Giant pituitary adenomas (GPAs) are defined as pituitary lesions larger than 40 mm of diameter. Surgical resection remains the gold standard to decompress the optic apparatus, reduce lesion load, and preserve hormonal function. The endoscopic endonasal approach (EEA) has been increasingly used for the treatment of pituitary adenomas and skull base tumors due to the wide angle of view and exposure. Through the description of an exemplificative case of EEA resection of a nonsecreting GPA in the setting of a multimodal treatment, the authors discuss the advantages and disadvantages of this management strategy and provide a detailed review of the literature.
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http://dx.doi.org/10.4103/ajns.AJNS_97_18 | DOI Listing |
J Neurol Surg Rep
January 2025
Intent Medical Group, Department of Neurosciences, Northwest Community Hospital, Part of Endeavor Health, Arlington Heights, Illinois, United States.
Nasopharyngeal stenosis is a challenging condition characterized by a narrowed nasopharynx, leading to nasal congestion, impaired breathing, and recurrent sinus issues. In this report, we present a unique surgical approach that combines the use of both the Da Vinci Xi robot and a 70-degree nasal endoscope in a patient with a type II stenosis of the nasopharynx. The benefits of improved visualization, maneuverability, and precision of this novel combined approach are highlighted.
View Article and Find Full Text PDFJ 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.
Eur Arch Otorhinolaryngol
January 2025
Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
Purpose: The escalating number of endoscopic skull base procedures necessitates exploring additional materials to reduce postoperative cerebrospinal fluid (CSF) leaks in revision or staged surgeries. This study evaluates the effectiveness of reused nasoseptal flaps (NSFs) in such clinical scenarios.
Methods: A retrospective review was conducted on patients who previously underwent surgery involving NSFs and later had revision or secondary skull base surgeries via endoscopic endonasal approaches (EEAs) at a tertiary medical center.
Pituitary
January 2025
Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Purpose: Pituitary adenomas, despite their histologically benign nature, can severely impact patients' quality of life due to hormone hypersecretion. Invasion of the medial wall of the cavernous sinus (MWCS) by these tumors complicates surgical outcomes, lowering biochemical remission rates and increasing recurrence. This study aims to share our institutional experience with the selective resection of the MWCS in endoscopic pituitary surgery.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District 100070, Beijing, China.
Deep vein thrombosis (DVT) in patients undergoing endoscopic endonasal surgery remains underexplored, despite its potential impact on postoperative recovery. This study aimed to develop and validate a predictive nomogram for assessing the risk of lower-limb DVT in such patients without chemoprophylaxis. A retrospective analysis was conducted on 935 patients with postoperative lower-limb vein ultrasonography.
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