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The 3-D endoscope is a useful alternative to the 2-D HD endoscope for transnasal anterior skull-base surgery. Preliminary results suggest it is more efficient surgically and has a shorter learning curve. As 3-D technology and resolution improve, it should serve to be an invaluable tool for neuroendoscopy.

Arterial injury is an uncommon event after endoscopic endonasal surgery. Attempts at arterial repair are rarely successful, and vessel sacrifice is the most reliable technique at this point.

background: Postoperative cerebrospinal fluid (CSF) fistula is the most serious complication after transsphenoidal surgery. Objective: To analyze the incidence of CSF fistula after endoscopic transsphenoidal surgery for tumor removal in sellar region; to discuss associated factors and methods used for sellar closure. Method: Retrospective study of 67 patients (73 surgeries) operated via transsphenoidal endoscopy at Hospital Vall D'Hebron and Hospital Clinic of the Universidad de Barcelona, Spain. The data collected included: age, sex, hospitalization stay, suprasellar extension of the lesion, type of tumor, evidence of intraoperative CSF fistula, complications of postoperative CSF fistula, previous surgery and radiotherapy. results: Six patients (8.2%) had postoperative CSF fistula, and their average hospitalization was 5 days longer with resulting complications: two of whom had pneumoencephalus and two with meningitis. No association was found between the data collected and postoperative CSF fistula. conclusion: The rate of CSF fistula after endoscopic transsphenoidal surgery from the present study is contained within the literature. Unlike other reports, no association between the variables and postoperative CSF fistula was found in this report. Key words: cerebrospinal rhinorrhea, endoscopy, pituitary neoplasms.Fístula liquórica após cirurgia transesfenoidal endoscópica: experiência de um centro espanhol resuMO A fístula liquórica pós-operatória é a complicação mais séria após cirurgia transesfenoidal. Objetivo: Analisar a incidência de fístula liquórica após cirurgia endoscópica transesfenoidal para remoção de tumores selares, discutir fatores associados e método utilizado para fechamento selar. Método: Estudo retrospectivo de 67 pacientes (73 cirurgias) operados via endoscopia transesfenoidal no Hospital Vall D'Hebron e Hospital Clínic da Universidad de Barcelona, Espanha. Os dados coletados foram: idade, sexo, dias de internação, extensão supra-selar da lesão, tipo de tumor, evidência de fístula liquórica intra-operatória, complicações da fístula liquórica pós-operatória, cirurgia e radioterapia prévias. resultados: Seis pacientes (8.2%) tiveram fístula liquórica pós-operatória. Nestes a média de internação hospitalar foi 5 dias maior e tendo complicações decorrentes: dois com pneumoencéfalo e dois com meningite. Não se encontrou associação entre os dados coletados e fístula liquórica pós-operatória. conclusão: A taxa de fistula liquórica após cirurgia transesfenoidal endoscópica do presente estudo está dentro da literatura. Ao contrário de outros relatos, nesta pesquisa não foi encontrada associação entre as variáveis e fístula liquórica pós-operatória. Palavras-chave: endoscopia, neoplasias hipofisárias, rinorreia de líquido cefalorraquidiano.

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Orbital meningiomas usually invade the orbit as an extension of the sphenoid wing meningiomas, clinoidal meningiomas, cavernous sinus meningiomas and tuberculum sella tumors. They also arise into the orbit originating from the optic sheath or as ectopical lesions. The authors present a review of clinical aspects and surgical treatment of the orbital meningiomas. Material and methods: The authors present a literature review of the anatomical, clinical, and surgical aspects of the orbital meningiomas, add illustrative cases, pointing their principal concerns about the treatment of such tumors. Results: Exophthalmos and unilateral visual loss are the most common features of the orbital meningiomas. There are two important surgical routes to approach such tumors, which are extracranial (transorbital) and transcranial approaches. Recurrence is higher in sphenoorbital meningiomas and related to bone and neurovascular invasion. Conclusions: The anatomical structures involved by orbital meningiomas challenge the microsurgical resection. Total removal should be the goal at the first surgical approach. Orbital reconstruction should be performed in cases where the orbital floor is not preserved or in extensive lateral and roof removal with no preservation of the periorbit.

Before this research, there was no record of the measurements of the choroid plexus in the interventricular foramen. The remaining variables of the present study show a greater number in normal brains compared with others.

Background:The diencephalic leaf of the Liliequist's membrane is a continuous structure that should be perforated in the endoscopic third ventriculostomy. Its lateral borders are penetrated by the third cranial nerve and the posterior communicating arteries. The most important complication of endoscopic third ventriculostomy is the vascular injury, such as the posterior communicating artery. The purpose of this study is to measure the distance between posterior communicating arteries located below the third ventricle floor and anterior of the mammillary bodies.Methods:In this observational prospective study 20 fresh brains from cadavers were utilized to measure the distance between the posterior communicating arteries in April 2008 at the Death Check Unit of our Institution. A digital photograph of the posterior communicating arteries was taken and the distance between the arteries was measured. The measurement was analyzed using descriptive statistics.Results:In the descriptive analysis of the 20 specimens, the posterior communicating arteries distance was 9 to 18.9 mm, a mean of 12.5 mm, median of 12.2 mm, standard deviation of 2.3 mm.Conclusion:The detailed knowledge of vascular structures involved in the endoscopic third ventriculostomy as to the posterior communicating arteries distance provides a safe lateral vascular border when performing such procedure.