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https://www.readbyqxmd.com/read/29775155/long-term-surgical-outcomes-following-transsphenoidal-surgery-in-patients-with-rathke-s-cleft-cysts
#1
Michelle Lin, Michelle A Wedemeyer, Daniel Bradley, Daniel A Donoho, Vance L Fredrickson, Martin H Weiss, John D Carmichael, Gabriel Zada
OBJECTIVE Rathke's cleft cysts (RCCs) are benign epithelial lesions of the sellar region typically treated via a transsphenoidal approach with cyst fenestration and drainage. At present, there is limited evidence to guide patient selection for operative treatment. Furthermore, there is minimal literature describing factors contributing to cyst recurrence. METHODS The authors conducted a retrospective analysis of 109 consecutive cases of pathology-confirmed RCCs treated via a transsphenoidal approach at a single center from 1995 to 2016...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29775030/-endoscopic-transnasal-approach-for-surgical-treatment-of-skull-base-clival-area-chordomas-report-of-2-cases
#2
J Ma, P Fang, D Wang, Y J Liu
The case 1 performanced submandibular trauma because of the faint Suddenly. There were no obvious abnormality in physical examination. CT result showed that the tumour located in the lower clivus, and the atlas was infringed. MRI imaging showed the tumour located in the both sides of the internal carotid artery, infringed clivus and atlas front, forwarded into the nasal cavity and oral cavity. The case 2 performanced the left nose stuffy and increased gradually, nasopharyngeal mirror showed the left nasal cavity filled with new life...
February 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29767762/surgical-outcomes-following-repeat-transsphenoidal-surgery-for-nonfunctional-pituitary-adenomas-a-retrospective-comparative-study
#3
Joshua Bakhsheshian, Sarah Wheeler, Ben A Strickland, Martin H Pham, Robert C Rennert, John Carmichael, Martin Weiss, Gabriel Zada
BACKGROUND: Endonasal transsphenoidal surgery (ETSS) remains the preferred treatment for recurrent or residual nonfunctional pituitary adenomas (NFPAs). However, surgical complications and outcomes with repeat ETSS are unclear. OBJECTIVE: To compare outcomes from primary and repeat ETSS in patients with NFPAs. METHODS: Retrospective review of ETSS for NFPAs at USC University Hospital and LAC + USC Medical Center between 2000 and 2015. Patients with ≥3-mo follow-up data were included...
May 15, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29767319/endoscopic-vs-microscopic-transsphenoidal-surgery-for-cushing-s-disease-a-systematic-review-and-meta-analysis
#4
Leonie H A Broersen, Nienke R Biermasz, Wouter R van Furth, Friso de Vries, Marco J T Verstegen, Olaf M Dekkers, Alberto M Pereira
PURPOSE: Systematic review and meta-analysis comparing endoscopic and microscopic transsphenoidal surgery for Cushing's disease regarding surgical outcomes (remission, recurrence, and mortality) and complication rates. To stratify the results by tumor size. METHODS: Nine electronic databases were searched in February 2017 to identify potentially relevant articles. Cohort studies assessing surgical outcomes or complication rates after endoscopic or microscopic transsphenoidal surgery for Cushing's disease were eligible...
