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Domenico Catapano, Chris A. Sloffer, Giorgio Frank, Ernesto Pasquini, Vincenzo A. D’Angelo and Giuseppe Lanzino

ipsilateral to the approach. Acknowledgments We acknowledge Storz (Tuttlingen, Germany), which provided the endoscopes and the endoscopic instruments used in this study. We also acknowledge the kind assistance of JoAnna Gass in editing the manuscript. References 1 Alfieri A , Schettino R , Tarfani A , Bonzi O , Rossi GA , Monolo L : Endoscopic endonasal removal of an intrasuprasellar Rathke’s cleft cyst: case report and surgical considerations . Minim Invasive Neurosurg 45 : 47 – 51 , 2002 2 Arai H , Sato K , Okuda O , Miyajima

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Kazunori Arita, Atsushi Tominaga, Kazuhiko Sugiyama, Kuniki Eguchi, Koji Iida, Masayuki Sumida, Keisuke Migita and Kaoru Kurisu

spontaneous disappearance: three cases of equivocal Rathke’s cleft cyst] . No To Shinkei 52 : 929 – 933 , 2000 . (Jpn) 12 Igarashi T , Saeki N , Yamaura A : Long-term magnetic resonance imaging follow-up of asymptomatic sellar tumors — their natural history and surgical indications . Neurol Med Chir (Tokyo) 39 : 592 – 599 , 1999 13 Kaufman B , Arafah B , Selman WR : Advances in neuroradiologic imaging of the pituitary gland: changing concepts . J Lab Clin Med 109 : 308 – 319 , 1987 14 Klibanski A , Zervas NT : Diagnosis and

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Concurrent lymphocytic hypophysitis and pituitary adenoma

Case report and review of the literature

Shaye I. Moskowitz, Amir Hamrahian, Richard A. Prayson, Mercedes Pineyro, Robert R. Lorenz and Robert J. Weil

Rathke’s cleft cyst . Neurosurgery 22 : 133 – 136 , 1988 2 Arzt E , Paez Pereda M , Costas M , Sauer J , Renner U , Holsboer F , : Cytokine expression and molecular mechanisms of their auto/paracrine regulation of anterior pituitary function and growth . Ann N Y Acad Sci 840 : 525 – 531 , 1998 3 Asaeda M , Kurosaki M , Kambe A , Takenobu A , Horie Y , Ya-mane Y , : [MR imaging study of edema along the optic tract in patient with Rathke’s cleft cyst] . No To Shinkei 56 : 243 – 246 , 2004 . (Jpn) 4 Bettendorf M

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Brian D. Thorp, Satyan B. Sreenath, Charles S. Ebert, M.P.H. and Adam M. Zanation

/epidermoid 2(1.6) chordoma 2(1.6) granular cell tumor 1 (0.8) epidermoid cyst 1 (0.8) hemangioma 1 (0.8) osteoradionecrosis 1 (0.8) Rathke’s cleft cyst 1 (0.8) osteoma 1 (0.8) spindle cell oncocytoma 1 (0.8) malignant 25 esthesioneuroblastoma 5 (20.0) SNUC 4 (16.0) squamous cell carcinoma of skull base 4 (16.0) mucosal melanoma 4 (16.0) immature teratoma 2 (8.0) basaloid cell carcinoma 1 (4.0) B-cell lymphoma 1 (4.0) juvenile pilocytic astrocytoma 1 (4.0) malignant

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. Methods We conducted a five-year retrospective review of our first 1015 transsphenoidal surgeries since establishing a pituitary center of expertise. Results Of 1015 patients with sellar lesions, 340 presented with headache. Of patients with headache, 30% presented with headache as their only symptom. Patients with Rathke’s cleft cysts (RCCs) had the highest percentage of headache at 60%, followed by craniopharyngioma (46%) and apoplexy (44%), while endocrine inactive and active adenomas had lower rates of headache (28–29%). Multivariate analyses revealed

