Image-guided navigation and video-assisted thoracoscopic spine surgery: the second generation.

Object: Video-assisted thoracoscopic surgery (VATS) has evolved for treatment of a variety of spinal disorders. Early incorporation with image-guided surgery (IGS) was challenged due to reproducibility and adaptability, limiting the procedure's acceptance. In the present study, the authors report their experience with second-generation IGS and VATS technologies for anterior thoracic minimally invasive spinal (MIS) procedures.

Surgical management of primary spinal hemangiopericytomas: an institutional case series and review of the literature.

Purpose: Hemangiopericytoma (HPC) is a rare tumor of the central nervous system. Primary spinal occurrence of this tumor is extremely uncommon and cases involving the intramedullary spinal cord are even more rare. The purpose of this study was to explore the clinical features, surgical strategies, outcome and pathology in a consecutive series of patients treated at a single institution.

Image-guided thoracoscopic resection of thoracic dumbbell nerve sheath tumors.

Background: Surgical removal of dumbbell nerve sheath tumors (NSTs) remains challenging because these neoplasms occupy ≥ 2 spinal and extraspinal spaces. The presence of intraspinal extension, tumor dimension, and/or its location within the thoracic cavity have previously made the resection of these types of neoplasms difficult.

Objective: To describe the feasibility of performing minimally invasive thoracoscopic surgery, as facilitated by an image guidance system (IGS), to achieve gross total resection of select dumbbell NSTs located in the thoracic spine.

Image-guided thoracoscopic spinal surgery: a merging of 2 technologies.

Study Design: Retrospective clinical and intraoperative navigational data review.

Objective: To evaluate quantitatively the application of frameless stereotactic image guidance in thoracoscopic discectomy procedures.

Summary Of Background Data: Thoracoscopic spinal surgery has technical and anatomic challenges that result in difficult orientation with a 2-dimensional imaging procedure in a complex 3-dimensional structure.

Repeated transsphenoidal surgery to treat recurrent or residual pituitary adenoma.

Object: In this paper the authors describe the indications for and the results and complications of repeated transsphenoidal surgery (RTSS) to treat recurrent or residual pituitary adenoma.

Methods: A retrospective review was conducted of 96 consecutive patients who underwent RTSS to treat recurrent or residual pituitary adenoma. Ninety-six patients underwent RTSS: 42 to treat a recurrent or residual pituitary mass and 54 to treat a recurrent or persistent hormone hypersecretion.

Surgery for Rathke cleft cysts: technical considerations and outcomes.

Object: The aim of this study was to identify the optimal surgical goals and techniques for managing symptomatic Rathke cleft cysts (RCCs).

Methods: The authors conducted a retrospective study of 62 consecutive patients who had undergone surgery for RCCs. Postoperative follow up was a mean of 28 months.

Endoscopy in neuro-otologic surgery.

Endoscopy offers several distinct advantages over the operating microscope during neuro-otologic surgery that make it an excellent adjunctive tool to the microscope or independent modality during cranial base surgery. The high magnification gives excellent definition of perforating blood vessels, cranial nerves, and neural structures, which in many cases is superior to that achieved with the microscope. Furthermore, the use of angled or flexible endoscopes allows one to look around corners and behind anatomic structures blocking the view seen via a 0 degree microscope.

Giant prolactinomas: clinical management and long-term follow up.

Object: Giant prolactinomas are rare tumors whose treatment and outcome has only been addressed in isolated case reports. The authors document the long-term follow-up findings and clinical outcome in a group of patients with giant prolactinomas.

Methods: This study is a retrospective chart and clinical review of more than 2000 cases of pituitary tumors treated at the authors' institution, of which 10 met the criteria for inclusion (prolactin level > 1000 ng/ml, diameter > 4 cm on neuroimaging studies, and clinical signs of hyperprolactinemia/mass effect).

Granular cell tumor of the pituitary fossa.

Although granular cell tumors are relatively common in the head and neck, symptomatic granular cell tumors of the neurohypophysis are extremely rare. Ophthalmologic symptoms are most common, followed by endocrinologic manifestations. We report a case of a granular cell tumor of the pituitary fossa that was surgically treated.