Geographic Disparities in the Proliferation of Minimally Invasive Approaches for Sellar/Parasellar Lesions

Garg, Kanwaljeet; Chaurasia, Bipin; Pahwa, Bhavya; Arnaout, Mohamed M.; Zenonos, Georgios A.; Piloto, Orestes López; Fontanella, Marco Maria; Schwartz, Theodore H.

doi:10.1016/j.wneu.2022.09.066

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…It should be noted that the risk of further visual decline is greater in conservatively treated patients. Moreover, the extent of resection (total or subtotal) is reported not to influence visual outcomes significantly [ 1 , 2 , 8 , 11 , 23 ]. Hence, surgical treatment in patients with impaired visual function can provide better visual outcomes with relatively low risk of complications.…”

Section: Discussionmentioning

confidence: 99%

Optochiasmatic cavernoma: Surgical treatment and outcomes

Konovalov,

Saripov,

Gadzhiagaev

et al. 2023

J Cerebrovasc Endovasc Neurosurg

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Objective: Optochiasmatic cavernoma is an extremely rare cerebral lesion. They account for approximately 1% of all cavernomas of the central nervous system. Reports on this pathology are limited. Abrupt visual deterioration is a common symptom of the disease. Treatment strategy and visual outcomes after different treatment approaches remain a subject for discussion.Methods: Patients operated in a period 2005-2021 were analyzed in this study. All patients preoperatively underwent computed tomography (CT) scan, CT-angiography, and magnetic resonance imaging (MRI). Visual function of the patients was assessed pre-op, post-op and at the follow-up. Duration of visual dysfunction was noted as well. Surgical details were also extracted from medical notes. All patients were followed up, and control MRI was performed one month after operation. We assessed surgical series of optochiasmatic cavernomas published for last 10 years. Further comparative analysis with our data was performed.Results: Five patients were included into this study. There were four men and one woman. Mean age comprised 33.8 years (range 20-48 years). Most patients were admitted to our hospital due to visual disturbances (80%). Visual function improved in four patients. Visual function was unchanged in one patient, lacking visual disturbancies pre-op. Complication developed in one patient.Conclusions: Optochiasmatic cavernomas are encountered extremely rare. Despite the use of contemporary diagnostic options, differential diagnosis remains challenging. Full diagnostic work-up is mandatory. After the diagnosis is made, surgical treatment should be considered first. Total microsurgical or endoscopic transsphenoidal removal of the optochiasmatic cavernoma is a relatively safe and effective treatment method facilitating improvement of visual function.

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Section: Discussionmentioning

confidence: 99%

Optochiasmatic cavernoma: Surgical treatment and outcomes

Konovalov,

Saripov,

Gadzhiagaev

et al. 2023

J Cerebrovasc Endovasc Neurosurg

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“…We have come to better understand the reasons for this reticence in applying EEA to every pituitary adenoma. First, the learning curve for surgeons and assistants for the EEA can be steep, and adoption is more likely to occur at any given institution if that institution has staff who have been trained in the approach, to avoid postoperative complications like cerebrospinal fluid leaks and hypopituitarism [2][3][4]. Second, the capital resources required to purchase and maintain necessary endoscopic equipment and to train individuals on its use and handling are high [3].…”

Section: To the Editormentioning

confidence: 99%