Search Results

You are looking at 1 - 10 of 946 items for :

  • "transsphenoidal surgery" x
  • Refine by Access: all x
Clear All
Restricted access

Shigeaki Kobayashi, Kenichiro Sugita, Toshiki Takemae, and Yoshio Tanizaki

R etraction during craniotomy has been reported for various approaches; 7, 8 however, the only retractor described for transsphenoidal surgery is the self-retaining bivalve speculum used to secure an approach. 1, 2 We describe a retraction technique that we have used around the target area in 30 recent cases involving transsphenoidal procedures for pituitary adenomas, craniopharyngiomas, and chordomas. Technique The patient's head is fixed in the Sugita multipurpose head frame, and a modified Hardy technique 2 is used to approach the sellar region. A

Restricted access

Lewis J. Brown

T ension pneumocephalus is an infrequent complication of transsphenoidal surgery. The air can be subdural, epidural, subarachnoid, or intraventricular and is readily identified by using imaging studies. Intracranial pressure may increase as the air warms and expands, producing clinical deterioration requiring prompt intervention. This report documents a further unusual presentation of retained air following transsphenoidal surgery. Case Report History and Examination This 24-year-old man had enjoyed excellent health until he developed mild bitemporal

Restricted access

Harold Rosegay

Guiot. Surg Neurol 11: 1–2, 1979 24. Hardy J : Transsphenoidal hypophysectomy. J Neurosurg 34 : 582 – 594 , 1971 Hardy J: Transsphenoidal hypophysectomy. J Neurosurg 34: 582–594, 1971 25. Hardy J : Transsphenoidal microsurgery of the normal and pathological pituitary. Clin Neurosurg 16 : 185 – 217 , 1969 Hardy J: Transsphenoidal microsurgery of the normal and pathological pituitary. Clin Neurosurg 16: 185–217, 1969 26. Hardy J , Wigser SM : Transsphenoidal surgery

Restricted access

Transsphenoidal surgery following unsuccessful prior therapy

An assessment of benefits and risks in 158 patients

Edward R. Laws Jr., Nicolee C. Fode, and Michael J. Redmond

T he effectiveness of a transsphenoidal microsurgical approach in primary surgical management of pituitary tumors and other lesions in and about the sella turcica is now well established. 9, 11, 26, 30, 46, 65, 67 No systematic analysis of the risks and benefits of transsphenoidal surgery as either secondary or tertiary management in patients with prior treatment has been published. Previous analyses of the results and complications of transsphenoidal surgery 12, 15, 20, 25, 27, 38, 40–43, 49, 50, 57, 59, 65, 67 have tended to include all patients

Restricted access

Pituitary apoplexy treated by transsphenoidal surgery

A clinicopathological and immunocytochemical study

Michael J. Ebersold, Edward R. Laws Jr., Bernd W. Scheithauer, and Raymond V. Randall

transsphenoidal surgery in 11 cases treated within the past 10 years, and a report of the histopathological and immunocytochemical analysis of 13 cases of pituitary apoplexy studied during the same period (the 11 patients with transsphenoidal surgery and two additional patients treated by craniotomy). Summary of Cases Patient Population Between November, 1972, and September, 1982, 940 patients were treated for pituitary adenoma by transsphenoidal surgery. The fact that only 11 of these patients presented with pituitary apoplexy reflects the relatively recent

Restricted access

Robert B. Friedman, Edward H. Oldfield, Lynnette K. Nieman, George P. Chrousos, John L. Doppman, Gordon B. Cutler Jr., and D. Lynn Loriaux

despite previous pituitary surgery, these treatments are not always successful, may not eradicate the pituitary tumor, and may be associated with adverse side effects. 14 Although repeat transsphenoidal surgery remains a therapeutic option for patients with recurrent or persistent Cushing's disease, there are limited data as to the efficacy of surgery in this setting. Only four patients who received transsphenoidal surgery for recurrent or persistent Cushing's disease after previous treatment by irradiation or surgery have been reported previously. 8 To determine the

Restricted access

José M. Cabezudo, Rafael Carrillo, Jesús Vaquero, Eduardo Areitio, and Roberto Martinez

Hemorrhagic complications in transsphenoidal surgery are not unknown, 8, 21, 32 although they have not been reported in some of the largest series. 6, 13, 17 They may be due to damage to the cavernous sinus, the carotid artery, or the anterior intercavernous sinus. Renn and Rhoton 29 demonstrated that the carotid arteries bulge within the sphenoid sinus in 71% of cases, and that the arteries are covered only by the dura mater of the cavernous sinus and the mucosa of the sphenoid sinus in 4% of cases. In addition, they found that carotid arteries come as close as 4 mm

Restricted access

Hélène Long, Hugues Beauregard, Maurice Somma, Ronald Comtois, Omar Serri, and Jules Hardy

somatostatin analog octreotide. Reoperation is recommended by some as the treatment of choice for persistently elevated GH levels or true recurrence of acromegaly after a first transsphenoidal selective adenomectomy if radiological demonstration of a circumscribed residual tumor is made. 12, 27 Others do not favor reexploration because of negative experience. 5, 15, 30 However, no study to date has evaluated the effectiveness and complications of a second transsphenoidal surgery for acromegaly. This retrospective study reports the outcome of transsphenoidal reoperation

Full access

James K. Liu, Maria Fleseriu, Johnny B. Delashaw Jr., Ivan S. Ciric, William T. Couldwell, and Ph.D.

C ushing disease, which is induced by a functional ACTH-producing adenoma of the anterior pituitary gland, is the most common cause of ACTH-dependent Cushing syndrome. The treatment of Cushing disease remains challenging for neurosurgeons and endocrinologists. Transsphenoidal surgery is currently the treatment of choice in patients who harbor ACTH-secreting pituitary tumors associated with Cushing disease. This surgery provides the best option for rapid biochemical remission with excellent long-term results. Remission rates after transsphenoidal resection

Restricted access

Ronald J. Benveniste, Wesley A. King, Jane Walsh, Jacob S. Lee, Bradley N. Delman, and Kalmon D. Post

possible, the imaging studies were retrospectively and independently reviewed by two fellowship-trained neuroradiologists at our institution (J.S.L. and B.N.D.) who were blinded to the patients' clinical histories; any disagreements were resolved by consensus. In other cases, data were obtained from contemporary reports in the patients' charts. Patients were contacted when necessary to request follow-up information or imaging studies. Surgical Technique Standard transsphenoidal surgery was performed in all patients. The sublabial approach was used exclusively