Comparative analysis of rhinologic outcomes in Cushing disease and non-functioning pituitary adenoma in patients submitted to endoscopic endonasal transsphenoidal surgery

2020 ◽  
Vol 277 (8) ◽  
pp. 2371-2374
Author(s):  
Mariana D. C. Toro ◽  
Thiago L. I. Serrano ◽  
Fernando A. L. Marson ◽  
Carlos T. Chone ◽  
Mateus Dal Fabbro ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Pituitary Adenoma ◽  
Transsphenoidal Surgery ◽  
Cushing Disease ◽  
Endoscopic Endonasal ◽  
Endoscopic Endonasal Transsphenoidal Surgery

scholarly journals Risk factors for postoperative intracranial infections in patients with pituitary adenoma after endoscopic endonasal transsphenoidal surgery: pneumocephalus deserves further study

2019 ◽  
Vol 47 (2) ◽  
pp. E5 ◽  
Author(s):  
Kang Guo ◽  
Lijun Heng ◽  
Haihong Zhang ◽  
Lei Ma ◽  
Hui Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Transsphenoidal Surgery ◽  
Bubble Diameter ◽  
Csf Leak ◽  
Endoscopic Endonasal ◽  
Cns Infections ◽  
Endoscopic Endonasal Transsphenoidal Surgery ◽  
Intracranial Infections

OBJECTIVEThe authors sought to identify the relevance between pneumocephalus and postoperative intracranial infections, as well as bacteriological characteristics and risk factors for intracranial infections, in patients with pituitary adenomas after endoscopic endonasal transsphenoidal surgery.METHODSIn total, data from 251 consecutive patients with pituitary adenomas who underwent pure endoscopic endonasal transsphenoidal surgeries from 2014 to 2018 were reviewed for preoperative comorbidities, intraoperative techniques, and postoperative care.RESULTSThis retrospective study found 18 cases of postoperative pneumocephalus (7.17%), 9 CNS infections (3.59%), and 12 CSF leaks (4.78%). Of the patients with pneumocephalus, 5 (27.8%) had CNS infections. In patients with CNS infections, the culture results were positive in 7 cases and negative in 2 cases. The statistical analysis suggested that pneumocephalus (maximum bubble diameter of ≥ 1 cm), diaphragmatic defects (intraoperative CSF leak, Kelly grade ≥ 1), and a postoperative CSF leak are risk factors for postoperative CNS infections.CONCLUSIONSIn pituitary adenoma patients who underwent pure endoscopic endonasal transsphenoidal surgeries, intraoperative saddle reconstruction has a crucial role for patients with postoperative intracranial infections. Additionally, postoperative pneumocephalus plays an important role in predicting intracranial infections that must not be neglected. Therefore, neurosurgeons should pay close attention to the discovery of postoperative intracranial pneumocephalus because this factor is as important as a postoperative CSF leak. Pneumocephalus (maximum bubble diameter of ≥ 1 cm), diaphragmatic defects (an intraoperative CSF leak, Kelly grade ≥ 1), and a postoperative CSF leak were risk factors predictive of postoperative intracranial infections. In addition, it is essential that operative procedures be carefully performed to avoid diaphragmatic defects, to reduce exposure to the external environment, and to decrease patients’ suffering.

Endoscopic endonasal transsphenoidal surgery for invasive pituitary adenoma

2008 ◽  
Vol 15 (3) ◽  
pp. 241-245 ◽  
Author(s):  
Xiang Zhang ◽  
Zhou Fei ◽  
Wei Zhang ◽  
Jian-ning Zhang ◽  
Wei-ping Liu ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Transsphenoidal Surgery ◽  
Endoscopic Endonasal ◽  
Endoscopic Endonasal Transsphenoidal Surgery

scholarly journals Endoscopic endonasal transsphenoidal surgery using the iArmS operation support robot: initial experience in 43 patients

2017 ◽  
Vol 42 (5) ◽  
pp. E10 ◽  
Author(s):  
Toshihiro Ogiwara ◽  
Tetsuya Goto ◽  
Alhusain Nagm ◽  
Kazuhiro Hongo
Keyword(s):  
Pituitary Adenoma ◽  
Transsphenoidal Surgery ◽  
Arm Movement ◽  
Clinical Results ◽  
Initial Experience ◽  
Robotic Device ◽  
Endoscopic Endonasal ◽  
Arm Support ◽  
Study Population ◽  
Endoscopic Endonasal Transsphenoidal Surgery

ObjectiveThe intelligent arm-support system, iArmS, which follows the surgeon’s arm and automatically fixes it at an adequate position, was developed as an operation support robot. iArmS was designed to support the surgeon’s forearm to prevent hand trembling and to alleviate fatigue during surgery with a microscope. In this study, the authors report on application of this robotic device to endoscopic endonasal transsphenoidal surgery (ETSS) and evaluate their initial experiences.MethodsThe study population consisted of 43 patients: 29 with pituitary adenoma, 3 with meningioma, 3 with Rathke’s cleft cyst, 2 with craniopharyngioma, 2 with chordoma, and 4 with other conditions. All patients underwent surgery via the endonasal transsphenoidal approach using a rigid endoscope. During the nasal and sphenoid phases, iArmS was used to support the surgeon’s nondominant arm, which held the endoscope. The details of the iArmS and clinical results were collected.Results iArmS followed the surgeon’s arm movement automatically. It reduced the surgeon’s fatigue and stabilized the surgeon’s hand during ETSS. Shaking of the video image decreased due to the steadying of the surgeon’s scope-holding hand with iArmS. There were no complications related to use of the device.ConclusionsThe intelligent armrest, iArmS, seems to be safe and effective during ETSS. iArmS is helpful for improving the precision and safety not only for microscopic neurosurgery, but also for ETSS. Ongoing advances in robotics ensure the continued evolution of neurosurgery.

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