Prevalence of GH and other anterior pituitary hormone deficiencies in adults with nonsecreting pituitary microadenomas and normal serum IGF-1 levels.

Objective: GH is usually the first pituitary hormone to be affected following a pathological insult to the pituitary; however, data on the prevalence of GH deficiency in patients with nonsecreting pituitary microadenomas and normal serum IGF-1 levels are scarce. This study aims to evaluate the prevalence of GH and other anterior pituitary hormone deficiencies, and to determine whether microadenomas per se could be associated with reduced GH response rates to GHRH-arginine stimulation.

Design: Analytical, retrospective, two-site case-control study.

Fully endoscopic supraorbital resection of congenital middle cranial fossa arachnoid cysts: report of 2 cases.

Intracranial congenital arachnoid cysts are benign intra-arachnoidal fluid collections with a wall composed of arachnoid cells encompassing a cavity containing a fluid similar to cerebrospinal fluid. This cavity frequently communicates with the subarachnoid space. Arachnoid cysts are reported to account for about 1% of all intracranial space-occupying lesions.

The endoscopic supraorbital approach to tumors of the middle cranial base.

Background: Access to tumors of the middle cranial base has traditionally required wide surgical exposures via open craniotomies. These open techniques often require the use of potentially disfiguring skin incisions and are often associated with a significant degree of brain retraction and potential morbidity. We report our experience with the use of a minimally invasive supraorbital endoscopic approach through the eyebrow for excision of middle cranial base tumors in 2 cases.

Application of the supraorbital endoscopic approach to tumors of the anterior cranial base.

Access to tumors of the anterior cranial fossa traditionally has required wide exposure of the surgical field, along with prolonged retraction of the frontal lobes or potentially disfiguring transfacial approaches. These approaches subject patients to undesirable neurologic and cosmetic morbidity. With the introduction of progressively less-invasive approaches, intracranial tumors with craniofacial involvement have become amenable to en bloc resection with a minimum of deleterious consequences.

The application of craniofacial techniques and intracranial endoscopy to pituitary surgery.

The evolution of pituitary surgery during the last century is characterized by the development of progressively less invasive approaches to the pituitary gland that have been facilitated by simultaneous advances in medical technology. Once performed via an open transcranial operation involving prolonged brain retraction, resection of pituitary tumors can now be performed via a direct transnasal approach entirely under endoscopic imaging. This review discusses the evolution of pituitary surgery from open transcranial techniques to the fully endoscopic transnasal procedure.

Craniofacial and skull base trauma.

Background: Traumatic craniofacial and skull base injuries require a multidisciplinary team approach. Trauma physicians must evaluate carefully, triage properly, and maintain a high index of suspicion to improve survival and enhance functional recovery. Frequently, craniofacial and skull base injuries are overlooked while treating more life-threatening injuries.

Fully endoscopic vascular decompression of the glossopharyngeal nerve.

Microvascular decompression of the glossopharyngeal nerve is an effective treatment of patients with glossopharyngeal neuralgia in whom compression of the nerve by a blood vessel is implicated in the pathogenesis of the disease. The standard surgical technique uses a binocular operating microscope for intra-operative visualization. Growing experience with posterior fossa endoscopy, however, has suggested that endoscopes may provide more comprehensive anatomical views of cerebellopontine angle.