Regional disparities and practice patterns in surgical approaches to pituitary tumors in the United States

Abstract

Regional disparities in transsphenoidal practice patterns exist in the United States. Although the microscopic approach is still more common overall, there has been an evolving shift toward endoscopic TSAs in the last decade.

Evolving trends in sinus surgery: What is the impact of balloon sinus dilation?

“…Additionally, the most recent set of Medicare carrier files (2015), which encompass information from specific carriers (covering various states and regions), also were obtained for exploration of geographic trends. These resources have been used in numerous prior analyses examining nationwide and temporal trends covering a variety of topics . Evaluation was undertaken looking at traditional endoscopic surgery to respective BD procedures.…”

Impact of obstructive sleep apnea in transsphenoidal pituitary surgery: An analysis of inpatient data

“…This technique became the standard of care in the initial treatment of pituitary neoplasms after proving to be less invasive and associated with lower morbidity and mortality than the historically used transcranial surgical route . More recently, endoscopic techniques have gained popularity compared to microscopic techniques, due to better intraoperative visualization and tumor resection …”

“…[1][2][3] More recently, endoscopic techniques have gained popularity compared to microscopic techniques, due to better intraoperative visualization and tumor resection. [2][3][4] TSS complications have been previously characterized in various patient populations, such as those with acromegaly, Cushing's disease, and pituitary malignancies. [5][6][7] However, the impact of obstructive sleep apnea (OSA) on TSS outcomes is a relevant concern that has not been well examined.…”

Transsphenoidal surgery and diabetes mellitus: An analysis of inpatient data and complications

“…Due to its lower morbidity than transcranial approaches, TSS has emerged as the standard initial approach for pituitary resection. Advances have continued in recent decades while the endoscopic endonasal approach is rising in popularity, and it is predicted to eventually supplant the microscopic technique for resection of pituitary tumors . In order to improve perioperative management, it is important to understand the effect of DM on the postoperative course of TSS patients.…”

“…Advances have continued in recent decades while the endoscopic endonasal approach is rising in popularity, and it is predicted to eventually supplant the microscopic technique for resection of pituitary tumors. 8 In order to improve perioperative management, it is important to understand the effect of DM on the postoperative course of TSS patients. For example, cerebrospinal fluid (CSF) rhinorrhea is known to be one of the major complications of TSS.…”