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Transsphenoidal Surgery

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https://www.readbyqxmd.com/read/28089836/delayed-csf-rhinorrhea-after-gamma-knife-radiosurgery-with-or-without-preceding-transsphenoidal-resection-for-pituitary-pathology
#1
Avital Perry, Christopher S Graffeo, William R Copeland, Kathryn M Van Abel, Matthew L Carlson, Bruce E Pollock, Michael J Link
BACKGROUND: Skull base cerebrospinal fluid (CSF) leak after gamma knife radiosurgery (GKRS) is a very rare complication. In patients who were treated with both GKRS and transsphenoidal resection (TSR) for pituitary lesions, early CSF leak occurs at a comparable rate to the general TSR population (4%). Delayed CSF leak occurring more than a year after TSR, GKRS, or dual therapy, is exceedingly rare. METHODS: Retrospective chart review and review of the literature RESULTS: We present two cases of delayed CSF leak following GKRS to treat pituitary adenoma...
January 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28079350/transcranial-approach-in-giant-pituitary-adenomas-results-and-outcome-in-a-modern-series
#2
Thomas Graillon, Frédéric Castinetti, Stéphane Fuentes, Regis Gras, Thierry Brue, Henry Dufour
BACKGROUND: Today, transcranial (TC) approach indications are particularly rare in pituitary adenomas (PA), representing 1.1% of all PA surgeries in our experience. In these rare and selected cases, the complications, advantages, and disadvantages of TC approach were also analyzed. METHODS: 19 cases of giant PA (≥40 mm) operated via TC approach alone or combined with transsphenoidal (TS) approach between 2000 and 2016 were selected. RESULTS: The most frequently observed symptom was visual disturbance...
January 12, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28072724/fatal-antiphospholipid-syndrome-following-endoscopic-transnasal-transsphenoidal-surgery-for-a-pituitary-tumor-a-case-report
#3
Chiao-Zhu Li, Chiao-Ching Li, Chih-Chuan Hsieh, Meng-Chi Lin, Dueng-Yuan Hueng, Feng-Chen Liu, Yuan-Hao Chen
INTRODUCTION: The fatal type of antiphospholipid syndrome is a rare but life-threating condition. It may be triggered by surgery or infection. Endoscopic transnasal-transsphenoidal surgery is a common procedure for pituitary tumor. We report a catastrophic case of a young woman died of fatal antiphospholipid syndrome following endoscopic transnasal-transsphenoidal surgery. METHODS AND RESULT: A 31-year-old woman of a history of stroke received endoscopic transnasal-transsphenoidal surgery for a pituitary tumor...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28069358/pneumococcal-polysaccharide-vaccination-administered-early-after-neurotrauma-or-neurosurgery
#4
Anna Ljunghill Hedberg, Karlis Pauksens, Per Enblad, Jessika Söderberg, Björn Johansson, Helena Käyhty, Jan Sjölin
OBJECTIVES: Pneumococcal vaccination is recommended to lower the risk of posttraumatic meningitis, and early vaccination may be of importance. After both trauma and central nervous system injury, immune-suppression may occur, which could affect T-cell function and the response to T-cell dependent vaccines. We therefore aimed to investigate the response to early vaccination with a T-cell independent pneumococcal polysaccharide vaccine (PPSV). METHODS: Thirty-three patients with basilar skull fracture and 23 patients undergoing transsphenoidal pituitary gland surgery were vaccinated with PPSV within 10days after neurotrauma or neurosurgery...
January 6, 2017: Vaccine
https://www.readbyqxmd.com/read/28057594/significant-improvement-in-chronic-persistent-headaches-caused-by-small-rathke-cleft-cysts-after-transsphenoidal-surgery
#5
Issei Fukui, Yasuhiko Hayashi, Daisuke Kita, Yasuo Sasagawa, Masahiro Oishi, Osamu Tachibana, Mitsutoshi Nakada
PURPOSE: Rathke cleft cysts (RCC) are usually asymptomatic and can be observed using conservative methods. However, some patients with RCCs have severe headaches even if they are small enough to be confined to the sella, and these small RCCs have seldom been discussed. This study presents an investigation into clinical characteristics of small RCCs associated with severe headaches, demonstrating efficacy and safety of endoscopic transsphenoidal surgery (ETSS) to relieve headaches. METHODS: In this study, 13 patients with small RCCs (maximum diameter < 10mm) who presented with headaches and were treated by ETSS at our institute from 2009 to 2014 were recruited...
January 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28057099/-the-surgery-of-thyrotropin-secreting-pituitary-adenomas-and-the-significance-of-thyroid-stimulating-hormone-level-in-follow-up
#6
Y Y Yang, H Liu, A Hu, Y Zou, B Xing, Y Yao, R Z Wang, W Lian
Objective: To explore the clinical characteristics of thyrotropin-secreting pituitary adenomas and the effect of the transsphenoidal approach of procedure with/without drug treatment for thyrotropin-secreting pituitary adenomas, and to investigate the correlation between the prognosis of thyrotropin-secreting pituitary adenomas and the postoperative level of thyroid stimulating hormone (TSH). Methods: A total of 45 patients with thyrotropin-secreting pituitary adenoma who hospitalized in Peking Union Medical College Hospital from 2000 to 2015 were enrolled in the study...
