Objective: To explore the techniques and methods of endoscopic transnasal transsphenoid surgery for pituitary adenoma.
Method: We treated 678 cases with pituitary adenoma by endoscopic transsphenoidal surgery between May 2000 and May 2006. All cases were operated through a transnasal transsphenoid approach between the nasal septum and middle nasal concha, first to enlarged sphenoid ostium and opened sellar floor with a high-speed drill and then removed the tumor step by step. Sixty-two percent of cases (420 cases) got 6-24 months of follow-up.
Results: Among the 678 pituitary adenomas, tumor removal was total in 543 (80.1%), subtotal in 118 (17.4%) and partial in 17 (2.5%). Ninety-eight percent (643 of 655 cases) obtained an improvement in clinical symptoms at some extent after the operation. Post-operative complication (including subarachnoid hemorrhage, nasal cavity bleed, nostril infection, nasal wing deformation and cerebrospinal fluid nasal leakage) occurred in 21 patients (3%). Among the 420 follow-up patients, tumor in four cases recurred 2 years after the first operation.
Conclusion: Endoscopic transsphenoidal surgery of pituitary adenomas is a valuable microinvasive neurosurgery technique of minimal invasiveness, being effective and safe, yet requiring simple manipulation. With technological and scientific advancements, endoscopic transsphenoidal surgery will improve and develop step by step.
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http://dx.doi.org/10.1179/174313208X298110 | DOI Listing |
J Otolaryngol Head Neck Surg
January 2025
Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, ON, Canada.
Importance: Pituitary adenomas (PAs) present a notable economic burden on healthcare systems due to their management's reliance on multimodal, often costly interventions.
Objective: To determine total and relative healthcare costs for PAs at Ontario-based institutions.
Design: A retrospective, propensity-score-matched cohort analysis.
Pituitary
January 2025
Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 NW 14th Terrace, 2nd Floor, Miami, Fl, 33136, USA.
Purpose: Prolonged length of stay (PLOS) can lead to resource misallocation and higher complication risks. However, there is no consensus on defining PLOS for endoscopic transsphenoidal pituitary surgery (ETPS). Therefore, we investigated the impact of varying PLOS definitions on factors associated with PLOS in patients undergoing ETPS.
View Article and Find Full Text PDFJ Neurosurg
January 2025
Departments of1Neurological Surgery.
Objective: The present study aimed to investigate the association between pituitary adenoma (PA) consistency and other measurable tumor characteristics, extent of resection (EOR), postoperative complications, and outcomes.
Methods: In total, 507 PA resections were intraoperatively assigned a consistency grade from 1 (cystic/hemorrhagic tumors) to 5 (calcified tumors) based on intraoperative tumor characteristics. Tumor consistency was analyzed in tertiles (grades 1 and 2, grade 3, and grades 4 and 5) to determine associations with tumor characteristics, EOR, recurrence, postoperative outcomes, and complications.
Neurol Int
January 2025
Department of Neurosurgery, University of Ulm, Lindenallee 2, 89312 Günzburg, Germany.
Background: Endoscopic pituitary surgery might yield better endocrine outcomes compared to microscopic resection. We conducted a prospective, randomized, single-blinded study to compare the endocrine outcome and quality of life (QoL) of patients with newly diagnosed pituitary adenoma who underwent either endoscopic or microscopic transsphenoidal surgery (NCT03515603).
Methods: Due to slow recruitment, this study had to be stopped prematurely.
Anat Cell Biol
January 2025
Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.
The sphenoidal sinus septum is one of the most important landmarks during endonasal endoscopic transsphe-noidal operations. During routine coronal sectioning of the face, we found a variant Y-shaped septum in the sphenoidal sinus of a female cadaver. This unusual septum was found between two sections (anterior and posterior sections) and located inferior to the pituitary gland.
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