A technique for endoscopic pituitary tumor removal

Cusimano, Michael D.; Fenton, Ronald S.

doi:10.3171/foc.1996.1.1.3

Cited by 32 publications

(20 citation statements)

References 15 publications

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“…Endoscopic Technique: Our standard purely endoscopic endonasal technique, originally performed in 1993 and reported in 1996, is used 21 with the following key points. An Ear, Nose and Throat (ENT) surgeon performs the initial part of the procedure.…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…Suggested factors include smaller adenomas and the confirmation of adenoma intraoperatively. 18,20 The question of whether the newer endoscopic surgical technique (endo TSS) 21 has improved results compared to the older microscopic technique (micro TSS) remains to be answered. The aim of this report is to study the outcomes of ABSTRACT: Background: Cushing disease (CD) constitutes a challenging condition for the pituitary surgeon.…”

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confidence: 99%

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Impact of Technique on Cushing Disease Outcome Using Strict Remission Criteria

Alahmadi

Cusimano

Woo

et al. 2013

Can. J. Neurol. Sci.

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334Cushing's Disease (CD) is the commonest cause of endogenous hypercortisolemia 1 and is associated with significant morbidity and mortality. [2][3][4] Transsphenoidal pituitary surgery remains the first line treatment for this condition with reported remission rates of 52% to 89%. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Many attempts have been made to identify factors that would predict sustained remission after surgical intervention. Suggested factors include smaller adenomas and the confirmation of adenoma intraoperatively. 18,20 The question of whether the newer endoscopic surgical technique (endo TSS) 21 has improved results compared to the older microscopic technique (micro TSS) remains to be answered. The aim of this report is to study the outcomes of ABSTRACT: Background: Cushing disease (CD) constitutes a challenging condition for the pituitary surgeon. Given the variety of factors affecting outcomes in CD, it is uncertain whether the newer endoscopic technique improves the results of surgery. Methods: A review was conducted of CD cases at our institution between 2000 and 2010. Analysis was done to: determine if surgical technique had an effect on outcome, identify the predictors of outcome and provide details of failed cases. Remission was defined as normal postoperative 24-hour urinary free cortisol (24-h UFC), suppression of morning serum cortisol to <50 nmol/L after 1mg of dexamethasone or being dependent on steroid replacement. Results: Forty-two patients met our inclusion criteria. Average follow-up period was 33 months. There were 15 macroadenomas and 27 microadenomas. Seventeen patients had an endoscopic transsphenoidal surgery and twenty-five patients had a microscopic transsphenoidal procedure. Long-term overall remission was achieved in 26 (62%) patients. There was no significant difference in remission rates between the two techniques (p value 0.757). Patient's subjective symptomatic improvement and drop of morning serum cortisol in the postoperative period to less than 100 nmol/L correlated with longterm remission (p value 0.0031and 0.0101, respectively) while repeat surgery was the only predictor of the lack of postoperative remission (p value 0.0008). Conclusions: Revision surgery predicted poor remission rate for CD. Within the power of our study size, there was no difference in outcome between the endoscopic and microscopic approaches. Surgical outcomes should be reviewed in association with remission criteria used in a study. RÉSUMÉ: Évaluation de l'impact de la technique utilisée, au moyen de critères de rémission rigoureux, sur le résultat de la chirurgie dans le traitement de la maladie de Cushing. Contexte : La maladie de Cushing (MC) présente des défis pour le chirurgien qui la traite. Compte tenu de la variété des facteurs qui influencent le résultat du traitement dans la MC, nous ne savons pas si la nouvelle technique endoscopique améliore le résultat de la chirurgie. Méthode : Nous avons revu les dossiers des patients atteints de la MC traités dans notre instit...

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Section: Surgical Techniquesmentioning

confidence: 99%

mentioning

confidence: 99%

Impact of Technique on Cushing Disease Outcome Using Strict Remission Criteria

Alahmadi

Cusimano

Woo

et al. 2013

Can. J. Neurol. Sci.

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“…Surgery was performed using a biportal endoscopic transsphenoidal approach, with the addition of the Doppler probe for identification of the parasellar internal carotid arteries, as described in earlier studies [11,12]. The tumor was a well-circumscribed, heterogeneous mass below a rim of the compressed gland (i.e., the so-called "pseudocapsule").…”

Section: Operative Findings and Outcomementioning

confidence: 99%

Diagnostic and prognostic biomarkers of a sellar melanocytic tumor mimicking pituitary adenoma: Case report and literature review

Mohammed

Rotondo

Muñoz

et al. 2015

Pathology - Research and Practice

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“…Hopkins also developed 2 important types of endoscopes known today: rigid and flexible endoscopes (30,33,90). To name a few, the integration of glass-rod scopes, fiberoptics in transmitting cold light (23,30,33,36,70), viewing lenses that allow smaller diameters and wider viewing angles, cameras and video cameras, working channels in the sheath of the endoscope, and navigation systems all have emerged to the improvement of the endoscopic instrument for brain surgery as well as for other kinds of surgeries (14,15,17,29,30,33,45,52,53,65,68,74,90). These developments are still in progress as scientists and physicists introduce and test new tools and apply modern concepts and ideas to endoscopic neurosurgery (15,16).…”

Section: Introductionmentioning

confidence: 99%

“…As neuroendoscopy continues to grow as a more common application in neurosurgery (14,16), it is important to understand the parts that contribute to the mechanism and functionality of the instrument. The current literature discusses the general history of neuroendoscopy, whereas the present article focuses strictly on the technical aspects of it.…”

Section: Introductionmentioning

confidence: 99%