Endoscopic transsphenoidal approach to skull base lesions. A clinical prospective study
- PMID: 29455219
- PMCID: PMC6751911
- DOI: 10.17712/nsj.2018.1.20170229
Endoscopic transsphenoidal approach to skull base lesions. A clinical prospective study
Abstract
Objective: To review the patients operated by endoscopic transphenoidal approach for skull base lesions. All the clinical data including age, gender, type of pathology, surgical outcome and surgical complications were studied.
Methods: A clinical prospective study was conducted on 94 cases with skull base lesion that were treated in Neuroscience Hospital in Baghdad, Iraq between October 2011 and December 2016. We followed each patient for an average of 2 years after surgery to determine most common lesion involving the skull base, age and gender distribution, surgical outcome, complications and hospital accommodation. Freeze system of Storz all the cases in the study.
Results: The majority of our patients were between the ages of 20-29 years. Among the 94 patients, 67% had macro adenomas, followed by craniopharyngioma 11%. The mortality rate was 2.1%, Gross total removal was 57.4%. All patients show improvement of the headache after surgery, visual improvement was noticed in 73.4% and hospital accommodation was 2-5 days. Three patients developed cerebrospinal fluid leak, Infection meningitis developed in 3 patients 3.1%, and 2 patients (2.1%) suffered from hormonal disorders and were referred to endocrinologist for therapy. Diabetes insipidus developed as a temporary complication in 4 cases (4.2%).
Conclusion: Trassphenoidal surgery is relatively safe surgery for properly selected patients.
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References
-
- Jane JA, Jr, Han J, Prevedello DM, Jagannathan J, Dumont AS, Laws ER., Jr Perspectives on endoscopic transsphenoidal surgery. Neurosurg Focus. 2005;19:E2. - PubMed
-
- Doglietto F, Prevedello DM, Jane JA, Jr, Han J, Laws ER., Jr Brief history of endoscopic transsphenoidal surgery--from Philipp Bozzini to the First World Congress of Endoscopic Skull Base Surgery. Neurosurg Focus. 2005;19:E3. - PubMed
-
- Tatarana L, Gorgan M, Ciubotaru V, Dricu A, Dediuet A, Ene B, et al. Endoscopic Endonasal Transphenoidal approach in the management of sellar and para sellar lesions: indications and standard surgical Technique (part1) Romanian Neurosurgery. 2010;2:52–63.
-
- Jho HD, Alfieri A. Endoscopic transsphenoidal pituitary surgery: various surgical techniques and recommended steps for procedural transition. Br J Neurosurg. 2000;14:432–440. - PubMed
-
- Baussart B, Aghakhani N, Portier F, Chanson P, Tadié M, Parker F. [Endoscope-assisted microsurgery for invasive endo- and suprasellar pituitary macroadenomas: a consecutive retrospective study with 13 patients] Neurochirurgie. 2005;51:455–463. - PubMed
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