The Evolution of Image Guidance in Transsphenoidal Pituitary Surgery

Rosseau, Gail

doi:10.1016/j.wneu.2012.12.026

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…1 This technique was unrivaled until the 1990s when the endoscope was introduced. 2 Superior illumination, exposure, and visualization revolutionized pituitary surgery and the entire field of skull base surgery, given its greater safety and efficacy. 3 Most recently, stereotactic technology, or computer-guided surgery, has again transformed pituitary surgery as multiple studies have demonstrated a robust safety profile and lower rate of complications.…”

Section: Introductionmentioning

confidence: 99%

Outcomes in Pediatric Transsphenoidal Pituitary Surgery Stratified by the Use of Image Guidance: An Analysis of the Kids' Inpatient Database from 1997 to 2016

Lovin

Choi

et al. 2020

J Neurol Surg B Skull Base

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Background To evaluate the utilization of image guidance technology for pediatric transsphenoidal pituitary resection (TSPR) and analyze the complication rates, length of stay (LOS), and total cost for such surgeries as function of time and utilization of image guidance. Methods The Healthcare Cost and Utilization Project Kids' Inpatient Database (KID) was queried for all cases of TSPR between 1997 and 2016. Factors extracted included patient demographics, use of image guidance, LOS, total cost, and complications, including panhypopituitarism, diabetes insipidus (DI), cerebrospinal fluid (CSF) rhinorrhea, and cranial nerve (CN) III, IV, and VI palsies. Multivariate logistic regression was utilized to determine the odds ratio of developing panhypopituitarism, DI, CSF rhinorrhea, and CN palsies for image-guided versus nonimage-guided cases. A generalized linear model was used to determine the effect of image guidance on inflation-adjusted total cost and LOS. Results A total of 1,297 cases of TSPR were included in the KID over this time period. The majority were female, Caucasian, and older than 15 years. Utilization of image guidance has rapidly increased since 2006. Complication rates were comparable, but when controlling for other factors, the use of image guidance showed a lower risk of postoperative DI (p = 0.05). The use of image guidance also resulted in a shorter LOS by 2.84 days (p < 0.001) with no associated increase in total cost (p = 0.663). Conclusion The use of imaging guidance for pediatric TSPR has precipitously increased in recent years, as it is cost-effective, decreases LOS, and may lead to lower complication rates, such as DI.

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Section: Introductionmentioning

confidence: 99%

Outcomes in Pediatric Transsphenoidal Pituitary Surgery Stratified by the Use of Image Guidance: An Analysis of the Kids' Inpatient Database from 1997 to 2016

Lovin

Choi

et al. 2020

J Neurol Surg B Skull Base

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Multi-slice computed tomography-assisted endoscopic transsphenoidal surgery for pituitary macroadenoma: a comparison with conventional microscopic transsphenoidal surgery

Tosaka

Nagaki

Honda

et al. 2015

Neurological Research

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Transsellar Ultrasound in Pituitary Surgery With a Designated Probe

Solheim

Johansen

Cappelen

et al. 2016

Operative Neurosurgery

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We found the images from our custom-designed ultrasound probe to be clinically helpful for anatomic orientation during surgery, and the technology is potentially helpful for improving the extent of resection during transsphenoidal surgery. This quick and flexible form of intraoperative imaging in transsphenoidal surgery could be of great support for surgeons in both routine use and difficult cases. The concept of transsellar intraoperative ultrasound imaging can be further refined and developed.

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The Evolution of Image Guidance in Transsphenoidal Pituitary Surgery

Cited by 3 publications

References 9 publications

Outcomes in Pediatric Transsphenoidal Pituitary Surgery Stratified by the Use of Image Guidance: An Analysis of the Kids' Inpatient Database from 1997 to 2016

Outcomes in Pediatric Transsphenoidal Pituitary Surgery Stratified by the Use of Image Guidance: An Analysis of the Kids' Inpatient Database from 1997 to 2016

Multi-slice computed tomography-assisted endoscopic transsphenoidal surgery for pituitary macroadenoma: a comparison with conventional microscopic transsphenoidal surgery

Transsellar Ultrasound in Pituitary Surgery With a Designated Probe

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