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Transsphenoidal Surgery

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https://www.readbyqxmd.com/read/28535639/-curative-effect-analysis-of-two-surgical-methods-for-removal-of-pituitary-adenoma-via-endonasal-transsphenoidal-approach
#1
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]
https://www.readbyqxmd.com/read/28526958/-ectopic-suprasellar-type-iia-prl-secreting-pituitary-adenoma
#2
REVIEW
Heng-Jun Zhou, De-Sheng Pan, Xiao-Qun Ba, Ren-Ya Zhan, Xiu-Jue Zheng, Yue-Hui Ma
BACKGROUND: Ectopic pituitary adenomas (EPAs) are rare, and the suprasellar cistern seems to be the most common location. At this time, no detailed original classification, diagnosis, or treatment protocols for suprasellar pituitary adenomas (SPAs) have been described. CASE DESCRIPTION: A 19-year-old man showed visual disturbances and lack of libido for 3 years, he suffered a sharp decline in vision with only light perception in the last week. Magnetic resonance imaging scans revealed a large suprasellar cystic lesion with a normal pituitary in the sella turcica...
May 19, 2017: Pituitary
https://www.readbyqxmd.com/read/28520927/preoperative-stratification-of-transsphenoidal-pituitary-surgery-patients-based-on-surgical-urgency
#3
Hasan A Zaidi, Amy J Wang, David J Cote, Timothy R Smith, Daniel Prevedello, Domenico Solari, Paolo Cappabianca, Monica Quiroga, Edward R Laws
BACKGROUND: Currently, there is no prioritization scale available to distinguish those patients with pituitary tumors who require urgent surgical intervention from those who are candidates for elective treatment. OBJECTIVE: To develop a classification system that can help primary care physicians, endocrinologists, neurosurgeons, ancillary support staff, and hospital administrators identify high-priority surgical candidates. METHODS: An expert international panel of clinicians consisting of endocrinologists and neurosurgeons who are involved in the diagnosis and management of sellar disease was convened...
May 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28516968/preliminary-experience-with-4k-ultra-high-definition-endoscope-analysis-of-pros-and-cons-in-skull-base-surgery
#4
M Rigante, G La Rocca, L Lauretti, G Q D'Alessandris, A Mangiola, C Anile, A Olivi, G Paludetti
During the last two decades endoscopic skull base surgery observed a continuous technical and technological development 3D endoscopy and ultra High Definition (HD) endoscopy have provided great advances in terms of visualisation and spatial resolution. Ultra-high definition (UHD) 4K systems, recently introduced in the clinical practice, will shape next steps forward especially in skull base surgery field. Patients were operated on through transnasal transsphenoidal endoscopic approaches performed using Olympus NBI 4K UHD endoscope with a 4 mm 0° Ultra Telescope, 300 W xenon lamp (CLV-S400) predisposed for narrow band imaging (NBI) technology connected through a camera head to a high-quality control unit (OTV-S400 - VISERA 4K UHD) (Olympus Corporation, Tokyo, Japan)...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28505327/histone-deacetylase-inhibitor-saha-is-a-novel-promising-treatment-for-cushing-s-disease
#5
Jie Lu, Grégoire P Chatain, Alejandro Bugarini, Xiang Wang, Dragan Maric, Stuart Walbridge, Zhengping Zhuang, Prashant Chittiboina
Context: Remission failure following transsphenoidal surgery in Cushing's disease (CD) from pituitary corticotroph tumors (CtT) remains clinically challenging. Histone deacetylase (HDAC) inhibitors are antitumor drugs approved for oral clinical use, with potential to affect adrenocorticotropin (ACTH) hypersecretion by inhibiting proopiomelanocortin (POMC) transcription. Objective: Testing efficacy of suberolyl hydroxamic acid (SAHA) on human and murine ACTH-secreting tumor cells...
