Hypophysectomy in dogs: A review

Meij, Björn P.

doi:10.1080/01652176.1999.9695008

Cited by 7 publications

(9 citation statements)

References 25 publications

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“…Pituitary-dependent hyperadrenocorticism is a chronic, progressive, and eventually fatal condition, present in 80-85% of dogs with naturally occurring hyperadrenocorticism (1)(2)(3). It is caused by the presence of a functional corticotroph pituitary mass secreting the adrenocorticotropic hormone (ACTH) and subsequent adrenal cortisol release (4).…”

Section: Introductionmentioning

confidence: 99%

“…Etiological treatment requires a transsphenoidal craniectomy (i.e., hypophysectomy) to remove the pituitary gland and associated neoplasm. Transsphenoidal hypophysectomy is becoming increasingly popular for dogs with pituitary-dependent hyperadrenocorticism, judging by recent publications, and is considered the treatment of choice for dogs with Cushing's disease (1,(9)(10)(11)(12)(13)(14)(15)(16)(17). According to Hanson et al (12) looking at 150 dogs, a remission rate of 84% is seen after surgery and the 1, 2, 3, and 4-year survival rates are 83.5, 76.1, 71.5, and 67.8%, respectively (12).…”

Section: Introductionmentioning

confidence: 99%

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A 3-Dimensional Printed Patient-Specific Surgical Guide to Facilitate Transsphenoidal Hypophysectomy in Dogs

Escauriaza

Fenn²,

McCue³

et al. 2022

Front. Vet. Sci.

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ObjectiveHypophysectomy in dogs is a difficult surgery that requires specific learning and training. We aimed to evaluate the accuracy of a 3-dimensional printed patient-specific surgical guide to facilitate choosing the entry point in the basisphenoid bone before approaching the sella turcica during transsphenoidal hypophysectomy in dogs.MethodsTwo canine cadavers and 8 dogs undergoing transsphenoidal hypophysectomy for Cushing's disease treatment, involving design and fabrication of a 3-dimensional printed guide. The ideal entry point in the basisphenoid bone outer cortical layer was determined in each dog pre-operatively; its anatomical location was described with a set of measurements then compared to post-operative computed tomography measures describing the location of the outer cortical window created in the basisphenoid bone.ResultsSeveral guide designs were proposed, and a consensus reached based on surgeons' experience performing hypophysectomy. The device chosen could be applied to the size and shape of skulls encountered in this case series. The pre-planned measurements were comparable to post-operative measurement (there was also no statistical difference), with median of differences <0.1 mm, which we judged as clinically acceptable.Clinical SignificanceHypophysectomy in dogs is a challenging procedure that has a learning curve and needs to be performed by specialist neurosurgeons. We propose that a low-profile 3-dimensional printed surgical guide can aid the specialist neurosurgeon to locate the burring site of the outer cortical layer of the basisphenoid bone at a pre-defined location and with good accuracy. It does not alleviate the need to understand the anatomy of the region and to know how to create a slot within the basisphenoid bone, which remains essential to enter the sella turcica. This device could help specialist veterinary neurosurgeons wishing to be trained to perform hypophysectomy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A 3-Dimensional Printed Patient-Specific Surgical Guide to Facilitate Transsphenoidal Hypophysectomy in Dogs

Escauriaza

Fenn²,

McCue³

et al. 2022

Front. Vet. Sci.

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“…Since 1928, several surgical techniques have been described in the literature. Transbuccal (23), transcranial (24), and transsphenoidal (18, 25–27) techniques, with and without a neuronavigation system (28), have been used to approach the pituitary gland in dogs. Mamelak et al used a high-definition video telescope for surgery using the pilot hole technique (29).…”

Section: Introductionmentioning

confidence: 99%

A Recurrent Suprapituitary Ependymal Cyst Managed by Endoscopy-Assisted Transsphenoidal Surgery in a Canine: A Case Report

Lehner

Garamvölgyi

Jakab³

et al. 2019

Front. Vet. Sci.

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A 9-years-old spayed female mixed-breed dog was referred for the evaluation of intermittent head tremors, obtundation, long-standing blindness, and a tendency to seek confined spaces. The dog lost its vision 6 months before the current presentation. A menace response was absent on ophthalmological examination. Neurological examination did not show any abnormalities. A cyst measuring 16 × 18 × 14 mm was observed above the pituitary gland on magnetic resonance imaging. It extended toward the frontal area and compressed the optic chiasm and hypothalamic regions. A minimum preoperative database, including the findings of other required blood tests, was prepared. No abnormal laboratory findings were observed. Endoscopy-assisted transsphenoidal hypophysectomy was performed to remove the pituitary gland, drain the cyst, and partially excise the cyst wall. Normal pituitary gland tissue was observed on histopathology, and the mass was found to have a neuroendocrine or ependymal origin on cytology. Strict post-operative laboratory tests were performed at 1-h intervals for 24 h. An empty sella turcica region, and a collapsed and empty cyst wall was observed on follow-up magnetic resonance imaging. After 3 days of observation, the dog was discharged with a prescription of substitution therapy. However, the dog presented with the same signs and symptoms 73 days after the surgery. Cyst recurrence was apparent on magnetic resonance imaging. The owner requested euthanasia, and an ependymal cyst was observed on necropsy. To the best of our knowledge, we present the first case of an intra- and suprasellar ependymal cyst, and its surgical management in a canine. The findings from this case suggest that endoscopic transsphenoidal drainage and hypophysectomy could be a good surgical approach in cases where involvement of the pituitary gland is confirmed or strongly suspected on the basis of cytological and imaging findings.

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“…Historically, 2 approaches have been used. One is a transoral approach that requires the surgeon to operate through the mouth, 4–11 which has the advantage of minimizing tissue trauma but the disadvantage of reduced visualization of the pituitary and surrounding vascular structures. The other is the rostral intermandibular approach, 12 in which an approach to the sphenoid bone is made through the rostral intermandibular area and facilitated by mandibular symphysiotomy.…”

Section: Introductionmentioning

confidence: 99%

“…Inadequate, inexperienced or elaborate use of suction and curettes can result in either incomplete hypophysectomy (not effecting a cure of HAC) or extensive trauma to the brain and vascular tissues. Interestingly, residual anterior pituitary cells were found in most experimental dogs in previous studies when tissue remnants in the sella turcica were examined 5,8,9,13,14 …”

Section: Introductionmentioning

confidence: 99%