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https://www.readbyqxmd.com/read/29330227/earlier-post-operative-hypocortisolemia-may-predict-durable-remission-from-cushing-s-disease
#1
Natasha Ironside, Gregoire Chatain, David Asuzu, Sarah Benzo, Maya Lodish, Susmeeta Sharma, Lynnette Nieman, Constantine Stratakis, Russell Lonser, Prashant Chittiboina
CONTEXT: Achievement of hypocortisolemia following transsphenoidal surgery (TSS) for Cushing's disease (CD) is associated with successful adenoma resection. However, up to one third of these patients recur. OBJECTIVE: We assessed whether delay in reaching post-operative cortisol nadir may delineate those at risk of recurrence for CD following TSS. METHODS: A retrospective review of of 257 patients who received 291 TSS procedures for CD at NIH, between 2003 and 2016...
January 12, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29325947/usefulness-of-oblique-coronal-ct-and-mri-imaging-in-the-endoscopic-endonasal-approach-to-treat-skull-base-lesions
#2
Shigetoshi Yano, Naoki Shinojima, Mika Kitajima, Hiroyuki Uetani, Takuichiro Hide, Akitake Mukasa
OBJECTIVE: This report examines the utility of the preoperative image to orientate the surgeon in the sphenoid sinus during an endoscopic endonasal transsphenoidal approach (ETSS). METHODS: ETSS was performed in 100 cases of sellar lesion and used to classify the sphenoid sinus septum shape. Preoperative CT and MRI scans were taken for two types of coronal imaging: conventional and oblique. Expected sphenoid sinus septum shape was compared with those from ETSS to estimate concordance...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29325941/towards-shorter-hospitalization-after-endoscopic-transsphenoidal-pituitary-surgery-day-by-day-analysis-of-early-postoperative-complications-and-interventions
#3
Viktoria E Shimanskaya, Margreet A E M Wagenmakers, Ronald H M A Bartels, Hieronymus D Boogaarts, J André Grotenhuis, Ad R M M Hermus, Annenienke C van de Ven, Erik J van Lindert
BACKGROUND: It is unclear which patients have the greatest risk to develop complications in the first days after endoscopic transsphenoidal pituitary surgery (ETS) and how long patients should stay hospitalized after surgery. The objective of this study is to identify which patients are at risk for early postoperative medical and surgical re-interventions in order to optimize the length of hospitalization. METHODS: The medical records of 146 patients who underwent ETS for a pituitary adenoma between January 2013 and July 2016 were reviewed retrospectively...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29322972/a-randomized-controlled-trial-to-determine-the-role-of-intraoperative-lumbar-cerebrospinal-fluid-drainage-in-patients-undergoing-endoscopic-transsphenoidal-surgery-for-pituitary-adenomas
#4
Gandham E Jonathan, Sauradeep Sarkar, Georgene Singh, Sunithi Mani, Regi Thomas, Ari George Chacko
BACKGROUND: Intraoperative cerebrospinal fluid (CSF) leaks are a frequent cause of morbidity in patients undergoing transsphenoidal surgery. This prospective study was performed to examine the impact of intraoperative lumbar subarachnoid drainage (LSAD) on the incidence of this complication and on the extent of resection in patients undergoing endoscopic transsphenoidal surgery for pituitary adenomas. MATERIALS AND METHODS: This prospective study was conducted in a single large academic medical center...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29314715/outcomes-of-endoscopic-and-microscopic-transsphenoidal-surgery-on-non-functioning-pituitary-adenomas-a-systematic-review-and-meta-analysis
#5
Shi-Yuan Yu, Qiu Du, Si-Yuan Yao, Ke-Nan Zhang, Jian Wang, Zhe Zhu, Xiao-Bing Jiang
Both microscopic and endoscopic transsphenoidal surgery are effective approaches for nonfunctioning pituitary adenomas. The issue on the comparison of their efficacy and safety remains inconsistent. A thorough search of the literatures (PubMed, EMBASE, MEDLINE) were performed up to March 2017. Studies reporting outcomes of microscopic or endoscopic transsphenoidal surgery on nonfunctioning pituitary adenomas were included. A meta-analysis was performed focusing on the early stage and long term outcomes. The final search yielded 19 eligible studies enrolling 3847 patients, 389 of them underwent microscopic approach and 3458 of them with endoscopic approach...
