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Endoscopic endonasal approach for resection of giant nonfunctional pituitary adenoma.
Muhsen, Baha'eddin A; Najera, Edinson; Cappello, Zachary; Borghei-Razavi, Hamid; Recions, Pablo F.
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  • Muhsen BA; Department of Neurosurgery and Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States.
  • Najera E; Department of Neurosurgery, Egil and Pauline Braathen Center, Cleveland Clinic Florida, Weston, FL, United States.
  • Cappello Z; Department of Otolaryngology, Head & Neck Institute, Cleveland Clinic, Cleveland, OH, United States.
  • Borghei-Razavi H; Department of Neurosurgery and Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States.
  • Recions PF; Department of Neurosurgery and Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States; Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue,
Clin Neurol Neurosurg ; 230: 107725, 2023 07.
Article en En | MEDLINE | ID: mdl-37172377
The giant pituitary adenoma (GPA)> 4 cm is considered a surgical challenging pathology and associated with higher surgical complications compared to non-giant pituitary adenoma [1]. These tumors are invasive and had extension to nearby neurovascular structures including cranial nerves and internal carotid artery. Endoscopic endonasal approach (EEA) is increasingly used in the last two decades, however tumors with significant height extension in the supraseller region makes surgeons in favor of transcranial approaches or combined approaches [2]. The accompanied symptoms arise from compression of neighboring structures as well as hypopituitarism [3]. In this video we present 65 year old male with PMH significant for HTN who presented with 2-3 months retro-orbital headaches, confusion, gait instability, urinary/fecal incontinence, found to have 5.1 × 2.1 × 2 cm sellaer-suprasellar mass compressing the floor of the third ventricle, mammillary body, and optic apparatus. The mass was associated with hydrocephalus. The endoscopic endonasal skull base approach (trans-sellar, transtubercular) was performed with significant tumor resection without a need for trans cranial approach. A titanium clips was used to reconstruct the diaphragma sella which was very helpful technique to change high flow CSF leak to low flow. The postoperative course of the patient was smooth with improved gait, memory, and vision. He was kept on a hormonal replacement for hypopituitarism.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Hipofisarias / Hipopituitarismo Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Humans / Male Idioma: En Revista: Clin Neurol Neurosurg Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Hipofisarias / Hipopituitarismo Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Humans / Male Idioma: En Revista: Clin Neurol Neurosurg Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos