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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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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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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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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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Beatriz R. Olson, Julie Gumowski, Domenica Rubino and Edward H. Oldfield

R ecently we 18 and others 12, 20, 22 reported that hyponatremia is a delayed, frequent, and occasionally serious complication of transsphenoidal pituitary surgery. Lack of appropriate suppression of arginine vasopressin (AVP) secretion in a few hyponatremic hypoosmolar patients 6, 14, 18, 20 and prevention of the development of hyponatremia by complete removal of the posterior pituitary in dogs 10 suggest that hyponatremia in this setting is caused by inappropriate antidiuretic hormone release 6, 10, 14, 18, 20, 23 from damaged posterior pituitary

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Alex M. Landolt

transsphenoidal pituitary surgery difficult. 4, 6 Large pituitary adenomas usually compress the intercavernous sinus, in which case the sinus is obliterated. But this is not so in the case of microadenomas or functional hypophysectomy. Abundant hemorrhage from an intercavernous sinus may force the surgeon to abandon the procedure. 5 It is essential to have perfect dural hemostasis before attempting the removal of a microadenoma, because continuous oozing may obscure delineation and make complete excision of the abnormal tissue difficult. To achieve this hemostasis

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Gautam U. Mehta, Russell R. Lonser and Edward H. Oldfield

with Cushing syndrome underlies the significant morbidity and significantly shortened life span in untreated patients. In most patients, Cushing syndrome arises from ACTH-secreting basophilic pituitary adenomas (CD), which are frequently less than 1 centimeter in diameter. While the current treatment of choice for these lesions is selective adenomectomy by transsphenoidal pituitary surgery, the widespread use and acceptance of pituitary surgery for CD was delayed until the latter half of the 20th century for a variety of reasons. Surgery of the pituitary gland and