Extended endoscopic endonasal approach to the suprasellar parachiasmatic cisterns: anatomic study

Abuzayed, Bashar; Tanrıöver, Necmettin; Akar, Zıya; Eraslan, Berna Şenel; Gazioğlu, Nurperi

doi:10.1007/s00381-010-1204-0

Cited by 28 publications

(32 citation statements)

References 46 publications

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“…If nasal pack for controlling severe epistaxis leads to pain and extreme discomfort and if nasal obstruction, dysphagia and occlusion of auditory tube are present and no response can be obtained from medication and pack therapy, arterial ligation is applied (Abelson et al; Maceri). Transanthral, transoral or endonasal endoscopic intervention methods are used for ligating the 3rd part of the maxillary artery and sphenopalatine artery (Stepnick et al, 1990;Abelson et al;Maceri;Voegels et al, 2001;Schwartzbauer et al;Kumar et al, 2003;Pradess et al, 2008;Abuzayed et al). Arterial embolization is used as an alternative and efficient method for persistent posterior epistaxis cases and it is performed under angiographic guidance (Maceri).…”

Section: Discussionmentioning

confidence: 99%

“…Although course and parts of the maxillary artery are defined in classical anatomy books, significant clinical information related with the main artery and its branches are included in several investigation reports (Navarro et al, 1982;Morton & Khan, 1991;Vrionis et al, 1996;Sashi et al, 1996;Choi & Park, 2003;Schwartzbauer et al, 2003;Isolan et al, 2007;Hussain et al, 2008;Abuzayed et al, 2009;Chiu, 2009;Kwak et al, 2010). As the most important contribution to the blood supply of the nose is made by maxillary artery from the external carotid system, it is reported that ligation of the maxillary artery and its branches via different procedures is the most efficient method for controlling the epistaxis (Stepnick et al, 1990;Abelson, 1991;Maceri, 1993;Abuzayed et al, 2009;Kwak et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

“…As the most important contribution to the blood supply of the nose is made by maxillary artery from the external carotid system, it is reported that ligation of the maxillary artery and its branches via different procedures is the most efficient method for controlling the epistaxis (Stepnick et al, 1990;Abelson, 1991;Maceri, 1993;Abuzayed et al, 2009;Kwak et al, 2010). In some persistent epistaxis cases, the angiography guided arterial embolization is mentioned as an efficient and alternative method of arterial ligation (Maceri).…”

Section: Introductionmentioning

confidence: 99%

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Clinical Significance of Maxillary Artery and its Branches: A Cadaver Study and Review of the Literature

et al. 2011

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SUMMARY:The aim of this study was to investigate the anatomy of the maxillary artery (MA) and its branches. Fourteen sides of Turkish adult cadavers were dissected. The specimens were classified according to the relation between MA and the lateral pterygoid. After the removal of the lateral pterygoid, parts and branches of MA were exposed. We classified the branching patterns of MA in the pterygopalatine fossa. The calibers and lengths of the arteries, and the distance between the zygomatic arch and MA, and between the infratemporal crest and MA were measured. The MA was found superficial to the lateral pterygoid in 57.2%. The inferior alveolar artery (IA) was arisen from MA before the middle meningeal artery (MM) in 35.7%, after MM in 35.7%. The IA and MM were arisen from the same area of MA in 14.3 %. In other two cases IA was arisen from the beginning of MA (14.3%). According to the contours of third portion of MA, we classified "Y" type (50%), "intermediate-T" type (14.3%), and "M" type (35.7%). This reinvestigation of the clinical anatomy of MA may provide useful information to the head and neck surgeons, dentists, neurosurgeons and radiologists related with this region.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Significance of Maxillary Artery and its Branches: A Cadaver Study and Review of the Literature

et al. 2011

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“…Indeed, even though in some studies an endoscopic endonasal route above the chiasm has been suggested, we considered this approach to be a major risk for visual chiasm or nerve damage. 1 Therefore, careful analysis of high-resolution preoperative imaging studies is of paramount importance before this route is considered.…”

Section: Discussionmentioning

confidence: 99%

Expanding indications for the extended endoscopic endonasal approach to hypothalamic gliomas: preliminary report

Zoli¹,

Mazzatenta²,

Valluzzi³

et al. 2014

FOC

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Object In the last decade the indications for the endoscopic endonasal approach have been progressively expanded to include lesions that have not been traditionally considered amenable to resection through the transsphenoidal route. In this study, the authors analyze their experience with hypothalamic gliomas treated via the endoscopic endonasal approach. Methods Consecutive cases of hypothalamic gliomas treated since 2007 via an endoscopic endonasal approach were reviewed. Preoperative and postoperative neuroimaging as well as endocrinological, neurological, and visual symptoms were analyzed to assess the surgical outcome. Signs and symptoms of hypothalamic dysfunction including body mass index (BMI), memory, sleep-wake rhythm, and polyphagia were prospectively collected pre- and postoperatively to assess hypothalamic function. Quality of life was evaluated using the Katz scale. Results In the initial phase the endoscopic endonasal approach was adopted in 3 cases with a palliative intent, to obtain a biopsy sample or for debulking of the mass followed by radio- or chemotherapy. In 2 later cases it was successfully adopted to achieve gross-total tumor resection. Complications consisted of 2 postoperative CSF leaks, which required an endoscopic endonasal reintervention. Visual deficit improved in 3 cases and normalized in the other 2. Four patients developed diabetes insipidus, and 3 an anterior panhypopituitarism. All patients had a moderate increase in BMI. No patients presented with any other signs of hypothalamic damage, and their quality of life at follow-up is normal. Conclusions Despite the limitations of a short follow-up and small sample, the authors’ early experience with the endoscopic endonasal approach has revealed it to be a direct, straightforward, and safe approach to third ventricle astrocytomas. It allowed the authors to perform tumor resection with the same microsurgical technique: dissecting the tumor with 2 hands, performing a central debulking, and controlling the bleeding with bipolar coagulation. The main limitations were represented by some anatomical conditions, such as the position of the chiasm and the anterior communicating artery complex and, finally, by the challenge of watertight plastic repair. To definitively evaluate the role of this approach in hypothalamic gliomas, a comparison with transcranial series would be necessary, but due to the rarity of these cases such a study is still lacking. The authors observed that more aggressive surgery is associated with a worse endocrinological outcome; thus they consider it to be an open question (in particular in prepubertal patients) whether radical removal is an advisable goal for hypothalamic gliomas.

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“…In general, vessels from the overlying pial network supply the chiasm. Inferiorly, the largest vessel contributing to this network is the superior hypophyseal artery, which gives off a recurrent branch along the inferomedial border of the proximal intracranial part of the optic nerve (Blunt and Steele, 1956;Abuzayed et al, 2010). These paired vessels are routinely encountered adherent to the tumor capsule in the endonasal endoscopic removal of VISUAL LOSS communicating arteries.…”

Section: Visual Lossmentioning

confidence: 97%

Surgical Approaches

2015

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Extended endoscopic endonasal approach to the suprasellar parachiasmatic cisterns: anatomic study

Cited by 28 publications

References 46 publications

Clinical Significance of Maxillary Artery and its Branches: A Cadaver Study and Review of the Literature

Clinical Significance of Maxillary Artery and its Branches: A Cadaver Study and Review of the Literature

Expanding indications for the extended endoscopic endonasal approach to hypothalamic gliomas: preliminary report

Surgical Approaches

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