May 12, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28490403/effects-of-changes-in-nasal-volume-on-voice-in-patients-after-endoscopic-endonasal-transsphenoidal-surgery
#6
Do Hyun Kim, Yong-Kil Hong, Sin-Soo Jeun, Jae-Sung Park, Soo Whan Kim, Jin Hee Cho, Yong Jin Park, Hyuck Jae Lee, Yeon-Shin Hwang, Sung Won Kim
OBJECTIVE: To investigate a potential correlation between changes in voice and changes in nasal volume. METHODS: The endoscopic endonasal transsphenoidal approach (EETSA) was performed on 120 patients between February 2009 and August 2016 by using the bilateral modified nasoseptal rescue flaps method. All the patients were subjected to pre- and postoperative paranasal computed tomography (CT) and voice evaluations by using acoustic analyses, a nasometer to measure the nasalance, and determination of the voice handicap index (VHI)...
May 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28490347/gh-secreting-pituitary-macroadenoma-acromegaly-associated-with-progressive-dental-malocclusion-and-refractory-cpap-treatment
#7
Jaume Miranda-Rius, Lluís Brunet-LLobet, Eduard Lahor-Soler, David de Dios-Miranda, Josep Anton Giménez-Rubio
BACKGROUND: A link between progressive dental malocclusion, the use of a continuous positive airway pressure mask and GH-secreting pituitary macroadenoma (acromegaly) has not been previously reported. The present clinicopathological analysis stresses that tooth malposition should not be seen exclusively as a local process. CASE PRESENTATION: A 62-year-old caucasian man with no relevant medical history reported difficulty chewing food and perceived voice alteration during his annual periodontal check-up...
May 10, 2017: Head & Face Medicine
https://www.readbyqxmd.com/read/28484567/clival-defect-causing-primary-spontaneous-rhinorrhea
#8
Vivek Tandon, Kanwaljeet Garg, Ashish Suri, Ajay Garg
Primary cerebrospinal fluid (CSF) rhinorrhea due to a defect in clivus is an extremely rare entity, till date only four such cases are reported in the world literature. We present a case of 55-year-old female who presented with primary spontaneous CSF rhinorrhea, for which endonasal surgery was performed about 9 years back. Patient developed recurrent CSF leak with a history of meningitis. Repeat imaging showed clival defect causing CSF leak. Transsphenoidal repair was performed under neuronavigation. In this paper, we discuss the possible mechanism of fistula formation and literature is reviewed...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28484553/granulomatous-hypophysitis-caused-by-rathke-s-cleft-cyst-mimicking-a-growth-hormone-secreting-pituitary-adenoma
#9
Masato Hojo, Ryota Ishibashi, Hiroshi Arai, Susumu Miyamoto
We report a case of granulomatous hypophysitis caused by Rathke's cleft cyst (RCC) mimicking a growth hormone (GH)-secreting pituitary adenoma. Neuroradiological and endocrinological evaluations showed abnormal findings consistent with acromegaly: Magnetic resonance imaging demonstrated a pituitary mass lesion, and GH and insulin-like growth factor I levels were markedly elevated, and GH levels were not suppressed in oral glucose tolerance test. Transsphenoidal surgery was performed, but no adenomatous tissue could be detected...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28470359/is-endoscopic-endonasal-transsphenoidal-surgery-increases-the-susceptibility-to-rhinosinusitis
#10
Muhammet Fatih Topuz, Murat Sarı, Adem Binnetoglu, Ramazan Dogrul, Onur Bugdaycı, Aşkın Şeker
The aim of the study was to analyze whether the measurement of changes in the anatomical position and volume of middle concha, the volume changes in the area between the middle concha and lamina papyracea, the evaluation of opacification in major paranasal sinuses, and osteomeatal complex occlusion in cases with middle concha by out-fracture technique during endoscopic endonasal transsphenoidal approach is a minimally invasive surgery, and also to find out whether these changes lead to the development of tendency to rhinosinusitis...
