Improved surgical microscopes and intraoperative radiofluoroscopic television have revived the transsphenoidal approach to pituitary tumors. The transsphenoidal approach offers an alternative to craniotomy, and in certain situations it has distinct advantages. The reported experience includes the common pituitary tumors, hypersecreting microadenomas, cerebrospinal rhinorrhea and parasellar aneurysms. The surgical technique, indications and contraindications, and results in 44 transsphenoidal operations are described.
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Sci Rep
January 2025
Department of Neurosurgery, Xinxiang Central Hospital, 56 Jinsui Avenue, Weibin District, Xinxiang, 453000, Henan, China.
Pituitary Neuroendocrine Tumors (PitNETs), often treated via endonasal transsphenoidal resection, present a risk for postoperative surgical site infections (SSIs), including intracranial infections such as meningitis. Identifying the risk factors associated with these infections is crucial for improving surgical outcomes and patient care. A retrospective study was conducted at a medical center from June 2020 to June 2023.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Stanford University School of Medicine, Stanford, California.
Background: The co-occurrence of Rathke cleft cysts (RCCs) and meningiomas in the sellar and parasellar regions represents an exceedingly rare clinical entity. Achieving maximal resection through a single operative approach while minimizing adverse events is challenging, often necessitating multiple surgical approaches, as suggested by previous reports.
Observations: The authors report the case of a 49-year-old female with a history of kidney transplant who presented with headaches and was diagnosed with coexisting RCC and meningioma in the sellar and planum sphenoidale regions, respectively.
J Korean Neurosurg Soc
January 2025
Department of Neurosurgery, General Hospital Bamberg, Bamberg, Germany.
The endoscopic transsphenoidal approach is a common approach used in skull base neurosurgery to reach the sellar region. One of the intraoperative risks of this approach is intraoperative bleeding out of the carotid artery. Gentle drilling can prevent carotid artery injury.
View Article and Find Full Text PDFSurg Innov
January 2025
Department of Neurosurgery, Istanbul University, Faculty of Medicine, Istanbul, Turkey.
Objective: The endoscopic transsphenoidal approach is commonly used for sellar and suprasellar pathologies. However, reaching above the diaphragma sella, especially for posterosuperior and retrocavernous orientation, still poses some challenges. We designed and developed a steerable tip suction cannula (STSC) that has distinct leverage for endoscopic resection of such pathologies.
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.
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