The evolution of extracranial approaches to the pituitary and anterior skull base

Grosvenor, Ashley E; Laws, Edward R.

doi:10.1007/s11102-008-0095-5

Cited by 35 publications

(23 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…34 However, it wasn't until the technical advances in the 1970s, 1980s, and 1990s that the endoscope became useful and effective as a neurosurgical tool. 34 Neuroendoscopy has emerged as an important adjunct to all types of neurosurgical procedures by extending the visualization of the neurosurgical approach beyond the tunnel vision of the operating microscope. 52 The endoscope provides greater direct illumination with higher magnification in a deep operative field.…”

Section: Advances In Neuroendoscopymentioning

confidence: 99%

Evolution of transoral approaches, endoscopic endonasal approaches, and reduction strategies for treatment of craniovertebral junction pathology: a treatment algorithm update

Dlouhy

Dahdaleh

Menezes³

et al. 2015

FOC

View full text Add to dashboard Cite

The craniovertebral junction (CVJ), or the craniocervical junction (CCJ) as it is otherwise known, houses the crossroads of the CNS and is composed of the occipital bone that surrounds the foramen magnum, the atlas vertebrae, the axis vertebrae, and their associated ligaments and musculature. The musculoskeletal organization of the CVJ is unique and complex, resulting in a wide range of congenital, developmental, and acquired pathology. The refinements of the transoral approach to the CVJ by the senior author (A.H.M.) in the late 1970s revolutionized the treatment of CVJ pathology. At the same time, a physiological approach to CVJ management was adopted at the University of Iowa Hospitals and Clinics in 1977 based on the stability and motion dynamics of the CVJ and the site of encroachment, incorporating the transoral approach for irreducible ventral CVJ pathology. Since then, approaches and techniques to treat ventral CVJ lesions have evolved. In the last 40 years at University of Iowa Hospitals and Clinics, multiple approaches to the CVJ have evolved and a better understanding of CVJ pathology has been established. In addition, new reduction strategies that have diminished the need to perform ventral decompressive approaches have been developed and implemented. In this era of surgical subspecialization, to properly treat complex CVJ pathology, the CVJ specialist must be trained in skull base transoral and endoscopic endonasal approaches, pediatric and adult CVJ spine surgery, and must understand and be able to treat the complex CSF dynamics present in CVJ pathology to provide the appropriate, optimal, and tailored treatment strategy for each individual patient, both child and adult. This is a comprehensive review of the history and evolution of the transoral approaches, extended transoral approaches, endoscopie assisted transoral approaches, endoscopie endonasal approaches, and CVJ reduction strategies. Incorporating these advancements, the authors update the initial algorithm for the treatment of CVJ abnormalities first published in 1980 by the senior author.

show abstract

Section: Advances In Neuroendoscopymentioning

confidence: 99%

Evolution of transoral approaches, endoscopic endonasal approaches, and reduction strategies for treatment of craniovertebral junction pathology: a treatment algorithm update

Dlouhy

Dahdaleh

Menezes³

et al. 2015

FOC

View full text Add to dashboard Cite

show abstract

“…1 This less-invasive approach was shown to be safe, with low morbidity and very low operative mortality. 1,2 However, the relatively recent introduction of the rigid fiberoptic endoscope is suggested to be a further technical refinement in pituitary surgery.…”

mentioning

confidence: 93%

A Learning Curve of Endoscopic Transsphenoidal Surgery for Pituitary Adenoma

Chi

Wang

Lin³

et al. 2013

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Experience is an important point in the effectiveness of the surgical procedure and in the reduction of complications in pituitary surgery. Endoscopic pituitary surgery differs from microscopic surgery because it requires a steep learning curve for endoscopic skills. In this study, we investigated the learning curve of endoscopic transsphenoidal pituitary surgery in our department. Endoscopic transsphenoidal operations were performed on 80 patients, who were retrospectively examined and grouped as the early and late experience groups to evaluate the learning curve. The patients' characteristics, gross total resection, endocrinological cure, visual field improvement, duration of surgery, postoperative hospital stay, and complications were noted. After examining our patients of the 2 groups of period, our experience showed that as the effectiveness of endoscopic surgery increases, the duration of surgery and postoperative hospital stay decrease. In this study, we identified a learning curve in endoscopic pituitary surgery.

show abstract

“…26 While the trans-sphenoidal route is not new, continuously improving endoscopy and instrumentation have greatly expanded the range of what can be safely attempted through the nasal cavity (Fig 10). 27 In addition to lesions in or adjacent to the sella turcica , lesions of the cribriform plate, planum sphenoidale, clivus, and dens may be accessed. 28 Some surgeons have also used the technique to access paramedian middle and posterior fossa lesions.…”

Section: Arachnoid Cystsmentioning

confidence: 99%

Minimally Invasive Pediatric Neurosurgery

Governale¹

2015

Pediatric Neurology

View full text Add to dashboard Cite

The evolution of extracranial approaches to the pituitary and anterior skull base

Cited by 35 publications

References 24 publications

Evolution of transoral approaches, endoscopic endonasal approaches, and reduction strategies for treatment of craniovertebral junction pathology: a treatment algorithm update

Evolution of transoral approaches, endoscopic endonasal approaches, and reduction strategies for treatment of craniovertebral junction pathology: a treatment algorithm update

A Learning Curve of Endoscopic Transsphenoidal Surgery for Pituitary Adenoma

Minimally Invasive Pediatric Neurosurgery

Contact Info

Product

Resources

About