January 4, 2018: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/29311226/outcome-of-endoscopic-vs-microsurgical-transsphenoidal-resection-for-cushing-s-disease
#6
REVIEW
Nidan Qiao
INTRODUCTION: It is unclear whether the proportions of remission and the recurrence rates differ between endoscopic transsphenoidal surgery (TS) and microscopic TS in Cushing's disease (CD); thus, we conducted a systematic review and meta-analysis to evaluate studies of endoscopic TS and microscopic TS. METHODS: We conducted a comprehensive search of PubMed to identify relevant studies. Remission and recurrence were used as outcome measures following surgical treatment of CD...
January 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29307020/gross-total-resection-of-pituitary-adenomas-after-endoscopic-vs-microscopic-transsphenoidal-surgery-a-meta-analysis
#7
REVIEW
Reem D Almutairi, Ivo S Muskens, David J Cote, Mark D Dijkman, Vasileios K Kavouridis, Erin Crocker, Kholoud Ghazawi, Marike L D Broekman, Timothy R Smith, Rania A Mekary, Hasan A Zaidi
BACKGROUND: Microscopic transsphenoidal surgery (mTSS) is a well-established method to address adenomas of the pituitary gland. Endoscopic transsphenoidal surgery (eTSS) has become a viable alternative, however. Advocates suggest that the greater illumination, panoramic visualization, and angled endoscopic views afforded by eTSS may allow for higher rates of gross total tumor resection (GTR). The aim of this meta-analysis was to determine the rate of GTR using mTSS and eTSS. METHODS: A meta-analysis of the literature was conducted using PubMed, EMBASE, and Cochrane databases through July 2017 in accordance with PRISMA guidelines...
January 6, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29304919/cranial-tumor-surgical-outcomes-at-a-high-volume-academic-referral-center
#8
Desmond A Brown, Benjamin T Himes, Brittny T Major, Benjamin F Mundell, Ravi Kumar, Bruce Kall, Fredric B Meyer, Michael J Link, Bruce E Pollock, John D Atkinson, Jamie J Van Gompel, W Richard Marsh, Giuseppe Lanzino, Mohamad Bydon, Ian F Parney
OBJECTIVE: To determine adverse event rates for adult cranial neuro-oncologic surgeries performed at a high-volume quaternary academic center and assess the impact of resident participation on perioperative complication rates. PATIENTS AND METHODS: All adult patients undergoing neurosurgical intervention for an intracranial neoplastic lesion between January 1, 2009, and December 31, 2013, were included. Cases were categorized as biopsy, extra-axial/skull base, intra-axial, or transsphenoidal...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29298966/pregnancy-in-a-woman-with-acromegaly-after-transsphenoidal-partial-resection-of-pituitary-macroadenoma-a-case-report
#9
Katarzyna Tomczyk, Paweł Rzymski, Jakub Woźniak, Maciej Wilczak
Acromegaly is a systemic disease caused by an excessive release of growth hormone and the hypopituitarism, which is induced by macroadenoma local mass effect. The gynecological and obstetric disorders include irregular menstrual cycles, anovulatory cycles and infertility. Therefore, pregnancy in patients affected by the disease is rare. A CASE REPORT: Patient described in this study became pregnant after pharmacological, surgical and infertility treatment. Hence, the following paper presents the course of pregnancy and the discussion of the impact of acromegaly on female fertility, pregnancy, and concerns related to the diagnosis and treatment...
December 22, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29288858/risk-factors-associated-with-meningitis-after-neurosurgery-operation-a-retrospective-cohort-study-in-a-chinese-hospital
#10
Shengsen Chen, An Cui, Kangkang Yu, Chong Huang, Mengqi Zhu, Mingquan Chen
OBJECTIVE: Meningitis is a serious complication occurring after neurosurgical operations, which can result in severe morbidity and high mortality. This retrospective cohort study aimed to determine the risk factors of postoperative meningitis in a large clinical center of Neurosurgery in China. METHODS: Patients who underwent neurosurgeries between January 2014 and December 2015 were selected and 1016 cases were included the final analysis. On the basis of propensity scores, 84 post-operative meningitis patients were successfully matched to the 84 patients without post-operative meningitis...
