach (EETSA). A few reports have evaluated the cause of flap failure in EETSA using NSFs. The aim of this study was to evaluate the perioperative risk factors for NSF failure. STUDY DESIGN: Patient series. SETTING: Retrospective review of medical records at a tertiary referral center...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28034815/transsphenoidal-posterior-pituitary-lobe-biopsy-in-patients-with-neurohypophysial-lesions
#14
Yasuyuki Kinoshita, Fumiyuki Yamasaki, Atsushi Tominaga, Satoshi Usui, Kazunori Arita, Tetsuhiko Sakoguchi, Kazuhiko Sugiyama, Kaoru Kurisu
OBJECTIVE: The differential diagnosis of neurohypophysial lesions is difficult and surgical biopsies are indispensable in the histological diagnosis of some patients. Although pituitary stalk biopsies are uniformly performed, there is a considerable risk that they will result in impaired hormonal secretion. We attempt to clarify the usefulness and safety of posterior pituitary lobe biopsy by transsphenoidal surgery (TSS). METHODS: The cases of 11 consecutive patients who underwent posterior pituitary lobe biopsies by TSS were retrospectively studied...
December 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28029524/-external-lumbar-drainage-with-volumetric-continuing-infusion-pump-in-patients-with-cerebrospinal-fluid-leak-a-case-series
#15
Ana Belén Manso Melgosa, Helena García Gutiérrez, Mónica Fernández Porras, Ana Berta Castrillo Manero, Belén Pérez Marijuán
OBJECTIVE: To describe the incidence and complications arising in a number of cases of patients with cerebrospinal fluid leak treated by external lumbar drainage with infusion pump (IP) volumetric continuous from 2001 to 2014. Quantify cerebrospinal fluid leak closed by lumbar drainage with IP. METHODS: Retrospective descriptive case series study. POPULATION: patients undergoing transsphenoidal pituitary surgery, Chiari surgery and laminectomy, that developed postoperative cerebrospinal fluid leak treated with continuous external lumbar drainage by IP...
October 28, 2016: Enfermería Clínica
https://www.readbyqxmd.com/read/28029519/adrenocorticotropic-hormone-levels-before-treatment-predict-recurrence-of-cushing-s-disease
#16
Chun-Heng Kuo, Shyang-Rong Shih, Hung-Yuan Li, Szu-Chi Chen, Po-Ju Hung, Fen-Yu Tseng, Tien-Chun Chang
BACKGROUND/PURPOSE: Cushing's disease (CD) is the most common cause of endogenous Cushing's syndrome. Transsphenoidal surgery (TSS) is the first choice of treatment. Predicting prognosis after treatment can benefit further strategies of management, but currently there is no convenient predictor. This study aims to investigate characteristic changes after treatment and to identify potential prognostic predictors. METHODS: We retrospectively studied the records of CD patients presenting to the National Taiwan University Hospital, Taipei, Taiwan between 1992 and 2011...
October 28, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28025627/patients-with-acromegaly-presenting-with-colon-cancer-a-case-series
#17
Murray B Gordon, Samer Nakhle, William H Ludlam
Introduction. Frequent colonoscopy screenings are critical for early diagnosis of colon cancer in patients with acromegaly. Case Presentations. We performed a retrospective analysis of the incidental diagnoses of colon cancer from the ACCESS trial (ClinicalTrials.gov identifier: NCT01995734). Colon cancer was identified in 2 patients (4.5%). Case  1 patient was a 36-year-old male with acromegaly who underwent transsphenoidal surgery to remove the pituitary adenoma. After surgery, the patient underwent routine colonoscopy screening, which revealed a 40 mm tubular adenoma in the descending colon...
2016: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28011356/endoscopic-removal-of-suprasellar-colloid-cyst-with-interpedincular-and-prepontine-cisterns-extension
#18
Caglar Temiz, Murat Kutlay, Mukerrem Safali, Cahit Kural, Can Ezgu, Yusuf Izci
BACKGROUND: Colloid cysts (CC) are rarely found in the sellar-suprasellar region. Differential diagnosis of CC is more challenging in this region because many other cystic lesions may locate or invade sellar or suprasellar structures. We present a large and unusual case of sellar-suprasellar colloid cyst with extension into the suprasellar, interpedincular and prepontine cisterns. This is the first case of sellar-suprasellar colloid cyst treated with endoscopic transsphenoidal approach...
December 21, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28009230/letter-to-the-editor-endoscopic-transsphenoidal-pituitary-surgery
#19
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/28009229/transoral-robotic-surgery-for-sellar-tumors-first-clinical-study
#20
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
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