The specific features of endonasal transsphenoidal approach in surgical treatment of pituitary adenoma

Karpishchenko, S.A.; Cherebillo, V. Yu.; Tamazyan, N. V.; Puzakov, N. S.; Stancheva, Olga A.; Danilova, D. M.

doi:10.18692/1810-4800-2018-3-47-53

Cited by 3 publications

(2 citation statements)

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“…The nasal endoscopy and computed tomography of the paranasal sinuses cannot be informative in case of small defect. In such cases, when it is not possible to determine the source of liquorrhea by the previous research methods, they resort to CT cisternography [5] or MRI cisternography [6]. The first method of analysis is the most sensitive, it can detect the definitely localization of a bone defect in 87% of cases [6].…”

Section: Introductionmentioning

confidence: 99%

“…In such cases, when it is not possible to determine the source of liquorrhea by the previous research methods, they resort to CT cisternography [5] or MRI cisternography [6]. The first method of analysis is the most sensitive, it can detect the definitely localization of a bone defect in 87% of cases [6]. The typical localization of the cerebrospinal fluid fistula is: the ethmoid plate, the posterior and lateral walls of the sphenoid sinus [7], especially the lateral wall and the cribriforme plate [8].…”

Section: Introductionmentioning

confidence: 99%

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Transsphenoidal Endoscopic Approach in Treatment of Spontaneous Nasal CSF-leak

Karpishchenko¹,

Cherebillo²,

Vereshchagina³

et al. 2019

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Spontaneous nasal liquorrhea is a pathological condition associated with defects between the nasal cavity and the intracranial structures, which results in CSF leak from the nasal cavity. Diagnostic criteria include: anamnesis, examination of the nasal fluid, endoscopic examination of the nasal cavity, and CT-and MRI-cisternography. Conservative therapy is applicable to small fistulas. In the case of the inefficiency of this method, surgical method is then applied to the defect closure. Purpose of the study: To evaluate the effectiveness of endoscopic endonasal approach in the CSF leak treatment. Materials and methods: For the period from 2008 to 2018 at the Pavlov First Saint Petersburg State Medical University, at the clinic of neurosurgery of the Kirov Medical Institute and the Medical Research Center Almazov, 38 patients with spontaneous nasal liquorrhea were treated. All patients underwent plastic surgery of the CSF fistula by endoscopic endonasal approach. Results: In 4 cases, there was a large defect requiring secondary surgical intervention 1-2 weeks after the initial operation. Conclusions: The use of auto tissues (muscle or fat) is the method of choice for repeated surgical plastics of the cerebrospinal fluid fistula or in the case of a large size defect.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transsphenoidal Endoscopic Approach in Treatment of Spontaneous Nasal CSF-leak

Karpishchenko¹,

Cherebillo²,

Vereshchagina³

et al. 2019

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Transsphenoidal endoscopic appro ach in the treat ment of spontaneous cerebrospinal fluid (CSF) leak

Черебилло¹,

Karpishchenko²,

Puzakov³

et al. 2019

VESTNIK KHIRURGII IMENI I.I.GREKOVA

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Introduction. Spontaneous nasal liquorrhea is a pathological condition associated with defect between nasal cavity and intracranial structures that lead to the expiration of the CSF from the nasal cavity.The objective is to evaluate the effectiveness of endoscopic endonasal approach in the CSF leak treatment.Material and methods. For the period from 2008 to 2018, 38 patients with spontaneous nasal liquorrhea were examined and treated in Pavlov First Saint Petersburg State Medical University, the clinic of neurosurgery of Kirov Medical Institute and Almazov National Medical Research Centre. All patients underwent plastic surgery of the CSF fistula by endoscopic endonasal aproach.Results. Only in 4 cases, there was a large defect, the failure of the closure of which required repeated surgical intervention in 1–2 weeks after the initial operation.Conclusion. The use of autologous tissues (muscle or fat autograft) is the method of choice for repeated surgical plastics of the cerebrospinal fluid fistula or in a large size defect (more than 5 mm).

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The Algorithm of the Treatment and Diagnostic Strategy for cystic formations of the chiasmal-sellar region

Puzakov

Cherebillo

Tregubenko

2020

Vestnik Nevrologii, Psihiatrii I Nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery)

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Due to the rare occurrence of cysts of the chiasmosellar region, neurologists and neurosurgeons do not always have experience with such a pathology. Additional difficulties are made by the difficulty of differential diagnosis due to the identical clinical symptoms of the formation of the chiasmal-sellar region and the frequent incorrect interpretation of neuroimaging data. But conducting an accurate preoperative differential diagnosis of cysts of the chiasmosellar region is an important step in preparing for surgical treatment, which allows you to determine the surgical tactics in advance, because each group of cysts of the chiasmosellar region has its own characteristics of surgical treatment, which can significantly reduce the number of complications and minimize the number of recidivities. The aim of this study was to improve the diagnosis and treatment of patients with cysts of the chiasmal-sellar region by developing an optimal diagnostic and treatment algorithm. For this, from 2009 to 2018, the medical documentation of 1740 patients was analyzed, of which 94 case histories were operated on with transsphenoidal endoscopic access for cystic pituitary adenomas and cysts of the chiasmosellar region. Patients were divided into 5 groups according to nosology. We analyzed the clinical picture, laboratory test data and MRI, features of surgical treatment and postoperative outcomes in each group. All obtained data were subjected to statistical analysis, on the basis of which the distinctive diagnostic and surgical features inherent in each group were determined. All the data obtained are summarized in a diagnostic and treatment algorithm, which allows for accurate differential diagnosis, based on which the specialist, using the developed algorithm, can determine the further treatment tactics and, if necessary, determine in advance the features of surgical treatment.

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The specific features of endonasal transsphenoidal approach in surgical treatment of pituitary adenoma

Cited by 3 publications

References 0 publications

Transsphenoidal Endoscopic Approach in Treatment of Spontaneous Nasal CSF-leak

Transsphenoidal Endoscopic Approach in Treatment of Spontaneous Nasal CSF-leak

Transsphenoidal endoscopic appro ach in the treat ment of spontaneous cerebrospinal fluid (CSF) leak

The Algorithm of the Treatment and Diagnostic Strategy for cystic formations of the chiasmal-sellar region

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