December 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29288106/pituitary-apoplexy-should-endoscopic-surgery-be-the-gold-standard
#11
Joaquim Teixeira, José Lavrador, Diogo Simão, José Miguéns
BACKGROUND: Pituitary apoplexy is an uncommon, potentially fatal condition due to spontaneous ischemia or hemorrhage in a pituitary adenoma. The treatment of this disorder has long been a matter of debate. METHODS: Retrospective cohort study including all patients admitted with pituitary apoplexy in our Department between 2005 and 2015. Clinical symptoms and signs on admission, treatment (conservative vs surgical), neurological deficit on discharge and at 6 months follow-up, endocrinological evaluation at 6 months follow-up were analyzed...
December 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29285405/prepontine-arachnoid-cyst-presenting-with-headache-and-diplopia-a-case-report-study
#12
Omidvar Rezaee, Kaveh Ebrahimzadeh, Ehsan Nazari Maloumeh, Armin Jafari, Misagh Shafizad, Mohammad Hallajnejad
Background: Arachnoid cysts are found everywhere in cerebrospinal axis, most often in the middle cranial fossa. They are very rare in prepontine location. Case Description: In this study, we report a 26-year-old female presenting with a 3-month history of headache and diplopia. On physical examination, she had clinical manifestations of sixth cranial nerve palsy. Magnetic resonance imaging revealed a prepontine arachnoid cyst with extension into interpeduncular and suprasellar cisterns...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29284879/a-comparison-of-dexmedetomidine-and-clonidine-in-attenuating-the-hemodynamic-responses-at-various-surgical-stages-in-patients-undergoing-elective-transnasal-transsphenoidal-resection-of-pituitary-tumors
#13
Summaira Jan, Zulfiqar Ali, Yasir Nisar, Imtiaz Ahmad Naqash, Syed Amer Zahoor, Shabir Ahmad Langoo, Khan Azhar
Background: Transsphenoidal approach to pituitary tumors is a commonly performed procedure with the advantage of a rapid midline access to the sella with minimal complications. It may be associated with wide fluctuations in hemodynamic parameters due to intense noxious stimulus at various stages of the surgery. As duration of the surgery is short and the patients have nasal packs, it is prudent to use an anesthestic technique with an early predictable recovery. Materials and Methods: A total of 60 patients of either sex between 18 and 65 years of age, belonging to the American Society of Anesthesiologists I and II who were undergoing elective transnasal transsphenoidal pituitary surgery were chosen for this study...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29283943/can-tumor-size-be-a-predictive-factor-of-olfactory-dysfunction-after-endoscopic-endonasal-trans-sphenoidal-approach
#14
Do Hyun Kim, Yong Kil Hong, Sin-Soo Jeun, Jae-Sung Park, Soo Whan Kim, Jin Hee Cho, Yong Jin Park, Jang-Won Jeong, Sung Won Kim
BACKGROUND AND OBJECTIVE: The aim of this study is to investigate the relationships between tumor size, nasal symptoms including olfactory function, and posoperative atrophic mucosal changes after the endoscopic endonasal transsphenoidal approach (EETSA). METHODS: This was a retrospective review of the medical records of 112 patients who underwent the 2 nostrils/4 hands EETSA with bilateral modified nasoseptal rescue flaps between February 2009 and January 2016...
December 27, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29280492/unexpected-prominent-tension-pneumosella-five-years-after-endoscopic-endonasal-transsphenoidal-surgery
#15
Tatsuma Matsuda, Kentaro Horiguchi, Yoshinori Higuchi, Toyoyuki Hanazawa, Yoshitaka Okamoto, Yasuo Iwadate
Tension pneumosella (TP) is a rare entity reported as the invagination of the sphenoid sinus mucosa into the skull base after endonasal transsphenoidal surgery. Few studies have reported on TP, and in these studies, invagination is confined to either the intrasellar or suprasellar area. We encountered a case of unexpected prominent TP toward the intracranial space 5 years after endoscopic endonasal transsphenoidal surgery (EETS) for a nonfunctioning pituitary adenoma. In addition, we present a hypothesis of the underlying mechanism by a pressure gradient change between the extracranial and intracranial space in TP formation...
