Endoscopic endonasal approaches (EEA) have gained popularity and acceptance in skull base surgery over the last two decades. So-called expanded EEA allow access in the sagittal plane from the frontal sinus to the odontoid process. The endoscopic endonasal transclival approach allows a unique trajectory into the midline clivus and skull base that is unachievable from traditional craniotomy approaches to lesions such as chondrosarcomas, chordomas, and posterior fossa meningiomas. In this review, we will assess the benefits and drawbacks to using an endoscopic endonasal approach versus transcranial approach to these challenging lesions, assess the anatomical limits of endoscopic endonasal transclival surgery, and discuss the published literature on the topic.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.23736/S0390-5616.18.04411-9 | DOI Listing |
Endocr Metab Immune Disord Drug Targets
January 2025
Department of Neurosurgery, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Background: Primary pituitary abscess is a rare disease with no specific symptoms for pituitary abscess alone. A preoperative diagnosis is quite challenging due to unclear imaging findings.
Case Presentation: We report the case of a patient with a pituitary lesion who presented with hypopituitarism, diabetes insipidus, and visual field defect and was misdiagnosed as a possible cystic pituitary adenoma.
Sci Rep
January 2025
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Currently, the direct endonasal approach is widely used in endoscopic endonasal surgery (EES) for pituitary neuroendocrine tumor. However, a large posterior septal perforation is inevitable. We routinely utilize a modified para/transseptal approach using the combination of a Killian and a contralateral rescue flap incision (PTSA with K-R incision).
View Article and Find Full Text PDFSurg Neurol Int
December 2024
Department of Neurosurgery Westchester Medical Center, Valhalla, New York, United States.
Background: Pituitary apoplexy (PA) is a rare, life-threatening clinical syndrome that occurs in response to acute ischemic infarction or hemorrhage of a pituitary adenoma. We report two cases of sudden neurologic and visual decline in patients with pituitary region masses in coronavirus disease (COVID)-positive patients with a focus on potential pathophysiological mechanisms and a safe approach to treatment.
Case Description: Case one is a 58-year-old male presenting with sudden-onset headache and visual disturbance.
Surg Neurol Int
December 2024
Center for Skull Base and Minimally Invasive Neurosurgery, Hospital Angeles Pedregal, Centro de Especialidades Quirúrgicas, Mexico City, Mexico.
Background: Collision sellar tumors are rare disease entities. Less than 30 cases have been reported in the literature in the last 20 years. We present the case of one patient diagnosed with a collision sellar tumor and describe the use of Enhanced Contact Endoscopy for pituitary gland and tumoral identification not previously described in the literature.
View Article and Find Full Text PDFSurg Neurol Int
December 2024
Department of Medicine, Federal University of Sergipe, Aracaju, Brazil.
Background: Intracranial chondrosarcomas are malignant tumors that most commonly affect the clivus region. For tumors in this location, the extended endoscopic endonasal approach could offer an alternative route. We present a case of pons herniation after this technique.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!