Top

Acta Neurochirurgica

Published in:

01-11-2008 | Clinical Article

Transsphenoidal approaches to the pituitary: a progression in experience in a single centre

Authors: Bulent Duz, Ferhat Harman, Halil Ibrahim Secer, Erol Bolu, Engin Gonul

Published in: Acta Neurochirurgica | Issue 11/2008

Abstract

Background

Evolving of a single centre by means of different transsphenoidal approaches during the survey of methodological advances in pituitary surgery is presented.

Materials and methods

Ninety-three consecutive patients with pituitary adenomas underwent transphenoidal pituitary operations at Gulhane Military Medical Academy from January 1996 to October 2007. Retrospective chart-based analysis of the surgical methods of transsphenoidal pituitary adenoma operations were done. Surgical methods were described. Outcomes and complications were presented. Attention is focused on the methodology of different surgical techniques of pituitary surgery.

Findings

During the evaluation period, 12 Sublabial approaches (1996–1998), 13 transseptal transsphenoidal approaches (1999–2000), 15 endonasal transsphenoidal approaches (2000–2004), 25 endoscopy assisted endonasal approaches (2002–2006) and 28 pure endoscopic endonasal approaches (2006–2007) were performed.

Conclusions

Technologic advancements in endoscopy and gaining experience in pituitary surgery drives neurosurgeons toward less invasive approaches.

Black PMcL, Zervas NT, Candia G (1987) Incidence and management of complications of transsphenoidal operation for pituitary adenomas. Neurosurgery 209:20–924PubMedCrossRef

Cappabianca P, Cavallo LM, Colao A, Del Basso De Caro M, Esposito F, Cirillo S, Lombardi G, de Divitiis E (2002) Endoscopic endonasal transsphenoidal approach: outcome analysis of 100 consecutive procedures. Minim Invasive Neurosurg 45(4):193–200PubMedCrossRef

Charalampaki P, Reisch R, Ayad A, Conrad J, Welschehold S, Perneczky A, Wuster C (2007) Endoscopic endonasal pituitary surgery: surgical and outcome analysis of 50 cases. J Clin Neurosci. 14(5):410–415PubMedCrossRef

Ciric I, Ragin A, Baumgartner C, Pierce D (1997) Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery 40:225–237PubMedCrossRef

Couldwell WT (2004) Transsphenoidal and transcranial surgery for pituitary adenomas. Journal of Neuro-Oncology 69:237–256PubMedCrossRef

Dickman JD, Beyer M, Hess BJ (2000) Three-dimensional organization of vestibular related eye movements to rotational motion in pigeons. Vision Res. 40(20):2831–2844PubMedCrossRef

Hardy J (1967) La chirugie de l’hypophyse par voie transsphenoidale. Union Med Can 96:702–712PubMed

Jho HD, Carrau RL, Ko Y, Daly MA (1997) Endoscopic pituitary surgery: an early experience. Surg Neurol 47:213–222PubMedCrossRef

Jho HD, Carrau RL (1997) Endoscopic endonasal transsphenoidal surgery: experience with 50 patients. J Neurosurg 87(1):44–51PubMed

10.

Kabil MS, Eby JB, Shahinian HK (2005) Fully endoscopic endonasal vs. transseptal transsphenoidal pituitary surgery. Minim Invasive Neurosurg 48(6):348–354PubMedCrossRef

11.

Kassam AB, Gardner P, Snyderman C, Mintz A, Carrau R (2005) Expanded endonasal approach: fully endoscopic, completely transnasal approach to the middle third of the clivus, petrous bone, middle cranial fossa, and infratemporal fossa. Neurosurg Focus 15(1):19

12.

Koc K, Anik I, Ozdamar D, Cabuk B, Keskin G, Ceylan S (2006) The learning curve in endoscopic pituitary surgery and our experience. Neurosurg Rev 29:298–305PubMedCrossRef

13.

Laws ER Jr, Piepgras DG, Randall RV, Abboud CF (1979) Neurosurgical management of acromegaly. Results in 82 patients treated between 1972 and 1977. J Neurosurg 50:454–461PubMedCrossRef

14.

Laws ER Jr (1987) Pituitary surgery. Endocrinol Metab Clin N Am 16:647–665

15.

Liu JK, Das K, Weiss MH, Laws ER Jr, Couldwell WT (2001) The history and evolution of transsphenoidal surgery. J Neurosurg 95(6):1083–1096PubMed

16.

Rhoton AL (2002) The sellar region. Neurosurgery 51(Suppl 1):335–374

17.

Spencer WR, Das K, Nwagwu C, Wenke E, Schaeffer SD, Moscatello A, Couldwell WT (1999) Approaches to the sellar and parasellar region: anatomic comparison of the microscope vs endoscope. Laryngoscope 109:791–794CrossRef

18.

Youssef AS, Agazzi S, van Loveren HR (2005) Transcranial surgery for pituitary adenomas. Neurosurgery 571(Suppl):168–175PubMedCrossRef

Title: Transsphenoidal approaches to the pituitary: a progression in experience in a single centre
Authors: Bulent Duz
Ferhat Harman
Halil Ibrahim Secer
Erol Bolu
Engin Gonul
Publication date: 01-11-2008
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 11/2008
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-008-0135-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Transsphenoidal approaches to the pituitary: a progression in experience in a single centre

Abstract

Background

Materials and methods

Findings

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Materials and methods

Findings

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2008

Cerebral ischaemia in pituitary apoplexy

The role of embolization in radical surgery of renal cell carcinoma spinal metastases

Intra-arterial nimodipine to treat symptomatic cerebral vasospasm following traumatic subarachnoid haemorrhage. Technical case report

Intractable hiccups as a presenting symptom of Chiari I malformation

Pilomyxoid astrocytoma of the fourth ventricle in an adult

Isolated intraorbital schwannoma arising from the abducens nerve