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Simona Mihaela Florea, Thomas Graillon, Thomas Cuny, Regis Gras, Thierry Brue, and Henry Dufour

database for each of the patients, cannot permit a more thorough statistical analysis. Conclusions Extraocular nerve dysfunction after transsphenoidal pituitary surgery essentially concerns CNs III and VI and occurs more frequently when the adenoma invades or extends into the cavernous sinus. This rare complication appears to be more frequent in patients treated by an endoscopic approach. For most of the patients the deficit appears with a delay of at least 12 hours as a result of a swelling process and recovers within the 3 months after surgery. In very few cases

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Richard F. Schmidt, Osamah J. Choudhry, Ramya Takkellapati, Jean Anderson Eloy, William T. Couldwell, and James K. Liu

foundation for much of the practice of modern pituitary surgery. Located in the middle of the skull base, pituitary tumors were considered virtually inaccessible at that time. Schloffer's bold decision to approach the pituitary gland through an extracranial transnasal route via the sphenoid sinus was not only groundbreaking as both a concept and a technical procedure, but it also brought pituitary surgery into mainstream practice and directly contributed to further advancements in its application. The underlying concept of transsphenoidal surgery has withstood the test of

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Gautam U. Mehta, Kamran D. Bakhtian, and Edward H. Oldfield

and eliminate any arachnoid herniation, ESS is more likely to present with microadenomas and hormonesecreting tumors. To date, treatment outcomes for pituitary tumors in the setting of primary ESS remain undefined, described only in case reports and small series. 1 , 2 , 4 , 7 , 12 , 15 , 19 , 20 , 26 , 27 Pituitary surgery, which is first-line therapy for adrenocorticotropin (ACTH)- and growth hormone (GH)-secreting tumors, is particularly challenging in the setting of ESS due to diminished pituitary gland volume, as well as the frequent presence of an arachnoid

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Shane Shahrestani, Alexander M. Ballatori, Xiao T. Chen, Andy Ton, Ben A. Strickland, Andrew Brunswick, and Gabriel Zada

previously been used to assess frailty’s impact on short-term outcomes of patients undergoing pituitary surgery. Asemota and Gallia conducted a propensity-matched study of frail versus nonfrail patients undergoing transsphenoidal pituitary surgery using the 2000–2014 National Inpatient Sample (NIS), and found that frail patients had significantly higher rates of fluid and electrolyte disorders, intracranial vascular complications, mental status changes, pulmonary insufficiency, acute kidney failure, and other postoperative complications. 18 Our study corroborates

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Lea M. Alhilali, Andrew S. Little, Kevin C. J. Yuen, Jae Lee, Timothy K. Ho, Saeed Fakhran, and William L. White

demonstrate that EPO MRI is not only accurate in determining residual tumor but also more accurate than LPO MRI, with superior interreader reliability. Furthermore, we found that LPO MRI detected no additional lesions in the setting of prior EPO MRI. In fact, discrepancies between LPO and EPO MRI were all settled in favor of EPO MRI. This result suggests that EPO MRI rather than LPO MRI should be used as the primary postoperative follow-up study in patients undergoing transsphenoidal pituitary surgery. After the initial EPO MRI, our data support the current recommendations

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Lea M. Alhilali, Andrew S. Little, Kevin C. J. Yuen, Jae Lee, Timothy K. Ho, Saeed Fakhran, and William L. White

demonstrate that EPO MRI is not only accurate in determining residual tumor but also more accurate than LPO MRI, with superior interreader reliability. Furthermore, we found that LPO MRI detected no additional lesions in the setting of prior EPO MRI. In fact, discrepancies between LPO and EPO MRI were all settled in favor of EPO MRI. This result suggests that EPO MRI rather than LPO MRI should be used as the primary postoperative follow-up study in patients undergoing transsphenoidal pituitary surgery. After the initial EPO MRI, our data support the current recommendations

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Anthony O. Asemota and Gary L. Gallia

In this study, we investigated the significance of frailty as a predictor of outcome in adult patients undergoing transsphenoidal pituitary surgery. Methods Data Source Data were obtained from the 2000–2014 National (Nationwide) Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) managed under the Agency for Healthcare Research and Quality (AHRQ). 19 Study Group Patient records containing a diagnosis of pituitary tumors or disorders were identified using ICD-9-CM codes 194.3, 227.3, 237.0, 239.7, 253.0, 253.8, 253.9, and 255.0. We included

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Iyan Younus, Mina M. Gerges, Georgiana A. Dobri, Rohan Ramakrishna, and Theodore H. Schwartz

, it is important to identify common causes and predictors of readmission to improve outcomes. Endonasal endoscopic transsphenoidal surgery (EETS) is an important modality for the treatment of pituitary adenomas. 6 , 7 , 15 , 16 , 24 , 32 , 36 , 37 , 39 This approach has been reported to have favorable outcomes compared with traditional approaches. 10 , 12 , 21 , 22 , 28–30 , 35 However, there are only a handful of reports of 30-day readmission rates after transsphenoidal pituitary surgery, and to the authors’ knowledge, no factors predictive of readmission have

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Peter J. Wilson, Sacit B. Omay, Ashutosh Kacker, Vijay K. Anand, and Theodore H. Schwartz

purpose of data presentation using a standard of 1 box plot per data series. Surgical Technique All operations were performed by a surgical team that included an otolaryngologist (V.K.A. or A.K.) and a neurosurgeon (T.H.S.) at the Institute for Minimally Invasive Skull Base and Pituitary Surgery. The details of surgical technique have been described previously. 16 In addition to the routine endoscopic endonasal approach to the sella, a lumbar puncture is routinely performed under general anesthesia but prior to the endonasal approach to facilitate injection of

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Iyan Younus, Mina Gerges, Theodore H. Schwartz, and Rohan Ramakrishna

associated with complications in pituitary surgery. 8 They found that patients with Medicaid insurance were significantly more likely to have a complication (OR 2.13, 95% CI 1.59–2.86). Goljo et al. also analyzed a nationwide cohort of patients undergoing pituitary surgery and found that African American and Hispanic patients have worse postoperative outcomes compared to white patients, as well as disproportionate utilization of Medicaid and low-volume pituitary surgery centers. 9 A significant limitation of the latter studies is that the presence of comorbidities and