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Open access

Endoscopic endonasal pituitary hemitransposition for resection of suprasellar and retrosellar dermoid cyst

Joao Paulo Almeida, Dennis Tang, Varun R. Kshettry, Raj Sindwani, and Pablo F. Recinos

This is the case of a 25-year-old woman who had had a previous rupture of a dermoid cyst and now presented with recent MRI scans suggesting further growth of her dermoid cyst. Her lesion was located in the suprasellar space and extended into the interpeduncular fossa and prepontine cistern. Considering the location of the tumor, an endoscopic pituitary hemitransposition was selected for its resection. In this video we present the technical nuances and illustrate the anatomy used for an endoscopic endonasal pituitary hemitransposition for resection of a suprasellar dermoid cyst with extension into the interpeduncular fossa. In this case, a near-total resection was achieved, with no complications and no additional hormonal deficit after surgery.

The video can be found here: https://youtu.be/BHtNf5invUI.

In Neurosurgical Focus: Video Volume 2: Issue 2 (Apr 2020): Endoscopic Skull Base Surgery

Open access

Endoscopic endonasal translacerum approach for resection of petroclival chondrosarcoma

Joao Paulo Almeida, Zachary Cappello, Hamid Borghei-Razavi, Pablo F. Recinos, Raj Sindwani, and Varun R. Kshettry

Petroclival chondrosarcomas are a formidable surgical challenge given the close relationship to critical neurovascular structures. The endoscopic endonasal approach can be utilized for many petroclival chondrosarcomas. However, tumors that extend to the inferior petrous apex require working behind the internal carotid artery (ICA). We present a case of a 33-year-old with a 1-year history of complete abducens palsy, with imaging showing an enhancing mass centered at the left petroclival fissure and inferior petrous apex behind the paraclival carotid artery and extending down into the nasopharynx abutting the cervical ICA. In this video, we describe the surgical steps of the endoscopic endonasal translacerum approach with ICA skeletonization and mobilization. We also highlight the relevant surgical anatomy with anatomical dissections to supplement the surgical video. The patient did well without complications. Postoperative MRI demonstrated complete resection and pathology revealed grade II chondrosarcoma. He underwent adjuvant proton beam radiotherapy.

The video can be found here: https://youtu.be/80QXALJW9ME.

In Neurosurgical Focus: Video Volume 2: Issue 2 (Apr 2020): Endoscopic Skull Base Surgery