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Transsphenoidal Surgery

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https://www.readbyqxmd.com/read/28736351/intraoperative-ultrasound-in-patients-undergoing-transsphoidal-surgery-for-pituitary-adenoma-a-systematic-review
#1
REVIEW
Hani J Marcus, Tom Vercauteren, Sebastien Ourselin, Neil L Dorward
BACKGROUND: Transsphenoidal surgery is the gold standard for pituitary adenoma resection. However, despite advances in microsurgical and endoscopic techniques, some pituitary adenomas can be challenging to cure. OBJECTIVE: To determine whether, in patients undergoing transsphenoidal surgery for pituitary adenoma, intraoperative ultrasound is a safe and effective technological adjunct. METHODS: The PubMed database was searched between January 1996 and January 2016 to identify relevant publications that (1) featured patients undergoing transsphenoidal surgery for pituitary adenoma, (2) used intraoperative ultrasound, and (3) reported on safety or effectiveness...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735124/inherent-tumor-characteristics-that-limit-effective-and-safe-resection-of-giant-nonfunctioning-pituitary-adenomas
#2
Hiroshi Nishioka, Takayuki Hara, Yuichi Nagata, Noriaki Fukuhara, Mitsuo Yamaguchi-Okada, Shozo Yamada
BACKGROUND: Surgical treatment of giant pituitary adenomas is sometimes challenging. We present our surgical series of giant nonfunctioning adenomas to shed light on the limitations of effective and safe tumor resection. METHODS: The preoperative tumor characteristics, surgical approaches, outcome, and histology of giant nonfunctioning adenoma (>40 mm) in 128 consecutive surgical patients are reviewed. The follow-up period ranged from 19 to 113 (mean 62.2) months...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28721598/a-retrospective-review-of-34-cases-of-pediatric-pituitary-adenoma
#3
Nannan Zhang, Peizhi Zhou, Yu Meng, Feng Ye, Shu Jiang
PURPOSE: The purpose of this paper is to study invasiveness, tumor features and clinical symptoms of pediatric pituitary adenoma, and to discuss some inconclusive results in prior studies. METHODS: We retrospectively reviewed 34 cases of children (<20 year-old) who were pathologically diagnosed with pituitary adenoma and surgically treated from 2010 to 2017. Data of general information, clinical symptoms, invasive behaviors, surgery approaches, and tumor features were collected and analyzed...
July 18, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28721218/spontaneous-reossification-of-the-sella-in-transsphenoidal-reoperation-associated-with-strontium-ranelate
#4
Maria Mercedes Pineyro, Daiana Arrestia, Mariana Elhordoy, Ramiro Lima, Saul Wajskopf, Raul Pisabarro, Maria Pilar Serra
Spontaneous reossification of the sellar floor after transsphenoidal surgery has been rarely reported. Strontium ranelate, a divalent strontium salt, has been shown to increase bone formation, increasing osteoblast activity. We describe an unusual case of a young patient with Cushing's disease who was treated with strontium ranelate for low bone mass who experienced spontaneous sellar reossification after transsphenoidal surgery. A 21-year-old male presented with Cushing's features. His past medical history included delayed puberty diagnosed at 16 years, treated with testosterone for 3 years without further work-up...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28721217/an-fsh-and-tsh-pituitary-adenoma-presenting-with-precocious-puberty-and-central-hyperthyroidism
#5
Guadalupe Vargas, Lourdes-Josefina Balcazar-Hernandez, Virgilio Melgar, Roser-Montserrat Magriña-Mercado, Baldomero Gonzalez, Javier Baquera, Moisés Mercado
A 19-year-old woman with a history of isosexual precocious puberty and bilateral oophorectomy at age 10 years because of giant ovarian cysts, presents with headaches and mild symptoms and signs of hyperthyroidism. Hormonal evaluation revealed elevated FSH and LH levels in the postmenopausal range and free hyperthyroxinemia with an inappropriately normal TSH. Pituitary MRI showed a 2-cm macroadenoma with suprasellar extension. She underwent successful surgical resection of the pituitary tumor, which proved to be composed of two distinct populations of cells, each of them strongly immunoreactive for FSH and TSH, respectively...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28711536/the-outcomes-of-primary-transsphenoidal-surgery-in-cushing-s-disease-experience-of-a-tertiary-center
#6
Fatma Ela Keskin, Hande Mefkure Ozkaya, Murat Bolayirli, Secil Erden, Pınar Kadioglu, Necmettin Tanriover, Nurperi Gazioglu
BACKGROUND: To report the initial and long-term remission rates and related factors, secondary treatments, and outcomes of a series of patients with Cushing's disease (CD). METHODS: One hundred forty-seven consecutive adult patients with CD who underwent primary trans-sphenoidal surgery between 1998 and 2014 were included in this study. Eighty-two were followed up in Cerrahpasa Medical Faculty Endocrinology and Metabolism outpatient clinic. The patients were requested to attend a long-term remission assessment; 55 could be contacted and data for the remaining 27 patients' last visit to the outpatient clinics were reviewed for early and late remission...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28691009/endoscopic-vs-microscopic-resection-of-sellar-lesions-a-matched-analysis-of-clinical-and-socioeconomic-outcomes
#7
Tej D Azad, Yu-Jin Lee, Daniel Vail, Anand Veeravagu, Peter H Hwang, John K Ratliff, Gordon Li
BACKGROUND: Direct comparisons of microscopic and endoscopic resection of sellar lesions are scarce, with conflicting reports of cost and clinical outcome advantages. OBJECTIVE: To determine if the proposed benefits of endoscopic resection are realized on a population level. METHODS: We performed a matched cohort study of 9,670 adult patients in the MarketScan database who underwent either endoscopic or microscopic surgery for sellar lesions...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28689230/the-extended-transnasal-transsphenoidal-approach-for-anterior-skull-base-meningioma-considerations-in-patient-selection
#8
Joseph P Castlen, David J Cote, Hasan A Zaidi, Edward R Laws
PURPOSE: In this study, we set out to define our institutional criteria for patient eligibility for transsphenoidal resection of parasellar meningiomas, and to report our experience with extended transnasal approaches for these lesions. We aimed to discuss the important considerations of patient selection and risk stratification to optimize outcomes for patients with these difficult lesions, and also include considerations that should be reviewed during surgical approach selection. METHODS: Medical records from Brigham and Women's Hospital were retrospectively reviewed for all patients who underwent transsphenoidal surgery for pituitary disease with the senior author from April 2008 to March 2017 (938 procedures)...
