Oronasal complications in patients after transsphenoidal hypophyseal surgery

Petry, Carolina; Leães, Carolina García Soares; Pereira-Lima, Júlia Fernanda Semmelmann; Gerhardt, Katia D.; Sant, Geraldo; Oliveira, Miriam da Costa

doi:10.1590/s1808-86942009000300006

Cited by 13 publications

(6 citation statements)

References 11 publications

(11 reference statements)

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“…On the other hand, in the transsnasal route, all complication related to the sublabial approach as chronic nasal irritation, septal perforation, labial, gingival or dental dysestesias, external nasal deformity, are not present [35]. As in our technique we do not use speculum, complications related to it, such as fracture of the orbit, diastasis of the maxilla or fracture of the hard palate caused by overspreading of the speculum, were not found.…”

Section: Oronasofacial Complicationsmentioning

confidence: 76%

Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients

et al. 2010

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The authors investigate the complications of transnasal transsphenoidal endoscopic surgery in the treatment of 301 patients with pituitary adenomas. A retrospective analysis of complications in 301 patients submitted to transsphenoidal transnasal endoscopic surgery at the General Hospital of Fortaleza, Brazil between January 1998 and December 2009. The complications were divided in two groups: anatomical (oronasofacial, sphenoid sinus, intrasellar, suprasellar and parasellar) and endocrinological complications (anterior and posterior pituitary dysfunctions). We observed a total of 81 complications (26.9%) in our series. Anatomical complications occurred in 8.97% (27 cases): 8 CSF postoperative leaks (2.6%), 6 cases (1.9%) of delayed nasal bleeding, 5 cases (1.6%) of sphenoidal sinusitis, 3 cases (0.9%) of carotid artery lesion, 2 cases of meningitis (0.6%) and one case (0.3%) of each of the uncommon following complications: intrasella-suprasella hematoma, pontine hematoma and chiasmaplexy. Endocrinological complications occurred in 17.9% (54 cases): additional postoperative anterior lobe insufficiency in 35 cases (11.6%), and postoperative diabetes insipidus in 19 cases (6.3%). In our series, 3 cases of deaths (not directly related to the procedure) were also observed. Endoscopic transsphenoidal surgery represents an effective option for the treatment of patients with pituitary tumor. Complications still occur and must be reduced as much as possible. Successful endoscopic pituitary surgery requires extensive training in the use of an endoscope and careful planning of the surgery. Additional improvement can be expected with greater experience and new technical developments.

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Section: Oronasofacial Complicationsmentioning

confidence: 76%

Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients

et al. 2010

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“…17,69 Satisfactory resolution of symptoms post-EES is frequently registered among the adult population. 9,10,51,54,63 From our pediatric series, the majority of patients with follow-up (112 [87.5%]) displayed at least a marked improvement in symptoms or deficits following endonasal surgery. Notwithstanding the once-feared challenge of approaching the pediatric skull base through small nostrils and sinonasal cavities, taking advantage of anatomical pathways to the sella in children as in adults may, in fact, aid in tumor resection/defect repair, simultaneously allowing decreased mucosal detachment and bony dissection, hastening recovery, and minimizing postoperative persistence of symptoms.…”

Section: Resolution Of Symptomsmentioning

confidence: 98%

Endoscopic endonasal skull base surgery in the pediatric population

Chivukula

Koutourousiou²,

Snyderman

et al. 2013

PED

123

136

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Object The use of endoscopic endonasal surgery (EES) for skull base pathologies in the pediatric population presents unique challenges and has not been well described. The authors reviewed their experience with endoscopic endonasal approaches in pediatric skull base surgery to assess surgical outcomes and complications in the context of presenting patient demographics and pathologies. Methods A retrospective review of 133 pediatric patients who underwent EES at our institution from July 1999 to May 2011 was performed. Results A total of 171 EESs were performed for skull base tumors in 112 patients and bony lesions in 21. Eighty-five patients (63.9%) were male, and the mean age at the time of surgery was 12.7 years (range 2.3–18.0 years). Skull base tumors included angiofibromas (n = 24), craniopharyngiomas (n = 16), Rathke cleft cysts (n = 12), pituitary adenomas (n = 11), chordomas/chondrosarcomas (n = 10), dermoid/epidermoid tumors (n = 9), and 30 other pathologies. In total, 19 tumors were malignant (17.0%). Among patients with follow-up data, gross-total resection was achieved in 16 cases of angiofibromas (76.2%), 9 of craniopharyngiomas (56.2%), 8 of Rathke cleft cysts (72.7%), 7 of pituitary adenomas (70%), 5 of chordomas/chondrosarcomas (50%), 6 of dermoid/epidermoid tumors (85.7%), and 9 cases of other pathologies (31%). Fourteen patients received adjuvant radiotherapy, and 5 received chemotherapy. Sixteen patients (15.4%) showed tumor recurrence and underwent reoperation. Bony abnormalities included skull base defects (n = 12), basilar invagination (n = 4), optic nerve compression (n = 3) and trauma (n = 2); preexisting neurological dysfunction resolved in 12 patients (57.1%), improved in 7 (33.3%), and remained unchanged in 2 (9.5%). Overall, complications included CSF leak in 14 cases (10.5%), meningitis in 5 (3.8%), transient diabetes insipidus in 8 patients (6.0%), and permanent diabetes insipidus in 12 (9.0%). Five patients (3.8%) had transient and 3 (2.3%) had permanent cranial nerve palsies. The mean follow-up time was 22.7 months (range 1–122 months); 5 patients were lost to follow-up. Conclusions Endoscopic endonasal surgery has proved to be a safe and feasible approach for the management of a variety of pediatric skull base pathologies. When appropriately indicated, EES may achieve optimal outcomes in the pediatric population.

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“…A cirurgia transesfenoidal é o procedimento cirúrgico mais utilizado para a abordagem da região hipofisária (PETRY, 2009). Embora segura e eficaz, a microcirurgia transnasal da hipófise às vezes tem sido associado a complicações que afetam os seios nasais, estruturas ósseas e cartilaginosas, e os dentes.…”

Section: Introductionunclassified

Prevalência E Perfil De Pacientes Em Reabilitação Neurofuncional Com Ênfase Em Fonoaudiologia

Carvalho¹,

Pinheiro²,

Crispim³

et al. 2023

Universo Multidisciplinar Na Área Da Saúde

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Os autores desta obra assumem publicamente a responsabilidade pelo seu conteúdo, garantindo que o mesmo é de autoria própria, original e livre de plágio acadêmico. Os autores declaram, ainda, que o conteúdo não infringe nenhum direito de propriedade intelectual de terceiros e que não há nenhuma irregularidade que comprometa a integridade da obra. Os autores assumem integral responsabilidade diante de terceiros, quer de natureza moral ou patrimonial, em razão do conteúdo desta obra. Esta declaração tem por objetivo garantir a transparência e a ética na produção e divulgação do artigo. Cumpre esclarecer que o conteúdo do artigo é de responsabilidade exclusiva dos autores, não refletindo, necessariamente, a opinião da editora ou do conselho editorial.

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Oronasal complications in patients after transsphenoidal hypophyseal surgery

Cited by 13 publications

References 11 publications

Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients

Endoscopic endonasal approach for pituitary adenoma: surgical complications in 301 patients

Endoscopic endonasal skull base surgery in the pediatric population

Prevalência E Perfil De Pacientes Em Reabilitação Neurofuncional Com Ênfase Em Fonoaudiologia

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