Extended endoscopic approaches for midline skull-base lesions

Ceylan, Savaş; Koç, Kenan; Anık, İhsan

doi:10.1007/s10143-009-0201-9

Cited by 109 publications

(62 citation statements)

References 25 publications

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“…10 In the present series no patient experienced damage to a neurovas- cular structure. The reported rates of CSF leakage after endoscopic craniopharyngioma resection range from 0 to 58%.…”

Section: Discussionmentioning

confidence: 71%

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Endocrinological and ophthalmological consequences of an initial endonasal endoscopic approach for resection of craniopharyngiomas

Campbell¹,

McGettigan

Luginbuhl

et al. 2010

FOC

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Object The expanded endoscopic approach to craniopharyngiomas has recently been described in several small case series. The authors present their experience with this technique and review the available literature. Methods Between September 2006 and September 2009, 14 patients underwent a purely endoscopic, endonasal approach for resection of newly diagnosed craniopharyngiomas. These procedures represent index surgeries; no patient had undergone previous tumor resection. A retrospective review of endocrinological and ophthalmological outcomes, extent of resection, and complication prevalence was completed. Additionally, a review of the English literature was performed to evaluate outcomes of similar endoscopic techniques for resection of craniopharyngiomas. Results Four patients (28.6%) underwent gross-total resection; near total resection or better was achieved in 9 patients (64.3%). All patients presented with some form of visual field or acuity deficit. Postoperatively, 12 patients (85.7%) experienced visual improvement, with 6 patients (42.9%) having complete visual recovery. One patient experienced worsening of her visual deficit. Visual acuity improved in 8 patients ((57.1%), while visual field defects improved in 11 (78.6%). The pituitary stalk was preserved in all cases. Eight (57.1%) of 14 patients experienced some form of anterior pituitary dysfunction postoperatively. Although 9 patients (64.3%) were documented to have either transient or permanent new diabetes insipidus immediately after surgery, at 1-month follow-up only 1 patient met clinical criteria. Five patients (35.7%) developed CSF leaks that were successfully treated by subsequent endoscopic revision. All CSF leaks occurred early in the series. Two patients (14.2%) were treated for presumed meningitis postoperatively. Conclusions The endoscopic endonasal approach is a minimally invasive alternative to open transcranial approaches for select craniopharyngiomas. Similar to previous transcranial series, rates of endocrinopathy and gross-total resection were dependent upon the adherence of the tumor capsule to the hypothalamus, pituitary stalk, and associated vasculature. A review of the literature suggests that the results of the current series are similar to other published series on this topic.

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“…10 In the present series no patient experienced damage to a neurovas- cular structure. The reported rates of CSF leakage after endoscopic craniopharyngioma resection range from 0 to 58%.…”

Section: Discussionmentioning

confidence: 71%

“…10,13,34,49 However, reconstruction represents one of the most challenging steps of the expanded approach and the current authors have developed a multilayered closure using a 2-layer fascia lata "button" graft to seal the dural defect. The "button" is constructed of 2 pieces of fascia lata attached to one another by suture (Fig.…”

Section: Operative Techniquementioning

confidence: 99%

Endocrinological and ophthalmological consequences of an initial endonasal endoscopic approach for resection of craniopharyngiomas

Campbell¹,

McGettigan

Luginbuhl

et al. 2010

FOC

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“…Extended endoscopic trans-sphenoidal approach (EETS) was recently developed to provide an alternative route to access midline skull base lesions [36][37][38][39][40]. One of the drawbacks of this approach is the limited visibility of the posterior aspect of the lesions.…”

Section: Extended Endoscopic Trans-sphenoidal Approachmentioning

confidence: 99%

Anatomical variations and neurosurgical significance of Liliequist’s membrane

et al. 2014

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“…Extended microscopic and endoscopic approaches for the cavernous sinus (CS) invasion have been reported in the literature (4,5,6,11,12,17,21,22).…”

Section: Introductionmentioning

confidence: 99%

A new endoscopic surgical classification and invasion criteria for pituitary adenomas involving the cavernous sinus

Ceylan¹,

Anık²,

Koç³

2011

Turkish Neurosurgery

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AIm: There are two major problems for the pituitary adenomas invading the Cavernous Sinus (CS); differentiation of extension and invasion and inability to demonstrate the medial wall via preoperative imaging methods. Two important corridors are defined in endoscopic cavernous sinus approaches; the lateral and medial corridor. mAterIAl and methOds: A retrospective analysis was performed in 400 endoscopic transphenoidal approaches and 360 pituitary adenomas underwent endoscopic transphenoidal surgery in our department between September 1997 and December 2010. 48 patients affected by the tumours involving the cavernous sinus were included in this study. results:We performed an intraoperative evaluation of cavernous sinus invasion considering visualization of the medial wall defect, intracavernous ICA segments, minor tumour extensions through small focal pit holes of the medial wall of CS or confirming carotid segments of CS by micro-doppler. Cavernous sinus involvement was classified into three types according to the medial and lateral corridor extension of the tumor as 25 isolated medial corridor involvement (Type I), 5 isolated lateral corridor involvement (Type II) and 18 total involvement (Type III).COnClusIOn: Our classification depends on fully surgical endoscopic approach supported by neuroimaging techniques and anatomical studies and shows a good predictive value for all cavernous sinus involvement. BulGulAr: Kavernöz sinus invazyonunu intraoperatif olarak medial duvar defektini, intrakavernöz carotid arter segmentlerini, kavernöz sinus medial duvarındaki küçük defektleri görüntüleyerek ya da mikrodopler ile kavernöz sinüsün karotid segmentlerini konfirme ederek sağladık. İnvazyonu tanımladıktan sonra kavernöz sinüse yayılım şeklini tümörün medial ve lateral koridorlardan ilerlemesine göre üç grupta sınıflandırdık.25 hastada izole medial koridor tutulumu (Tip I), 5 hastada lateral koridor tutulumu (Tip II) ve18 hastada da her iki koridor tutulumu saptadık (Tip III).sOnuÇ: Yapmış olduğumuz sınıflandırma anatomik çalışmalarla ve görüntüleme yöntemleriyle desteklenmiş bir endoskopik cerrahi sınıflandırmadır ve sadece yüksek dereceli değil, tüm kavernöz sinus tutulumları için prediktif değer taşımaktadır.

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Extended endoscopic approaches for midline skull-base lesions

Cited by 109 publications

References 25 publications

Endocrinological and ophthalmological consequences of an initial endonasal endoscopic approach for resection of craniopharyngiomas

Endocrinological and ophthalmological consequences of an initial endonasal endoscopic approach for resection of craniopharyngiomas

Anatomical variations and neurosurgical significance of Liliequist’s membrane

A new endoscopic surgical classification and invasion criteria for pituitary adenomas involving the cavernous sinus

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