Endoscopic Endonasal Transsphenoidal Approach to Large and Giant Pituitary Adenomas: Institutional Experience and Predictors of Extent of Resection

Endoscopic endonasal management of non-functioning pituitary adenomas with cavernous sinus invasion: a 10- year experience

“…Most recently several experiences in the treatment of giant pituitary adenomas reported variable rates of GTR ranging from 20.7% (27) to 24% (28) , but no data about CSI and pituitary function were specified. Data emerging from our series are consistent with these other results: we reported a CSI in 27.3% (56/205) of the NFPA treated, including in this group only the Knosp grade 3 and 4 tumors with concordant radiological and intraoperative findings, and obtained a GTR in 30.3% of cases and STR in 60.7%.…”

Multimodality Imaging for Navigation in Endoscopic Transsphenoidal Surgeries

“…Multimodal image fusion and its use for navigation was recently developed for transsphenoidal surgery. 20 Using different imaging modalities allows reconstruction of vital structures in vicinity to tumors and lesions, significantly improving surgical precision and safety. 9,14,16,21 The CT and MR images can be combined automatically or manually.…”

Extent of Endoscopic Resection for Anterior Skull Base Tumors: An MRI-Based Volumetric Analysis

“…4,25 We report on our institution's rates of resection for a diverse series of tumors approached via EEA, using three- dimensional volumetric analyses of pre-and immediately postoperative MR imaging. Such volumetric analysis of radiographic imaging has been used elsewhere as a reliable method of evaluating extent of resection of tumors involving the anterior skull base, [13][14][15][16] as gross total resection of many anterior skull base tumors is often a central oncologic goal of surgical resection. There remains, however, a paucity of published data on rates of gross total resection on tumors accessed via all surgical approaches including the EEA, and therefore a gap in our knowledge of how these tumors are currently managed, including what aspects of management could be targeted for future improvement.…”

“…Volumetric calculations using MR imaging have been used elsewhere to assess tumor volume for a variety of tumors, both benign and malignant. [13][14][15][16] However, despite advances in imaging, few studies have rigorously examined the utility of assessing extent of resection using pre-and postoperative imaging in an effort to objectify surgical outcomes. Such data are required to further delineate indications and limitations of EEAs for tumor resection.…”