December 20, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28034815/transsphenoidal-posterior-pituitary-lobe-biopsy-in-patients-with-neurohypophysial-lesions
#7
Yasuyuki Kinoshita, Fumiyuki Yamasaki, Atsushi Tominaga, Satoshi Usui, Kazunori Arita, Tetsuhiko Sakoguchi, Kazuhiko Sugiyama, Kaoru Kurisu
OBJECTIVE: The differential diagnosis of neurohypophysial lesions is difficult and surgical biopsies are indispensable in the histological diagnosis of some patients. Although pituitary stalk biopsies are uniformly performed, there is a considerable risk that they will result in impaired hormonal secretion. We attempt to clarify the usefulness and safety of posterior pituitary lobe biopsy by transsphenoidal surgery (TSS). METHODS: The cases of 11 consecutive patients who underwent posterior pituitary lobe biopsies by TSS were retrospectively studied...
December 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28029524/-external-lumbar-drainage-with-volumetric-continuing-infusion-pump-in-patients-with-cerebrospinal-fluid-leak-a-case-series
#8
Ana Belén Manso Melgosa, Helena García Gutiérrez, Mónica Fernández Porras, Ana Berta Castrillo Manero, Belén Pérez Marijuán
OBJECTIVE: To describe the incidence and complications arising in a number of cases of patients with cerebrospinal fluid leak treated by external lumbar drainage with infusion pump (IP) volumetric continuous from 2001 to 2014. Quantify cerebrospinal fluid leak closed by lumbar drainage with IP. METHODS: Retrospective descriptive case series study. POPULATION: patients undergoing transsphenoidal pituitary surgery, Chiari surgery and laminectomy, that developed postoperative cerebrospinal fluid leak treated with continuous external lumbar drainage by IP...
October 28, 2016: Enfermería Clínica
https://www.readbyqxmd.com/read/28029519/adrenocorticotropic-hormone-levels-before-treatment-predict-recurrence-of-cushing-s-disease
#9
Chun-Heng Kuo, Shyang-Rong Shih, Hung-Yuan Li, Szu-Chi Chen, Po-Ju Hung, Fen-Yu Tseng, Tien-Chun Chang
BACKGROUND/PURPOSE: Cushing's disease (CD) is the most common cause of endogenous Cushing's syndrome. Transsphenoidal surgery (TSS) is the first choice of treatment. Predicting prognosis after treatment can benefit further strategies of management, but currently there is no convenient predictor. This study aims to investigate characteristic changes after treatment and to identify potential prognostic predictors. METHODS: We retrospectively studied the records of CD patients presenting to the National Taiwan University Hospital, Taipei, Taiwan between 1992 and 2011...
October 28, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28025627/patients-with-acromegaly-presenting-with-colon-cancer-a-case-series
#10
Murray B Gordon, Samer Nakhle, William H Ludlam
Introduction. Frequent colonoscopy screenings are critical for early diagnosis of colon cancer in patients with acromegaly. Case Presentations. We performed a retrospective analysis of the incidental diagnoses of colon cancer from the ACCESS trial (ClinicalTrials.gov identifier: NCT01995734). Colon cancer was identified in 2 patients (4.5%). Case  1 patient was a 36-year-old male with acromegaly who underwent transsphenoidal surgery to remove the pituitary adenoma. After surgery, the patient underwent routine colonoscopy screening, which revealed a 40 mm tubular adenoma in the descending colon...
2016: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28009230/letter-to-the-editor-endoscopic-transsphenoidal-pituitary-surgery
#11
Chih-Chang Chang, Yu-Shu Yen, Tsung-Hsi Tu, Li-Yu Fay, Wen-Cheng Huang, Jau-Ching Wu
No abstract text is available yet for this article.
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28009229/transoral-robotic-surgery-for-sellar-tumors-first-clinical-study
#12
Dorian Chauvet, Stéphane Hans, Antoine Missistrano, Celeste Rebours, Wissame El Bakkouri, Guillaume Lot
OBJECTIVE The aim of this study was to confirm the feasibility of an innovative transoral robotic surgery (TORS), using the da Vinci Surgical System, for patients with sellar tumors. This technique was designed to offer a new minimally invasive approach, without soft-palate splitting, that avoids the rhinological side effects of classic endonasal approaches. METHODS The authors performed a prospective study of TORS in patients with symptomatic sellar tumors. Specific anatomical features were required for inclusion in the study and were determined on the basis of preoperative open-mouth CT scans of the brain...