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Andrew S. Little, Daniel Kelly, John Milligan, Chester Griffiths, Daniel M. Prevedello, Ricardo L. Carrau, Gail Rosseau, Garni Barkhoudarian, Bradley A. Otto, Heidi Jahnke, Charlene Chaloner, Kathryn L. Jelinek, Kristina Chapple and William L. White

flap. TABLE 1 Demographic characteristics Characteristic Value * Mean age in yrs (± SD) 51.7 ± 15.5 Male sex 44 (44) Tumor type  Nonfunctioning pituitary adenoma 65 (65)  Acromegaly 9 (9)  Cushing’s disease 7 (7)  Prolactinoma 15 (15)  Rathke’s cleft cyst 4 (4) Mean tumor size in mm (± SD) 17.6 ± 10.2 Prior transsphenoidal surgery 9 (9) History of sinusitis 11 (11) Prior sinus surgery 7 (7) * Values are number of patients (%) unless noted otherwise. TABLE 2

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Cheran Elangovan, Supriya Palwinder Singh, Paul Gardner, Carl Snyderman, Elizabeth C. Tyler-Kabara, Miguel Habeych, Donald Crammond, Jeffrey Balzer and Parthasarathy D. Thirumala

S urgical treatment of pediatric cranial base tumors such as craniopharyngiomas, chordomas, angiofi-bromas, pituitary adenomas, and Rathke’s cleft cysts has been evolving from conventional open skull base approaches to novel, less invasive techniques like endoscopic endonasal surgery (EES). 5 , 18 , 19 , 32 , 41 For properly selected tumors, EES offers several advantages over traditional methods, including the sparing of disfiguring facial incisions and craniotomy. EES allows the surgeons to access the entire ventral skull base, from the crista galli to

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Arman Jahangiri, Jeffrey R. Wagner, Sung Won Han, Mai T. Tran, Liane M. Miller, Rebecca Chen, Maxwell W. Tom, Lauren R. Ostling, Sandeep Kunwar, Lewis Blevins and Manish K. Aghi

, 11 but laboratory costs have changed considerably since that 1997 study. In terms of expectations when managing patients after NFA surgery, this study also found that deficits in 3 of the 5 anterior pituitary axes (male hypogonadism, hypothyroidism, and hyposomatotropism) experienced significant additional delayed normalization at 6 months after surgery relative to that which was noted at the 6-week postoperative visit. This finding contrasts with previous findings from other sellar and parasellar pathologies, such as Rathke’s cleft cysts and craniopharyngiomas

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Bruce L. Tai, Anthony C. Wang, Jacob R. Joseph, Page I. Wang, Stephen E. Sullivan, Erin L. McKean, Albert J. Shih and Deborah M. Rooney

P atients suffering from pathologies of the ventral and ventrolateral skull base often require surgical intervention. Access to the skull base traditionally required extensive tissue manipulation, but recent advances in endoscopic techniques have allowed access to the skull base using less destructive techniques via the nostril as a natural corridor. The endoscopic endonasal approach (EEA) is employed in the treatment of pituitary adenomas, Rathke’s cleft cysts, ventral cranial base meningiomas, craniopharyngiomas, chordomas, olfactory neuroblastomas, and

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G. Rene Alvarez Berastegui, Shaan M. Raza, Vijay K. Anand and Theodore H. Schwartz

, bone plaques Improved to normal, 6 wks Decker & Carras, 1977 1 60/F Transsphenoidal hypophysectomy for breast metastatic carcinoma 1 mo Transsphenoidal Lysis of adhesions, packing sella, fascia, bone strips Partially improved, 1 mo Scott et al., 1977 1 5/M Optochiasmatic arachnoiditis, tuberculous meningitis NDR Transcranial Lysis of adhesion Partially improved, 1 mo Fischer et al., 1994 1 22/M Transsphenoidal Rathke’s cleft cyst resection 1 mo & 20 days Transcranial Lysis of adhesion Partially improved, 2 wks