May 3, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28465267/outcome-of-endoscopic-transsphenoidal-surgery-for-acromegaly
#11
Jung Hee Kim, Kyu Yeon Hur, Jung Hyun Lee, Ji Hyun Lee, Young-Bem Se, Hey In Kim, Seung Hoon Lee, Do-Hyun Nam, Seong Yeon Kim, Kwang-Won Kim, Doo-Sik Kong, Yong Hwy Kim
OBJECTIVE: Endoscopic transsphenoidal surgery has recently been introduced in pituitary surgery. We investigated outcomes and complications of endoscopic surgery in two referral centers in Korea. METHODS: We enrolled 134 patients with acromegaly (microadenomas, n=15; macroadenomas, n=119) who underwent endoscopic transsphenoidal surgery at Seoul National University Hospital (n=74) and Samsung Medical center (n=60) between Jan 2009 and Mar 2016. Remission was defined as having a normal IGF-1 and a suppressed GH less than 1 ng/mL during an oral glucose tolerance test...
April 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28463614/endoscopic-endonasal-transsphenoidal-surgery-using-the-iarms-operation-support-robot-initial-experience-in-43-patients
#12
Toshihiro Ogiwara, Tetsuya Goto, Alhusain Nagm, Kazuhiro Hongo
Objective The intelligent arm-support system, iArmS, which follows the surgeon's arm and automatically fixes it at an adequate position, was developed as an operation support robot. iArmS was designed to support the surgeon's forearm to prevent hand trembling and to alleviate fatigue during surgery with a microscope. In this study, the authors report on application of this robotic device to endoscopic endonasal transsphenoidal surgery (ETSS) and evaluate their initial experiences. Methods The study population consisted of 43 patients: 29 with pituitary adenoma, 3 with meningioma, 3 with Rathke's cleft cyst, 2 with craniopharyngioma, 2 with chordoma, and 4 with other conditions...
May 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28458907/hypersecretion-of-acth-and-prl-from-pituitary-adenoma-in-men1-adequately-managed-by-medical-therapy
#13
Shinsuke Uraki, Hiroyuki Ariyasu, Asako Doi, Hiroto Furuta, Masahiro Nishi, Takeshi Usui, Hiroki Yamaue, Takashi Akamizu
SUMMARY: A 54-year-old man had gastrinoma, parathyroid hyperplasia and pituitary tumor. His family history indicated that he might have multiple endocrine neoplasia type 1 (MEN1). MEN1 gene analysis revealed a heterozygous germline mutation (Gly156Arg). Therefore, we diagnosed him with MEN1. Endocrinological tests revealed that his serum prolactin (PRL) and plasma adrenocorticotropic hormone (ACTH) levels were elevated to 1699 ng/mL and 125 pg/mL respectively. Immunohistochemical analysis of the resected pancreatic tumors revealed that the tumors did not express ACTH...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28449052/implementation-of-a-postoperative-outpatient-care-pathway-for-delayed-hyponatremia-following-transsphenoidal-surgery
#14
Michael A Bohl, Shahjehan Ahmad, William L White, Andrew S Little
BACKGROUND: After transsphenoidal surgery, delayed hyponatremia (DH) is the leading cause of 30-d unplanned hospital readmissions. OBJECTIVE: To determine the impact of a DH care pathway on 30-d readmissions after transsphenoidal surgery. METHODS: Data from before and after DH care pathway implementation were retrospectively reviewed. Patient demographics and clinical characteristics were compared. Readmission causes, clinical pathway failures, sodium trends, and symptoms were evaluated...
April 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28445162/binostril-endoscopic-transsphenoidal-neurosurgery-for-pituitary-adenomas-experience-with-42-patients
#15
Guan Sun, Ying Cao, Nan Jiang, Dekang Nie, Zhengqiang Wan, Min Li, Chiyuan Ma, Jun Guo
Here we review the technical aspects of our experience with the neuroendoscopic bilateral nostril (binostril) transsphenoidal approach for pituitary adenomas. A total of 42 patients were treated in our hospital from September 2013 to December 2015. Total tumor resection was completed in 31 cases, nearly full resection was achieved in 9 cases, and partial resection was achieved in 2 cases. In most cases clinical symptoms were relieved after surgery. These included 18/22 cases with visual field and vision disorders; 19/25 cases with headaches; 11/15 cases where high baseline PRL returned to normal levels; 6/7 cases where elevated blood GH returned to normal levels; and 2/3 cases where elevated blood ACTH returned to normal levels after surgery...