December 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29280026/management-of-non-functioning-pituitary-adenomas-surgery
#16
REVIEW
David L Penn, William T Burke, Edward R Laws
Non-functional pituitary adenomas (NFPAs) are benign tumors of the pituitary gland that do not over-secrete hormonal products, therefore, they are generally detected through symptoms of mass effect, including headache, vision loss, or hypopituitarism. There are multiple pathological subtypes of NFPAs, such as null cell adenomas, silent gonadotrophs, silent somatotrophs, silent corticotrophs, and silent subtype 3, all of which can be classified based on immunohistochemical studies and electron microscopy. Despite these numerous pathological subtypes, surgical resection remains the first-line treatment for NFPAs...
December 26, 2017: Pituitary
https://www.readbyqxmd.com/read/29274063/effects-of-growth-hormone-on-thyroid-function-are-mediated-by-type-2-iodothyronine-deiodinase-in-humans
#17
Ichiro Yamauchi, Yoriko Sakane, Takafumi Yamashita, Keisho Hirota, Yohei Ueda, Yugo Kanai, Yui Yamashita, Eri Kondo, Toshihito Fujii, Daisuke Taura, Masakatsu Sone, Akihiro Yasoda, Nobuya Inagaki
PURPOSE: Growth hormone (GH) therapy in adults alters thyroid function, and acromegaly often involves thyroid disease. The present study aimed to elucidate roles and mechanisms of GH in regulating thyroid function. METHODS: We performed two retrospective observational studies, which focused on consecutive patients with severe adult GH deficiency who received recombinant human GH (rhGH) therapy (n = 20) and consecutive patients with acromegaly who underwent transsphenoidal surgery (TSS) (n = 25)...
December 22, 2017: Endocrine
https://www.readbyqxmd.com/read/29260062/cavernous-sinus-syndrome-associated-with-metastatic-colorectal-cancer-and-perineural-spread-along-the-trigeminal-nerve
#18
Georges Nassrallah, Vincent Sun, Marie-Christine Guiot, Mikel Mikhail, Bryan Arthurs
Purpose: We report the case of a patient with cavernous sinus syndrome associated with biopsy-confirmed metastasis from colorectal cancer. Observations: A patient known for laryngeal carcinoma and metastatic colorectal carcinoma presented with symptoms of left trigeminal neuralgia and progressive, near-complete ophthalmoplegia. Magnetic resonance imaging (MRI) revealed a mass in the left cavernous sinus, extending into Meckel's cave with perineural spread along the mandibular branch of the left trigeminal nerve...
June 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29250724/cognitive-improvement-following-repair-of-a-basal-encephalocele
#19
Isabel Tulloch, Siobhan Palmer, Richard Scott, Dora Lozsadi, Andrew J Martin
We report the case of a 55-year-old woman presenting with progressive memory impairment secondary to a transsphenoidal encephalocele involving her dominant medial temporal lobe. Her clinical deterioration was accompanied by radiological progression in the encephalocele's size and associated encephalomalacia. Through a temporal craniotomy, her encephalocele was resected and the defect closed. Baseline neuropsychological assessment indicated global cognitive impairment, but post-operatively, she reported improved memory and concentration...
December 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29248833/endoscopic-management-of-atypical-sellar-cavernous-hemangioma-a-case-report-and-review-of-the-literature
#20
A M Al-Sharydah, S S Al-Suhibani, S A Al-Jubran, A H Al-Abdulwahhab, M Al-Bar, H M Al-Jehani, W M Al-Issawi
INTRODUCTION: supratentorial cavernous hemangiomas, particularly those found in the sellar region, are extremely rare. We present a case of sellar cavernous hemangioma with radiological characteristics that have never been reported. Due to the difficulty diagnosing these lesions, misdiagnosis might occur. Thus, briefing surgeons about the clinico-radiological features of such rare lesions is crucial for better understanding the enigmatic features of such rare lesions and to develop early management approaches that could result in better surgical excision with a lower tendency for complications...
December 8, 2017: International Journal of Surgery Case Reports
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