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Transsphenoidal Surgery

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https://www.readbyqxmd.com/read/27910710/management-of-a-pregnant-woman-with-thyrotropinoma-a-case-report-and-review-of-the-literature
#1
Carolina M Perdomo, Jorge A Árabe, Miguel Á Idoate, Juan C Galofré
INTRODUCTION: Pituitary disorders during pregnancy are uncommon. The approach should include a close follow-up in order to reduce maternal and fetal risks associated with physiological changes during pregnancy or treatment side effects. MATERIALS AND METHODS: We report a 21-year-old woman with a thyroid-stimulating hormone-secreting pituitary macroadenoma and positive antithyroid antibodies. She was initially treated using transsphenoidal pituitary surgery. The patient relapsed 17-month post-surgery...
December 2, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27903117/risk-factors-associated-with-the-surgical-management-of-craniopharyngiomas-in-pediatric-patients-analysis-of-1961-patients-from-a-national-registry-database
#2
Joshua Bakhsheshian, Diana L Jin, Ki-Eun Chang, Ben A Strickland, Dan A Donoho, Steven Cen, William J Mack, Frank Attenello, Eisha A Christian, Gabriel Zada
OBJECTIVE Patient demographic characteristics, hospital volume, and admission status have been shown to impact surgical outcomes of sellar region tumors in adults; however, the data available following the resection of craniopharyngiomas in the pediatric population remain limited. The authors sought to identify potential risk factors associated with outcomes following surgical management of pediatric craniopharyngiomas. METHODS The Nationwide Inpatient Sample database and Kids' Inpatient Database were analyzed to include admissions for pediatric patients (≤ 18 years) who underwent a transcranial or transsphenoidal craniotomy for resection of a craniopharyngioma...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27903115/aggressive-surgery-based-on-an-anatomical-subclassification-of-craniopharyngiomas
#3
Hiroki Morisako, Takeo Goto, Hiroyuki Goto, Christian Aisse Bohoun, Samantha Tamrakar, Kenji Ohata
OBJECTIVE Craniopharyngiomas remain a particularly formidable challenge in the neurosurgical field. Because these lesions involve the hypothalamus and ophthalmological systems, their resection is associated with either higher rates of mortality and recurrence or a lower rate of radical resection. The authors report the outcomes of aggressive surgeries based on an anatomical subclassification of craniopharyngiomas. METHODS Clinical and ophthalmological examinations, imaging studies, endocrinological studies, neuropsychological function, and surgical complications in all patients who had undergone microsurgical resection for craniopharyngioma at Osaka City University hospital between January 2000 and December 2014 were retrospectively reviewed through the medical records...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27885957/visual-pathway-impairment-by-pituitary-adenomas-quantitative-diagnostics-by-diffusion-tensor-imaging
#4
Ylva Lilja, Oscar Gustafsson, Maria Ljungberg, Göran Starck, Bertil Lindblom, Thomas Skoglund, Henrik Bergquist, Karl-Erik Jakobsson, Daniel Nilsson
OBJECTIVE Despite ample experience in surgical treatment of pituitary adenomas, little is known about objective indices that may reveal risk of visual impairment caused by tumor growth that leads to compression of the anterior visual pathways. This study aimed to explore diffusion tensor imaging (DTI) as a means for objective assessment of injury to the anterior visual pathways caused by pituitary adenomas. METHODS Twenty-three patients with pituitary adenomas, scheduled for transsphenoidal tumor resection, and 20 healthy control subjects were included in the study...
November 25, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27875509/osseous-repair-in-minimally-invasive-reconstruction-of-anterior-skull-base-defects
#5
Vijay R Ramakrishnan, Adam M Terella, Seerat Poonia, Alexander G Chiu, James N Palmer
Management of anterior skull base defects is an area of continued innovation for skull base surgeons. Various grafting materials have been advocated for the repair of skull base defects depending on needs, availability, harvest site morbidity, and surgeon preference. Spontaneous bony closure of small skull defects is known to occur in animal models without bone grafts, but this phenomenon has been unexplored in the human skull base. The objective of this study was to evaluate osseous skull base closure in patients undergoing endoscopic repair of skull base defects...