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28008629/lower-airway-disease-and-pituitary-surgery-is-there-an-association-with-postoperative-cerebrospinal-fluid-leak
#13
Curtis Hanba, Peter F Svider, Jeffrey T Jacob, Murali Guthikonda, James K Liu, Jean Anderson Eloy, Adam J Folbe
OBJECTIVES/HYPOTHESIS: To explore the relationship between lower airway disease and postoperative cerebrospinal fluid (CSF) rhinorrhea among patients undergoing pituitary surgery STUDY DESIGN: Retrospective review. METHODS: A retrospective review of the Healthcare Cost and Utilization Project's 2013 National Inpatient Sample was conducted to characterize the hospital stay and surgical outcomes of patients undergoing pituitary surgery. Patients with lower airway disease (including chronic obstructive pulmonary disease and asthma) were compared to a disease-free population identifying demographics and complications over-represented in the lower airway group...
December 23, 2016: Laryngoscope
https://www.readbyqxmd.com/read/28005257/safety-of-transsphenoidal-microsurgical-approach-in-patients-with-an-acth-secreting-pituitary-adenoma
#14
Carmine Antonio Donofrio, Marco Losa, Marco Gemma, Lodoviga Giudice, Lina Raffaella Barzaghi, Pietro Mortini
PURPOSE: Patients affected by Cushing's disease often have important comorbidities directly linked to hypercortisolism that might enhance the operative risk. We report the safety of transsphenoidal surgery in patients affected by Cushing's disease as compared with patients with nonfunctioning pituitary adenoma. METHODS: We have retrospectively analyzed 142 patients with Cushing's disease and 299 patients with nonfunctioning pituitary adenoma who underwent transsphenoidal surgery performed by a single experienced neurosurgeon between September 2007 and December 2014...
December 22, 2016: Endocrine
https://www.readbyqxmd.com/read/28002537/cerebral-arteriopathy-with-subcortical-infarcts-and-leukoencephalopathy-in-acromegalic-patient-with-severe-headache
#15
LuminiŢa Nicoleta Cima, Simona Vasilica Fica, Alice Ioana Albu, Ioana Maria Lambrescu, Ioana SmărăndiŢa Lăcău, Bogdan Ovidiu Popescu, Mihaela Gherghiceanu, Corin Virgil Badiu, Carmen Gabriela Barbu
A 68-year-old female patient was admitted in our clinic with severe frontal bilateral headache, dizziness, depression and cognitive decline in the context of a previously diagnosed acromegaly. She also had high blood pressure, dyslipidemia, secondary diabetes mellitus. Acromegaly was caused by a growth hormone (GH) secreting-pituitary macroadenoma, so a transsphenoidal surgery was performed. The postoperative magnetic resonance imaging (MRI) scan revealed a 20÷22÷25 mm pituitary mass remnant and medical therapy with somatostatin analogues (SSAs) was started...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27974387/decrease-of-serum-igf-i-following-transsphenoidal-pituitary-surgery-for-acromegaly
#16
Min Yu, David E Bruns, John A Jane, Ralf M Nass, Edward H Oldfield, Mary Lee Vance, Michael O Thorner
BACKGROUND: In the immediate postoperative period following resection of growth hormone (GH)-secreting pituitary tumors, serum concentrations of GH have limited ability to predict remission of acromegaly. Since many actions of GH actions are mediated by insulin-like growth factor-1 (IGF-I), we aimed to determine the rates of fall of IGF-I during 72 h after surgical resection of pituitary tumors. METHODS: We studied patients who were undergoing pituitary surgery for acromegaly...
December 14, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27967227/sodium-and-water-imbalance-after-sellar-suprasellar-and-parasellar-surgery
#17
Zareen Kiran, Aisha Sheikh, Sehrish Nizar Ali Momin, Isra Majeed, Safia Awan, Owais Rashid, Najmul Islam
OBJECTIVES: To report the frequency of sodium and water disturbances (SWD) in patients undergoing sellar, suprasellar and parasellar surgery (SSPS). METHODS: We conducted a cross-sectional retrospective study on 115 patients in the Aga Khan University Hospital after ethical approval. Patients were 16 years old or older undergoing pituitary or sellar surgeries. We collected data on basic sociodemographic characteristics and clinical indication for surgery. We noted laboratory values for serum electrolytes, plasma and urine osmolality, urine sodium and 24-hour fluid balance from immediate postoperative day till discharge and follow up...
December 14, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27956252/clinical-features-management-considerations-and-outcomes-in-a-case-series-of-patients-with-parasellar-intracranial-aneurysms-undergoing-anterior-skull-base-surgery
#18
Daniel M Raper, Dale Ding, Elizabeth Evans, Robert M Starke, R Webster Crowley, Kenneth C Liu, Edward H Oldfield, John A Jane
BACKGROUND: The co-incidence of parasellar aneurysms (IA) and anterior skull base (ASB) lesions, while rare, presents a management challenge. IAs embedded within, or adjacent to, ASB lesions are at risk in the perioperative period, and may have unique presentations, natural histories, and outcomes. The objective of this study was to outline management options and nuances in patients with coexisting IAs and ASB lesions. METHODS: We retrospectively evaluated all patients who presented for management of IAs and ASB lesions from January 2006 to January 2014...
December 9, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27910710/management-of-a-pregnant-woman-with-thyrotropinoma-a-case-report-and-review-of-the-literature
#19
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
#20
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
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