May 16, 2018: Pituitary
https://www.readbyqxmd.com/read/29765831/quality-of-life-before-and-after-endoscopic-pituitary-surgery-as-measured-by-the-short-form-36
#5
Edward C Kuan, Frederick Yoo, Jennifer Chyu, Angela Oh, Marvin Bergsneider, Marilene B Wang
Objectives/Hypotheses  To assess quality of life (QOL) after transnasal, endoscopic pituitary surgery using the 36-item short form (SF-36) instrument. Design  Retrospective review was used for this study. Setting  The study was conducted in a tertiary academic medical center. Participants  Patients who underwent endoscopic, transnasal, transsphenoidal surgery for pituitary adenomas between January 1, 2007 and July 1, 2016 and completed preoperative and postoperative SF-36 surveys. Main Outcome Measures  SF-36 survey data as measured by its eight domains (physical functioning, physical role functioning, emotional role functioning, energy/fatigue, emotional well-being, social functioning, pain, and general health)...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29765354/pituitary-directed-therapies-for-cushing-s-disease
#6
REVIEW
Fabienne Langlois, Jennifer Chu, Maria Fleseriu
Cushing's disease (CD) is caused by a pituitary corticotroph neuroendocrine tumor inducing uncontrolled hypercortisolism. Transsphenoidal surgery is the first-line treatment in most cases. Nonetheless, some patients will not achieve cure even in expert hands, others may not be surgical candidates and a significant percentage will experience recurrence. Many patients will thus require medical therapy to achieve disease control. Pharmacologic options to treat CD have increased in recent years, with an explosion in knowledge related to pathophysiology at the molecular level...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29764029/-staged-transcranial-and-transsphenoidal-surgery-for-giant-pituitary-adenomas-a-retrospective-study-of-21-cases
#7
D Y Liao, Z Y Liu, J Zhang, Q Q Ren, X Y Liu, J G Xu
Objective: To investigate the effect of the second-stage transcranial and transsphenoidal approach for giant pituitary tumors. Methods: A retrospective review of 21 patients, who had undergone the transcranial surgery and then transsphenoidal surgery for giant pituitary adenomas from 2012 to 2015 in the neurosurgery department of West China Hospital, was performed. Visual findings, endocrine presentation, complications, and tumor types were collected. All data were based on clinical feature, MRI, and follow-up...
May 8, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29754636/outcomes-of-pituitary-radiation-for-cushing-s-disease
#8
REVIEW
Natasha Ironside, Ching-Jen Chen, Cheng-Chia Lee, Daniel M Trifiletti, Mary Lee Vance, Jason P Sheehan
Achievement of biochemical remission with preservation of normal pituitary function is the goal of treatment for Cushing's disease. For patients with persistent or recurrent Cushing's disease after transsphenoidal resection, radiation therapy may be a safe and effective treatment. Stereotactic radiosurgery is favored over conventional fractionated external beam radiation. Hormonal recurrence rates range from 0% to 36% at 8 years after treatment. Tumor control rates are high. New pituitary hormone deficiency is the most common adverse effect after stereotactic radiosurgery and external beam radiation...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29754635/prognostic-factors-of-long-term-remission-after-surgical-treatment-of-cushing-s-disease
#9
REVIEW
Adriana G Ioachimescu
Transsphenoidal surgery is the main treatment of patients with adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas. Although biochemical remission occurs in most patients undergoing operations at specialized centers, the recurrence risk is significant. Visualization of microadenomas on preoperative imaging and confirmation of ACTH-positive adenomas have been associated with higher remission rates. Low cortisol levels in the first 2 weeks postoperatively have been associated with durable remission; however, recurrence cannot be excluded by any cortisol threshold...
June 2018: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/29743120/cavernous-sinus-involvement-in-human-papillomavirus-associated-oropharyngeal-squamous-cell-carcinoma-case-report-of-an-atypical-site-of-distant-metastasis
#10
David Forner, Derek Wilke, Matthew H Rigby, Sidney Croul, Anuradha Mishra, Emad Massoud, David B Clarke, Nathan Lamond
BACKGROUND: HPV-associated OSCC (HPV-OSCC) has been determined to be a distinct disease entity from non-HPV associated OSCC. Patients affected by HPV-OSCC generally have a more favourable prognosis, with improved rates of locoregional control and survival compared with their non-HPV counterparts. Despite this, HPV-OSCC has a similar rate of distant metastases. Interestingly, recent evidence has emerged that demonstrates more frequent atypical metastasis patterns when compared to non-HPV associated disease...
May 9, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29739724/nonfunctioning-pituitary-adenomas-in-elderly-patients
#11
REVIEW
Yasuyuki Kinoshita, Kaoru Kurisu, Kazunori Arita
BACKGROUND: Recently, several reports have revealed new aspects regarding transsphenoidal surgery (TSS) for pituitary lesions in elderly patients. OBJECTIVE: The aim of present study is to provide an updated review of the recent literature, which we hope will contribute to the management of nonfunctioning pituitary adenoma (NFPA) in elderly patients. METHODS: We searched PubMed and Web of Science for reports on TSS for NFPAs in elderly patients and reviewed the literature...