November 21, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27872697/co-occurrence-of-pituitary-adenoma-with-suprasellar-and-olfactory-groove-meningiomas
#6
Kai-Zheong Lim, Tony Goldschlager, Ronil V Chandra, Jonathan Hall, Brent Uren, Michael Pullar
INTRODUCTION: The co-existence of pituitary adenoma and meningioma is extremely rare. It is even rarer in patients with no previous known risk factors for either tumour. Here, we present a case of synchronous non-functioning pituitary adenoma with suprasellar and olfactory groove meningiomas in a patient without previous irradiation. METHODS: The tumours were diagnosed on MRI in the 65-year-old patient who presented with patchy visual deficits. The decision was made to undergo surgery for resection of the suprasellar meningioma and the pituitary adenoma, leaving the small olfactory groove meningioma intact...
October 2016: Basic and Clinical Neuroscience
https://www.readbyqxmd.com/read/27857869/endoscopic-transmaxillary-transposition-of-temporalis-flap-for-recurrent-cerebrospinal-fluid-leak-closure
#7
Regi Thomas, Shabari Girishan, Ari George Chacko
Objective To describe the technique of endoscopic transmaxillary temporalis muscle flap transposition for the repair of a persistent postoperative sphenoidal cerebrospinal fluid leak. Design The repair of a recurrent cerebrospinal fluid leak for a patient who had undergone endoscopic transsphenoidal excision of an invasive silent corticotroph Hardy C and Knosp Grade IV pituitary adenoma was undertaken. The patient had completed postoperative radiotherapy for the residual tumor and presented with cerebrospinal fluid leak, 1 year later...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27855233/a-macroprolactinoma-becoming-resistant-to-cabergoline-and-developing-atypical-pathology
#8
Emilia Sbardella, George Farah, Ahmed Fathelrahman, Simon Cudlip, Olaf Ansorge, Niki Karavitaki, Ashley B Grossman
: Pituitary adenomas are a common intracranial neoplasm, usually demonstrating a benign phenotype. They can be classified according to pathological, radiological or clinical behaviour as typical, atypical or carcinomas, invasive or noninvasive, and aggressive or nonaggressive. Prolactinomas account for 40-60% of all pituitary adenomas, with dopamine agonists representing the first-line treatment and surgery/radiotherapy reserved for drug intolerance/resistance or in neuro-ophthalmological emergencies...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27855229/late-presentation-of-acromegaly-in-medically-controlled-prolactinoma-patients
#9
Ekaterina Manuylova, Laura M Calvi, Catherine Hastings, G Edward Vates, Mahlon D Johnson, William T Cave, Ismat Shafiq
: Co-secretion of growth hormone (GH) and prolactin (PRL) from a single pituitary adenoma is common. In fact, up to 25% of patients with acromegaly may have PRL co-secretion. The prevalence of acromegaly among patients with a newly diagnosed prolactinoma is unknown. Given the possibility of mixed GH and PRL co-secretion, the current recommendation is to obtain an insulin-like growth factor-1 (IGF-1) in patients with prolactinoma at the initial diagnosis. Long-term follow-up of IGF-1 is not routinely done...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27847570/parasellar-extension-grades-and-surgical-extent-in-endoscopic-endonasal-transsphenoidal-surgery-for-pituitary-adenomas-a-single-surgeon-s-consecutive-series-with-the-aspects-of-reliability-and-clinical-validity
#10
Sang-Hyo Lee, Jae-Sung Park, Song Lee, Sung-Won Kim, Yong-Kil Hong
OBJECTIVE: The inter-rater reliability of the modified Knosp's classification was measured before the analysis. The clinical validity of the parasellar extension grading system was evaluated by investigating the extents of resection and complication rates among the grades in the endoscopic endonasal transsphenoidal surgery (EETS) for pituitary adenomas. METHODS: From November 2008 to August 2015, of the 286 patients who underwent EETS by the senior author, 208 were pituitary adenoma cases (146 non-functioning pituitary adenomas, 10 adrenocorticotropic hormone-secreting adenomas, 31 growth hormone-secreting adenomas, 17 prolactin-secreting adenomas, and 4 thyroid-stimulating hormone-secreting adenomas; 23 microadenomas, 174 macroadenomas, and 11 giant adenomas)...
