Endoscopic endonasal transsphenoidal surgery. Before scrubbing in: tips and tricks

Cavallo, Luigi Maria; Fabbro, Mateus Dal; Jalalod’din, Hasan; Messina, A.; Esposito, Isabella; Esposito, Felice; Divitiis, Enrico de; Cappabianca, Paolo

doi:10.1016/j.surneu.2006.09.040

Cited by 48 publications

(30 citation statements)

References 32 publications

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“…The majority of these tumours are managed surgically and the endoscopic endonasal trans-sphenoidal approach is becoming the procedure of choice. [14][15][16][17] This approach is safe and effective, with surgical results and a complication rate at least similar, if not better, to those reported in the main microsurgical series. 14,[18][19][20] Furthermore, patient compliance is improved.…”

Section: Pituitary Surgerysupporting

confidence: 64%

Endoscopic Tumour Surgery - Current Limits and Future Possibilities

Cappabianca¹,

Esposito²,

Cavallo³

et al. 2008

European Neurological Review

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Brain tumours represent a major focus of research in chemotherapy, radiotherapy and neurosurgery. The principle that guides all of these disciplines is: be effective on the tumour with fewer effects on normal brain tissue. In surgical sciences this concept has become known as 'minimally invasive surgery'. The development of endoscopic techniques has had a revolutionary impact in several disciplines such as urological, gastrointestinal and thoracic surgery. In neurosurgery, the use of the endoscope was initially limited to the treatment of hydrocephalus. Only during the last few decades have the indications for endoscopy -which has been driven by global technological progress, leading to the development of image-guided surgery, intra-operative-imagingdedicated surgical instruments and increasingly efficient endoscopesbeen extended to other pathologies such as aneurysms and tumours. Historical BackgroundUntil the 1960s, neurosurgical procedures for brain tumours were The Endoscopic TechniqueThe endoscope has become part of the equipment in all neurosurgical operating theatres and the surgeon can rely on low-profile endoscopes with straight or variably angled views, xenon light source, irrigation sheaths for cleaning the lenses inside the operating field and endoscope holders to perform bimanual dissection, as in microsurgery. Nevertheless, the endoscope is far from being commonly applied as a visualising tool during microsurgical procedures: the endoscope-assisted technique is devoted to surgery for aneurysms and cerebellopontine tumours. The reasons for this lie in the marked differences between the two imaging modalities. Despite the fact that several systems integration strategies have been applied, 3

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Section: Pituitary Surgerysupporting

confidence: 64%

Endoscopic Tumour Surgery - Current Limits and Future Possibilities

Cappabianca¹,

Esposito²,

Cavallo³

et al. 2008

European Neurological Review

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“…With the development of nasal microsurgery, it is necessary to resect the tumors thoroughly, with less surgical damage to the adjacent structures. The endoscopic surgery to target the lesions in the pterygopalatine fossa and cavernous sinus have also been reported recently [9,10] . The anatomical structures involved in this approach are complicated, and the correlated anatomical research has been seldom reported [11] .…”

Section: Introductionmentioning

confidence: 99%

Nasal cavity-maxillary sinus-pterygopalatine fossa-Meckel’s cave: a preliminary anatomic study of an endoscopy-based operative approach

et al. 2009

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Objective To provide a new approach for the treatment of tumor in Meckel's cave, by dissecting adjacent structures of the nasal cavity-maxillary sinus-pterygopalatine fossa-Meckel's cave approach. Methods Fifteen adult cadaver heads (30 sides) were dissected and the correlated anatomic landmarks were observed, measured and analyzed in an operative route. Results The approach was divided into 3 steps: entering the maxillary sinus, the later pterygopalatine fossa and the final Meckel's cave. Safe access to Meckel's cave could be achieved by tracing the vidian neurovascular bundles and dissecting the quadrangular space (QS). The distances from the nasal columella to the apertura maxillaries, the sphenopalatine foramen, and the anterior foramen of the pterygoid canal were (44.08±2.61) mm, (64.83±2.42) mm, and (70.43±2.94) mm, respectively.The angles between the horizontal plate of the palatine bone and the link from nasal columella to apertura maxillaries, between the horizontal plate of the palatine bone and the link from nasal columella to sphenopalatine foramen were (38.10±2.46)° and (26.15±2.26)°, respectively. Conclusion The endoscopic approach of transnasal maxillary sinus-pterygopalatine fossaMeckel's cave (ENMPA) is a safe and direct way to access Meckel's cave, and could be employed for the treatment of tumor in Meckel's cave.

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“…Transsphenoidal surgical techniques have been improving since 1907 when Schioffer performed the first successful transnasal operation in Vienna. In the USA, Hirsch (1910) and cushing (1912) contributed to the evo-lution of transsphenoidal surgery and had surgical mortality rates as low as 9.5 and 4.8% without the use of cortisone or antibiotics 2,3 . Cushing initially used a head light and otologic mirrors but eventually discontinued trans-sphenoidal surgery because of insufficient vision on the surgical field.…”

Section: Introductionmentioning

confidence: 99%

Outcome of Pituitary Adenoma Surgery Through Transphenoidal Microscopic Approach : A Study of 15 Cases

Nath

Barua

Das

et al. 2015

Chatt Maa Shi Hosp Med Coll J

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Background: Transphenoidal microscopic approach is minimally invasive surgery in case of pituitary adenoma. Comparatively less complication than transcranial approach. Objective: The purpose of the study to see the outcome of transphenoidal microscopic removal of pituitary adenoma. Results: The study showed the majority 8(53.33%) of patients were female. It was documented that 7(46.66%) of patient had age group 21-40 years. It was evident that 13(86.66%) of patient had macroadenoma. Among the 15 patients 14(93.33%) had visual disturbance and 1(6.64%) had pituitary apoplexy. Tumor was totally removed under microscope in 10(66.67%) cases. It was documented that 12(80.11%) of patients improved after surgery. Conclusion: Transphenoidal microscopic pituitary surgery is one of the important procedure which can save many lives with lack of postoperative complication.

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Endoscopic endonasal transsphenoidal surgery. Before scrubbing in: tips and tricks

Cited by 48 publications

References 32 publications

Endoscopic Tumour Surgery - Current Limits and Future Possibilities

Endoscopic Tumour Surgery - Current Limits and Future Possibilities

Nasal cavity-maxillary sinus-pterygopalatine fossa-Meckel’s cave: a preliminary anatomic study of an endoscopy-based operative approach

Outcome of Pituitary Adenoma Surgery Through Transphenoidal Microscopic Approach : A Study of 15 Cases

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