May 5, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29732314/modified-two-flap-palatoplasty-in-asymptomatic-transsphenoidal-encephalocele-a-case-report
#12
Sunil Richardson, Rakshit Vijay Khandeparker, Ajit Kumar Raghuvaram, Ram Mohan
About one-third of patients with transsphenoidal basal encephaloceles have associated congenital anomalies, including cleft palate. Moreover, they are often plagued by symptomatic exacerbations in the form of upper respiratory obstructions, cerebrospinal fluid leaks, meningitis, etc., with few patients being asymptomatic. We herein present a rare asymptomatic case of transsphenoidal basal encephalocele in an 18-month-old child with cleft palate and highlight a modified version of two-flap palatoplasty.
April 2018: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/29730106/imaging-evaluation-of-the-location-and-fenestration-of-sellar-floor-during-endonasal-transsphenoidal-surgery-in-patients-with-pituitary-adenomas
#13
Shousen Wang, Yong Qin, Deyong Xiao, Zhifeng Wu, Liangfeng Wei
To evaluate the clinical value of three-dimensional (3D) CT reconstruction of the sphenoidal sinus separation in localizing sellar floor during endonasal transsphenoidal surgery, and determine the size and location of sellar floor fenestration. After exclusion,51 patients were eligible for study inclusion. A pre-operative CT scan of the paranasal sinus and CT scan and MRI of the pituitary gland were obtained. Sphenoidal sinus separation was reconstructed using Mimics 15.0 software and the quantity, shape, and orientation were observed and compared with intra-operative data, the purpose of which was to guide the localization of sellar floor...
May 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29698879/use-of-pipeline%C3%A2-embolization-device-for-the-treatment-of-traumatic-intracranial-pseudoaneurysms-case-series-and-review-of-cases-from-literature
#14
Mairaj T Sami, Domenico A Gattozzi, Hesham M Soliman, Alan R Reeves, Christopher J Moran, Paul J Camarata, Koji C Ebersole
OBJECTIVE: Intracranial traumatic pseudoaneurysms (PSA) are a rare but dangerous subtype of cerebral aneurysm. Reports documenting use of flow-diverting stents to treat traumatic intracranial PSAs are few and lack long-term follow-up. To our knowledge, this is the largest case-series to date demonstrating use of Pipeline Endovascular Device (PED) for traumatic intracranial PSAs. PATIENTS AND METHODS: Retrospective review of 8 intracranial traumatic PSAs in 7 patients treated using only PED placement...
June 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29695647/a-case-of-tsh-secreting-pituitary-adenoma-with-cyclic-fluctuations-in-serum-tsh-levels
#15
Hideyuki Okuma, Koshi Hashimoto, Takuya Ohashi, Masatomo Mihara, Isao Minami, Hajime Izumiyama, Shigekazu Sasaki, Naoko Inoshita, Hiroshi Nishioka, Shozo Yamada, Takanobu Yoshimoto
A 29-year-old man was referred to our department due to adrenal insufficiency with the inappropriate secretion of TSH (SITSH). Magnetic resonance imaging revealed a pituitary tumor. A weak TSH response in the TRH test, elevated sex hormone binding globulin (SHBG) levels, and the absence of a family medical history of SITSH or TRβ gene mutations supported the diagnosis of TSH-secreting pituitary adenoma (TSHoma). However, complete TSH suppression and a blunted cholesterol response in the T3 suppression test as well as normal glycoprotein α-subunit (α-GSU) levels were not compatible with TSHoma...