November 2016: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/27846864/one-and-a-half-nostril-endoscopic-transsphenoidal-approach-for-pituitary-adenomas-a-technical-report
#11
Guodao Wen, Chao Tang, Chunyu Zhong, Junyang Li, Zixiang Cong, Yuan Zhou, Kaidong Liu, Yong Zhang, Mamatemin Tohti, Chiyuan Ma
BACKGROUND: Binostril endoscopic transsphenoidal approach (BETA) provides sufficient manipulation space and wide endoscopic vision, although it increases the trauma of nose. Mononostril endoscopic transsphenoidal approach (META) has minimal trauma of nose, at the expense of space within the operation. We describe a one-and-a-half nostril endoscopic transsphenoidal approach (OETA) that combines the advantages of BETA and META. METHODS: We introduced OETA for pituitary adenomas with a detailed technical description...
November 15, 2016: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27824399/p27-cdkn1b-translational-regulators-in-pituitary-tumorigenesis
#12
C S Martins, R C Camargo, F P Saggioro, L Neder, H R Machado, A C Moreira, M de Castro
In pituitary tumors, P27(CDKN1B) is underexpressed. We aimed to clarify whether translational regulation underlies this phenomenon. This study evaluated the expression of P27/CDKN1B, its targets (CCNE1, CDK2) and translational regulators (DKC1, RPS13, miR221, miR222) and screened for DKC1 variants in sporadic pituitary adenomas. Samples were obtained during transsphenoidal surgery from 48 patients with pituitary adenomas: 10 ACTH-, 17 GH-secreting, and 21 nonfunctioning (NFPA). The control group comprised 7 normal pituitaries (NP) obtained during autopsies...
November 7, 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/27812603/transsphenoidal-pituitary-surgery-by-microscopic-or-endoscopic-approach-the-still-unsolved-question-of-superiority
#13
EDITORIAL
Eduardo de Arnaldo S Vellutini
No abstract text is available yet for this article.
October 2016: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27792102/pituitary-colloid-cyst
#14
Mustafa Guduk, Halil Ibrahim Sun, Murat Aydin Sav, Zafer Berkman
Colloid cysts appear most commonly in the third ventricle, their occurrence in the sellar region is uncommon. The authors report a female patient with a pituitary colloid cyst. She was diagnosed incidentally with a sellar lesion by a routine paranasal computed tomography examination performed for planning of a dental implant surgery. Radiologic examinations revealed a pituitary lesion that was removed by transnasal transsphenoidal route. Her pathologic examination revealed that the lesion was a colloid cyst...
October 27, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27791524/reoperative-endoscopic-endonasal-surgery-for-residual-or-recurrent-pituitary-adenomas
#15
Hazem M Negm, Rafid Al-Mahfoudh, Manish Pai, Harminder Singh, Salomon Cohen, Sivashanmugam Dhandapani, Vijay K Anand, Theodore H Schwartz
OBJECTIVE Regrowth of the lesion after surgical removal of pituitary adenomas is uncommon unless subtotal resection was originally achieved in the first surgery. Treatment for recurrent tumor can involve surgery or radiotherapy. Locations of residual tumor may vary based on the original approach. The authors evaluated the specific sites of residual or recurrent tumor after different transsphenoidal approaches and describe the surgical outcome of endoscopic endonasal transsphenoidal reoperation. METHODS The authors analyzed a prospectively collected database of a consecutive series of patients who had undergone endoscopic endonasal surgeries for residual or recurrent pituitary adenomas after an original transsphenoidal microscopic or endoscopic surgery...