April 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28437813/presenting-symptoms-of-pituitary-apoplexy
#16
Efstratios-Stylianos Pyrgelis, Ioannis Mavridis, Maria Meliou
The classical term "pituitary apoplexy" (PA) describes a clinical syndrome usually characterized by abrupt onset of headache accompanied by neurologic and/or endocrinologic deterioration due to sudden expansion of a mass within the sella turcica as a result of hemorrhage or infarction within a pituitary tumor and adjacent pituitary gland. PA is a medical emergency and a difficult diagnosis to establish. Thus this article reviews the presenting symptoms of PA patients to help clinicians recognize or at least suspect this critical condition early on...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28434959/analysis-of-137-patients-who-underwent-endoscopic-transsphenoidal-pituitary-adenoma-resection-under-high-field-intraoperative-magnetic-resonance-imaging-navigation
#17
Huaping Zhang, Fuyu Wang, Tao Zhou, Peng Wang, Xiaolei Chen, Jiashu Zahng, Dingbiao Zhou
OBJECTIVE: Endonasal resection of the pituitary embodies the minimally invasive concept. Pure endoscopic resection of pituitary adenoma has become the most popular surgical approach. Intraoperative magnetic resonance imaging (iMRI) systems have been in use for endoscopic resection of pituitary adenomas. The study aimed to evaluate the effectiveness of iMRI and neuroimaging navigation techniques during endoscopic endonasal transsphenoidal surgery of pituitary adenomas. METHODS: Data from 137 patients who underwent resection of endoscopic pituitary adenoma under 1...
April 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28423663/a-novel-total-pituitary-hormone-index-as-an-indicator-of-postoperative-pituitary-function-in-patients-undergoing-resection-of-pituitary-adenomas
#18
Shousen Wang, Biao Li, Chenyu Ding, Deyong Xiao, Liangfeng Wei
The purpose of this study was to investigate the differences between pre- and postoperative pituitary hormone levels in patients undergoing surgical resection of pituitary adenoma and to identify factors associated with preoperative hypopituitarism.Data from 81 patients with histologically confirmed functioning and non-functioning pituitary adenomas (NFPA) who underwent transsphenoidal resection from January 2011 to December 2013 were retrospectively analyzed. Logistic regression was applied to analyze factors associated with preoperative hypopituitarism...
March 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28421822/deflation-of-a-rathke-cleft-cyst-triggered-rupture-of-a-superior-hypophyseal-artery-aneurysm-a-case-report
#19
Ryuheki Kitai, Takahiro Yamauchi, Yoshikazu Arai, Tetsuya Hosoda, Norichika Hashimoto, Kenzo Tsunetoshi, Yoshifumi Higashino, Ken-Ichiro Kikuta
A 57-year-old woman was diagnosed as a Rathke cleft cyst (RCC). Endoscopic transsphenoidal surgery (TSS) was performed uneventfully. She developed subarachnoid haemorrhage on postoperative day 3. The vessels adhered the cyst had been pulled into the pituitary fossa, causing an aneurysm.
April 19, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28410953/spontaneous-cerebrospinal-fluid-fistula-in-the-clivus
#20
A Codina Aroca, J R Gras Cabrerizo, M De Juan Delago, H Massegur Solench
INTRODUCTION: Spontaneous cerebrospinal fluid (CSF) fistulas are infrequent and only 10 cases in the literature have been located in the clivus. We describe two new cases of CSF fistulas in this site and review the literature. CASE REPORT: The first patient was a 52-year-old woman referred to our centre for intermittent rhinorrhea that had been diagnosed after an episode of meningitis. The second case was a 69-year-old man who was visited for rhinorrhea of one-year duration; he also developed meningitis during the preoperative study...
April 11, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
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