July 8, 2017: Pituitary
https://www.readbyqxmd.com/read/28687446/preservation-of-hormonal-function-by-identifying-pituitary-gland-at-endoscopic-surgery
#9
Stefan Linsler, Renate Hero-Gross, Bettina Friesenhahn-Ochs, Salman Sharif, Frank Lammert, Joachim Oertel
OBJECTIVE: The endonasal endoscopic approach has been established for perisellar tumor surgery with a higher resection rate and reduced complications. We analyzed the potential to identify the pituitary gland under endoscopic view, at surgery and see its relation to postoperative hormonal insufficiency in endonasal endoscopic procedures. METHODS: Between January 2011 and January 2014, 70 cases of pituitary adenomas with preoperative intact pituitary function underwent endoscopic endonasal transsphenoidal procedures for intrasellar pathologies...
July 4, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28684370/a-primary-pigmented-choroid-plexus-papilloma-located-within-the-sella-turcica-case-report-and-literature-review
#10
Xuan Gong, Chao Liu, Longbo Zhang, Zhenyan Li, Christopher M Bartley, Zhixiong Liu
BACKGROUND: Choroid plexus papillomas (CPPs) are rare benign tumors and the pigmented subtype is even more rarely observed. CASE DESCRIPTION: We present the case of a 43-year-old woman with complaints of headache and progressive left monocular visual deterioration, whose initial plain CT showed an ovate high density tumor located within in sellar region. MRI revealed a homogeneously contrast-enhancing tumor extending from the sella turcica to the suprasellar cistern...
July 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28684150/sandwich-technique-using-fibrin-coated-collagen-fleece-for-sellar-reconstruction-in-large-dural-defects-during-transsphenoidal-surgery
#11
Jaeyoung So, Hunho Park, Kyeong-Soo Sung, Kyu Sung Lee, Chang-Ki Hong
PURPOSE: Various surgical methods to prevent intraoperative and postoperative cerebrospinal fluid (CSF) leaks during transsphenoidal approach (TSA) surgeries have been reported, but surgical techniques to address large dural defects have been less thoroughly investigated in the literature. The authors retrospectively evaluated the usefulness of the sandwich technique using fibrin-coated collagen fleece (TachoSil) to prevent intraoperative CSF leakage from large dural defects in TSA surgery...
July 3, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28676462/risks-and-benefits-of-endoscopic-transsphenoidal-surgery-for-non-functioning-pituitary-adenomas-in-patients-of-the-9th-decade
#12
Rares Chinezu, Franklin Fomekong, Héllène Lasolle, Jacqueline Trouillas, Alexandre Vasiljevic, Gerald Raverot, Emmanuel Jouanneau
BACKGROUND: The population over 80 years of age (very elderly) is increasing and the management of these patients with pituitary surgery is controversial. Our study aimed to determine the prevalence of pituitary tumors in the elderly and to determine the safety of endoscopic transsphenoidal pituitary surgery for non-functioning pituitary adenomas in patients aged over 80. METHODS: This retrospective study included elderly (65-75 years old) and very elderly consecutive patients operated between 2007 and 2015 for non-functioning pituitary adenomas...
July 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28676314/cerebrospinal-fluid-leaks-after-transsphenoidal-surgery-effect-of-a-polyethylene-glycol-hydrogel-dural-sealant
#13
REVIEW
Erlick A C Pereira, Carly A Grandidge, Victoria A Nowak, Simon A Cudlip
To investigate cerebrospinal fluid (CSF) leak rates after mainly endoscopic endonasal transsphenoidal surgery with and without polyethylene glycol hydrogel dural sealant (DuraSeal®), we prospectively collected data from a single-centre consecutive case series over four years from January 2007 to December 2010 inclusive. 250 patients were identified (135 male, 115 female; median age 52years, range 14-83). 180 patients received DuraSeal® (72%). 85 (34%) had intra-operative dural breach and 13 (5.2%) developed post-operative CSF leaks (3 without intra-operative dural breach) requiring lumbar drainage or formal repair...
