By E.R. Laws Jr., J.P. Sheehan, E. Ghigo, F. Guaraldi, A. Benso
ISBN-10: 1423796926
ISBN-13: 9781423796923
ISBN-10: 3805580517
ISBN-13: 9783805580519
The administration of pituitary adenomas and different sellar tumors is without doubt one of the such a lot tricky projects for neurosurgeons and endocrinologists. optimum remedy calls for a multidisciplinary technique; neurological, ophthalmological, and endocrinological assessments are all required. thankfully, the earlier decade has noticeable quick advancements within the administration of sufferers with pituitary adenomas and different sellar tumors. Transsphenoidal surgical procedure has long past from being an leading edge method of pituitary adenomas to having develop into the traditional approach for a complete number of sellar and para-sellar lesions.The authors contributing to this ebook expertly element the state of the art remedy of sufferers with pituitary adenomas, overlaying operative techniques, peri-operative administration, surgical pathology in addition to the more recent extensions comparable to photo suggestions and endoscopy. additionally they determine the complementary roles of radiosurgery and transcranial surgical procedure within the method of sellar and suprasellar tumors. furthermore the textual content supplies a glimpse at what the long run may possibly carry for the therapy of such tumors. the current quantity of Frontiers of Hormone study might be of serious price for endocrinologists, neurosurgeons, neuropathologists, neuro-ophthalmologists, and otolaryngologists within the therapy of sufferers with pituitary adenomas.
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Additional info for Pituitary Surgery: A Modern Approach (Frontiers of Hormone Research)
Example text
Exceptional care must be taken with regard to effecting a watertight dural seal and skull base reconstruction. Interhemispheric Transcallosal Approach This approach is usually only necessary for large septated craniopharyngiomas [56], for tumors exclusively in the third ventricle or for tumors extending up to the foramen of Monro (fig. 12). Dilatation of the lateral ventricles becomes advantageous in the exposure. Care must be taken to avoid excessive manipulation of the fornix and to preserve both the thalamostriate and internal cerebral veins.
Bipolar electrocoagulation is often effective, however, the combination of electrocautery with surgical clips is sometimes necessary. The sinus must be Extended Transsphenoidal Approach 41 Fig. 12. Schematic drawing of sellar and sphenoid sinus packing with fat. From Cappabianca et al. [55]. thoroughly coagulated prior to sectioning. The transection of the sinus may be performed in steps, with bipolar coagulation performed followed by partial sectioning of the sinus until it is completely divided.
J Clin Endocrinol Metab 2002;87:2745–2750. Yasargil MG: Microneurosurgery. Stuttgart, Thieme, 1984, vol 2. Hoffman HJ, De Silva M, Humphreys RP, Drake JM, Smith ML, Blaser SI: Aggressive surgical management of craniopharyngiomas in children. J Neurosurg 1992;76:47–52. Patterson RH Jr, Danylevich A: Surgical removal of craniopharyngiomas by a transcranial approach through the lamina terminalis and sphenoid sinus. Neurosurgery 1980;7:111–117. Steno J, Malacek M, Bizik I: Tumor-third ventricular relationships in supradiaphragmatic craniopharyngiomas: correlation of morphological, magnetic resonance imaging, and operative findings.