October 28, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27773901/a-case-of-bacterial-meningitis-caused-by-methicillin-resistant-staphylococcus-lugdunensis-after-surgery
#16
Yasuhiro Sasaki, Ayumi Kanamaru, Hisae Uchida, Masataka Yano, Hiroshi Tada
An 51-year-old man had undergone surgery for Rathke's cleft cyst by transsphenoidal approach on October 2015. After the surgery, cerebrospinal fluid (CSF) rhinorrhea arose. Surgical treatment of CSF rhinorrhea was performed by the same approach. Ten days after reoperation, he suffered from severe headache, high fever, and nuchal rigidity. CSF findings indicated bacterial meningitis. CSF culture showed methicillin-resistant Staphylococcus lugdunensis. He received vancomycin intravenously for 19 days and recovered from the bacterial meningitis with no serious complication...
November 29, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/27770308/the-surgical-treatment-of-acromegaly
#17
Michael Buchfelder, Sven-Martin Schlaffer
PURPOSE: Surgical extraction of as much tumour mass as possible is considered the first step of treatment in acromegaly in many centers. In this article the potential benefits, disadvantages and limitations of operative acromegaly treatment are reviewed. METHODS: Pertinent literature was selected to provide a review covering current indications, techniques and results of operations for acromegaly. RESULTS: The rapid reduction of tumour volume is an asset of surgery...
October 21, 2016: Pituitary
https://www.readbyqxmd.com/read/27769949/rathke-cleft-cyst-with-entirely-ossified-cyst-wall-and-partially-solid-content-in-the-cyst-a-case-report-and-literature-review
#18
Yasuhiko Hayashi, Masahiro Oishi, Issei Fukui, Yasuo Sasagawa, Yasuhiro Aida, Mitsutoshi Nakada
BACKGROUND: In Rathke cleft cysts (RCCs), inflammation by the cyst contents infrequently spreads to the surrounding structures. Calcification, which is regarded as a consequence of chronic inflammation of the cyst wall, can rarely be found in RCCs, and moreover, ossification is extremely rare. CLINICAL PRESENTATION: A 60-year-old woman presented with headaches, fatigue and weight loss due to panhypopituitarism. Magnetic Resonance imaging revealed a mass lesion in the sellar region, which was comprised of two different parts, with hypointensity anteriorly and hyperintensity posteriorly on T1-weighted image (WI), and the rim with significant hypointensity entirely on T2-WI...
October 18, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27763976/transseptal-subperichondrial-endoscopic-hypophysectomy-with-preservation-of-vital-nasal-structures
#19
Hasmet Yazici, Sedat Doğan, Mehmet Akif Sönmez, Olcay Eser
INTRODUCTION: Pituitary surgery involving different techniques is often applied to the excision of benign adenomas. Operative interventions involved various approaches and techniques. Endoscopic transsphenoidal approach is the less traumatic route to the sella turcica, avoiding brain retraction, and also permitting good visualization, with lower rates of morbidity and mortality. Although mortality of pituitary surgery decreased by advances in surgical techniques morbidities such as synechiae formation, anosmia, bleeding, nasal septal perforations, drying, and incrustation due to traumatization of the nasal structures such as septum, nasal mucosa, and middle concha are the current problems in pituitary surgery...
October 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27760662/-surgical-treatment-of-pituitary-adenomas-in-childhood-and-adolescence
#20
J N Wang, L X Wang, W Lian, B Xing, Y Yao, M Feng, R Z Wang
Objective: To investigate the clinical characteristics and treatment of pituitary adenomas of childhood and adolescence. Methods: Thisarticle was a retrospective study of 140 pituitary adenomas of childhood and adolescence that was admitted into Peking Union Medical College Hospital from December 1987 to December 2014, whose clinical manifestations, hormone secretions, images, pathological types, surgical complications and follow-ups were studied. Results: A total of 58 (41.4%) males and 82 females (58.6%) were included, whose mean age was 12...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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