July 1, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28675669/a-two-year-audit-of-outcomes-of-pituitary-surgery-at-an-australian-teaching-hospital
#14
Timothy M E Davis, Imran Badshah, Jocelyn Drinkwater, Emily Kusich, Erin Latkovic, Neville Knuckey
BACKGROUND: There is evidence that cure rates and complications are influenced by the case load in neurosurgical centres performing transsphenoidal pituitary surgery. Although Australian centres may perform relatively small numbers of these procedures, there have been few published audits of their performance. AIMS: To conduct an audit of surgery for pituitary tumours between 2012 and 2014 in the only public hospital neurosurgical unit in the state of Western Australia...
July 4, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#15
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28662972/utilization-of-sinus-stents-as-a-novel-approach-for-benign-cystic-lesions-of-the-sella
#16
Akina Tamaki, Berje Shammassian, Abhishek Ray, Warren R Selman, Kenneth Rodriguez
Steroid-releasing sinus stents have emerged as a safe and effective tool in endoscopic sinus surgery. In this case report, we present two patients with recurrent cystic sellar masses. Transsphenoidal approach was used to access the sella. Following resection and drainage of the cystic pathology, a Propel (Menlo Park, CA) stent was placed through the corridor of the resection site to stent the cavity open. This is the first report where a steroid-releasing sinus stent was used in the treatment of a sellar lesion...
June 21, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28652753/pituitary-abscess-report-of-two-cases-and-review-of-the-literature
#17
Yu Liu, Feng Liu, Qi Liang, Yexin Li, Zhifei Wang
Pituitary abscess is a rare but critical disorder caused by an infectious process where purulent material accumulates inside the sella turcica. Since symptoms, signs and radiographic characteristics of pituitary abscess are similar to several other pituitary lesions, correct diagnosis before surgery is challenging. In this article, two cases of pituitary abscess treated in our department are reported, followed by a literature review. In these two cases, both patients presented with intermittent fever. Magnetic resonance imaging revealed a suprasellar lesion with rim enhancement after contrast injection...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28645320/acromegaly-discovered-during-a-routine-out-patient-surgical-procedure-a-case-report
#18
Chukwudi O Chiaghana, Julia M Bauerfeind, Cheri A Sulek, J Christopher Goldstein, Caleb A Awoniyi
BACKGROUND: Acromegaly is a rare syndrome in which there is unregulated hypersecretion of growth hormone. The anesthetic management of patients with this disorder is particularly challenging due to pre-existing cardiovascular and respiratory dysfunction, as well as recognized difficulties with airway management. Because of the insidious progression of the disease and the presence of nonspecific signs and symptoms, diagnosis is often made late when characteristic acromegalic features become apparent...
June 24, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28643208/visual-outcomes-after-endoscopic-endonasal-pituitary-adenoma-resection-a-systematic-review-and-meta-analysis
#19
REVIEW
Ivo S Muskens, Amir H Zamanipoor Najafabadi, Vanessa Briceno, Nayan Lamba, Joeky T Senders, Wouter R van Furth, Marco J T Verstegen, Timothy R S Smith, Rania A Mekary, Christine A E Eenhorst, Marike L D Broekman
PURPOSE: Patients with pituitary adenomas often present with visual deficits. While the aim of endoscopic endonasal transsphenoidal surgery (EETS) is to improve these deficits, permanent worsening is a possible outcome. The aim of this meta-analysis was to evaluate the effect of EETS for pituitary adenomas on visual outcomes. METHODS: A meta-analysis was conducted according to the PRISMA guidelines. Pooled prevalence was calculated for complete recovery, improvement, and deterioration of visual field deficits, visual acuity and unspecified visual function in fixed- and random-effect models, including assessment of heterogeneity (I(2)) and publication bias (Begg's test)...
June 22, 2017: Pituitary
https://www.readbyqxmd.com/read/28642181/surgery-outcome-of-growth-hormone-secreting-pituitary-adenoma-with-empty-sella-using-a-new-classification
#20
Qiang Wang, Xiaopeng Guo, Lu Gao, Zihao Wang, Kan Deng, Wei Lian, Renzhi Wang, Huijuan Zhu, Bing Xing
OBJECTIVE: To investigate the outcomes and identified risk factors for a cure and intraoperative cerebrospinal fluid leak following transsphenoidal surgery using a new classification for growth hormone-secreting pituitary adenoma associated with "empty sella". METHODS: This retrospective cohort study included 51 patients enrolled from January 2010 to June 2016. All subjects were categorized into three groups using a new classification scheme: Grade A, whole tumor occupation area beneath a horizontal line drawn along the lowest level of ES; Grade B, tumor occupation area that crossed the horizontal line on one side; and Grade C, tumor occupation area that crossed the horizontal line on two sides...
June 19, 2017: World Neurosurgery
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