Endoscopic transsphenoidal treatment of pituitary adenomas

Zhang, Yazhou; Wang, Zhongcheng; Yejian, Liu; Zong, Xuyi; Song, Minju; Ao, Pei; Zhao, Peng; Zhang, Pengfei; Ming-xue, Piao

doi:10.1179/174313208x298110

Cited by 41 publications

(34 citation statements)

References 12 publications

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“…Because of its low morbidity and short operation duration and the possibility of an approach toward the wide part of the sinus with an angled telescope, the endonasal endoscopic approach was the most commonly used in past years to enter the sphenoid sinus [1,2]. This approach has been used in treatment of diseases of the sphenoid sinus, such as chronic rhinosinusitis resistant to medical treatment, nasal polyps, mucoceles, cerebrospinal fistulas, fungal infections, foreign objects and tumors, and in many other diseases, such as sellar or parasellar tumors and optic nerve decompression [3,4].…”

Section: Introductionmentioning

confidence: 99%

Surgical Measurement of the Sphenoid Sinus on Sagittal Reformatted CT in the Turkish Population

Kaplanoğlu

Toprak

et al. 2013

EAJM

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Objective: The objectives of this study were to determine sinus measurements specific for the Turkish population using CT sagittal thin-slice reconstruction images and to clarify the three-dimensional anatomical features of the sphenoid sinus, along with its surrounding structures, that are relevant to performing an endoscopic sphenoidotomy. Materials and Methods:Images of 300 patients (165 female, 135 male) were studied. The research was conducted on the axial plane with a 1 mm slice thickness and a 0.6 mm slice interval, and sagittal reconstruction was performed with a 0.4 mm slice interval. Measurements of the sinus were obtained, and the presence of Onodi cells was researched.Results: Line 1 was found to be significantly shorter in the Turkish patients of this study compared to studies of other populations. Lines 4 and 6 were found to be longer on the left side (Line 4 right: 18.8±3.6 mm, left: 19.3±3.4 mm, p=0.027; Line 6 right: 24.1±6.8 mm, left: 24.3±6.8 mm, p=0.008). Lines 2, 3, 4 and 6 were longer in men than in women (p<0.05). Conclusion:In the Turkish population, Line 1 is shorter, so the risk of skull base perforation is greater. Lines 4 and 6 are longer on the left side; thus, choosing the left ostium in sinus dilation is safer. Because of sex differences regarding Lines 2, 3, 4 and 6, sex should be considered in sphenoid sinus procedures.

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Section: Introductionmentioning

confidence: 99%

Surgical Measurement of the Sphenoid Sinus on Sagittal Reformatted CT in the Turkish Population

Kaplanoğlu

Toprak

et al. 2013

EAJM

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“…In patients with macroadenomas with visual field cuts, complete normalization of preoperative visual defect was noted in 50% of endoscopically approached tumors in one study, with an additional 39% having improvement (Dehdashti et al, 2008). Zhang et al achieved 70% recovery of preoperative visual defects in over 300 cases (Zhang et al, 2008). These reported rates of visual recovery in the endoscopic literature are slightly higher than those traditionally reported for microscopic approaches (Schaberg et al, 2010).…”

Section: Endoscopic Endonasal Surgery: Advantagesmentioning

confidence: 53%

Endoscopy in Intracranial Pathology

Najjar¹,

Turkmani²

2011

Advances in Endoscopic Surgery

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“…The comparison between microscopic approach and transnasal endoscopic approach had been discussed in a great number of literature [3][4][5][6][7][8][9][10]. We have no experiences in microscopic pituitary adenoma surgery; so we simply focus on the practical skill of transnasal endoscopic pituitary surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In the pituitary surgery, the procedure by nasal endoscope has a lot of advantages that microscope can't afford [3][4][5][6][7][8][9][10][11][12][13][14][15]17], though it also has several disadvantages, however which will be overcomed along with the continuously developing of new instruments and new techniques.…”

Section: Discussionmentioning

confidence: 99%

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Full Endoscopic Transsphenoidal Surgery for Pituitary Adenoma-emphasized on Surgical Skill of Otolaryngologist

Fan

Feng

et al. 2011

Indian J Otolaryngol Head Neck Surg

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The purpose is to summarize the experience in full endoscopic transsphenoidal resection of pituitary adenoma in 28 patients by rhinologist, and introduce the surgical skill of otolaryngologist, especially skills and cautions when operating inside nose. We removed pituitary adenoma in 28 patients via entirely endoscopic transsphenoidal approach with the help of special-designed instruments; we performed the procedure bloodlessly within limited time. The skill emphasized bilateral nostrils and four hands technique which was as delicate as possible not to scratch nasal mucosa or injure nasal frame. The special instruments included curette with suction, monopolar electrotome and bipolar coagulation forceps with suction, powered surgical equipments (Diamond Bur, Irrigation Tubing for Blades and Burs for nasal endoscopic surgery). Among 28 patients, there were 16 total resections, 8 subtotal resections, 3 partial resections, and 1 only biopsy due to excessive bleeding and hard nature. Of 19 patients with preoperative visual impairment, 12 patients had postoperative improvement in visual acuity and visual field. All the procedures were finished within 60 to 90 min. Complications seldom occurred except transient diabetes insipidus, especially no nasal-related signs or complications but 1 had epistaxis. The full endoscopic transsphenoidal surgery is a promising approach for pituitary adenoma resection. Multidisciplinary collaboration will lead to optimal cure for the patients. New technique and special-designed instruments can facilitate greatly this procedure.

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Endoscopic transsphenoidal treatment of pituitary adenomas

Cited by 41 publications

References 12 publications

Surgical Measurement of the Sphenoid Sinus on Sagittal Reformatted CT in the Turkish Population

Surgical Measurement of the Sphenoid Sinus on Sagittal Reformatted CT in the Turkish Population

Endoscopy in Intracranial Pathology

Full Endoscopic Transsphenoidal Surgery for Pituitary Adenoma-emphasized on Surgical Skill of Otolaryngologist

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