April 26, 2018: Endocrine Journal
https://www.readbyqxmd.com/read/29694638/a-review-of-cushing-s-disease-treatment-by-the-department-of-neuroendocrinology-of-the-brazilian-society-of-endocrinology-and-metabolism
#16
Márcio Carlos Machado, Maria Candida Barisson Vilares Fragoso, Ayrton Custódio Moreira, César Luiz Boguszewski, Leonardo Vieira Neto, Luciana A Naves, Lucio Vilar, Luiz Antônio de Araújo, Nina Rosa Castro Musolino, Paulo Augusto C Miranda, Mauro A Czepielewski, Monica R Gadelha, Marcello Delano Bronstein, Antônio Ribeiro-Oliveira
The treatment objectives for a patient with Cushing's disease (CD) are remission of hypercortisolism, adequate management of co-morbidities, restoration of the hypothalamic-pituitary-adrenal axis, preservation of fertility and pituitary function, and improvement of visual defects in cases of macroadenomas with suprasellar extension. Transsphenoidal pituitary surgery is the main treatment option for the majority of cases, even in macroadenomas with low probability of remission. In cases of surgical failure, another subsequent pituitary surgery might be indicated in cases with persistent tumor imaging at post surgical magnetic resonance imaging (MRI) and/or pathology analysis of adrenocorticotropic hormone-positive (ACTH+) positive pituitary adenoma in the first procedure...
February 2018: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29686164/-treatment-of-rathke-s-cleft-cyst-technical-note-for-preservation-of-pituitary-function
#17
Miiko Ito, Kenichiro Matsuda, Atsushi Kuge, Shinya Sato, Takamasa Kayama, Yukihiko Sonoda
Pituitary dysfunction, such as panhypopituitarism or diabetes insipidus(DI), is often found in patients with Rathke's cleft cyst. Patients were treated with transsphenoidal microscopic surgery; however, pituitary dysfunction did not usually recover. Recently, endoscopic transsphenoidal surgery(eTSS)has enabled minimally invasive surgery for patients with Rathke's cleft cyst. In this study, we analyzed 22 consecutive patients with Rathke's cleft cyst who underwent eTSS to determine if pituitary dysfunction recovered...
April 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29682011/endoscopic-versus-microscopic-pituitary-adenoma-surgery-an-institutional-experience
#18
Hanuman Prasad Prajapati, Shashi Kant Jain, Virendra D Sinha
Aim: The aim of this study was to compare the efficacy of endoscopic versus microscopic excision of pituitary adenoma, and to evaluate the merits and demerits of each approach. Materials and Methods: Prospective data were collected and patients were surgically treated for pituitary adenoma at SMS Hospital, Jaipur, Rajasthan, India. Patients consent was obtained. Age, sex, presenting symptoms, length of hospital stay, pre- and post-operative hormone status, extent of resections of tumors, and intra- and post-operative complication were noted...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29680444/sinonasal-outcome-after-endoscopic-mononostril-transsphenoidal-surgery-a-single-center-cohort-study
#19
Stefan Linsler, Benjamin Prokein, Philipp Hendrix, Joachim Oertel
OBJECTIVE: The endoscopic endonasal approach has been well established for skull base surgery. However, there are only few studies pointing out nasal complaints after surgery. In this study, the authors evaluated postoperative nasal complaints and complications after mononostril endoscopic procedures. METHODS: All patients operated on parasellar and sellar pathologies at our department via an endoscopic mononostril transnasal transsphenoidal approach from January 2011 to May 2015 were analyzed...
April 18, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29675075/pediatric-cushing-s-disease-dichotomy-in-lateralization-between-imaging-and-inferior-petrosal-sinus-sampling-with-review-of-literature
#20
Salman Tehran Shaikh, Vikram S Karmarkar, Chandrashekhar Eknath Deopujari
Inferior petrosal sinus sampling (IPSS) is a minimally invasive method done in adrenocorticotrophic hormone (ACTH)-dependent pituitary adenoma cases where magnetic resonance imaging (MRI) either gives equivocal results or fails to localize it. A 12-year-girl with cushingoid features and raised ACTH levels presented to us with two consecutive MRI's done outside showing gross change in the morphology of a left-sided pituitary adenoma. Hence, a bilateral IPSS was done which showed a higher IPS/periphery ACTH ratio on the right side as compared to left...
October 2017: Journal of Pediatric Neurosciences
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