Endoscopic Endonasal Approach for Pituitary Tumor Resection

Video Type: CVideo
  • 2-5 min videos of a particular surgery or technique. These again show major events in the surgery
  • Clearly annotated and narration is a must in these videos
  • These have clear but concise abstracts are not able to be indexed in PubMed
  • Distributed in newsletters, featured on our website and social media
  • Peer reviewed

Author: Walter Jean
Published:
Specialties: Neurosurgery, Otolaryngology, Rhinology Skullbased
Schools: George Washington University
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Basic Info

Contributors: Timothy R. DeKlotz

With the widespread use of the endoscope in pituitary surgery, many technical nuances have emerged. Some surgeons still use a sublabial incision and a speculum, despite using the endoscope for visualization, while others favor approaches that are purely endonasal. Some surgical teams, using an endoscope-holder, work sequentially and individually, while others prefers two surgeons working together simultaneously. In this video, we demonstrate an endoscopic endonasal approach, in which the tumor resection is performed with a 4-hand technique with both surgeons working simultaneously.

DOI#: http://dx.doi.org/10.17797//bdxmmtst16

Advanced

Procedure

Endoscopic Endonasal Approach for Pituitary Tumor Resection

Indications

adenoma of the pituitary gland

Contraindications

prolactinomas amendable to medical therapy

Instrumentation

Setup

Preoperative Workup

visual field test
endocrine laboratory tests (pituitary panel)

Anatomy and Landmarks

os the sphenoid sinus
floor of the sella turcica
optico-carotid recess
planum sphenoidale

Advantages/Disadvantages

Advantage: fast healing for the patient, no incision
Disadvantage: possible CSF leak, potential injury to carotid artery more difficult to control

Complications/Risks

Risks: post-operative CSF leak, endocrinopathy

Disclosure of Conflicts

Risks: post-operative CSF leak, endocrinopathy

Acknowledgements

References

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