scholarly journals Infrasellar Endoscopic Endonasal Approach for a Pituitary Adenoma Extending into the Third Ventricle, with Anterior Displacement of the Pituitary Gland

2018 ◽  
Vol 79 (S 02) ◽  
pp. S233-S234
Author(s):  
Georgios Zenonos ◽  
Eric Wang ◽  
Juan Fernandez-Miranda
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Outcome Measures ◽  
Third Ventricle ◽  
Visual Fields ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Anterior Displacement ◽  
The Third

Objectives The current video presents the nuances of the infrasellar endoscopic endonasal approach for a pituitary adenoma extending into the third ventricle, with anterior displacement of the pituitary gland. Design The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon at a teaching academic institution. Participants The case refers to 73-year-old female patient who was found to have a sellar mass after failure of vision to improve with cataract surgery. She also reported a several-month history of progressive loss of vision along with daily retro-orbital headaches. The adenoma extended into the clivus as well as in the retrosellar and suprasellar regions, eroding into the floor of the third ventricle. The normal gland was displaced anteriorly. Main Outcome Measures The main outcome measures consisted of reversal of patient symptoms (headaches and visual disturbance), recurrence-free survival based on imaging, as well as absence of any complications. Results The patient's headaches and visual fields improved. There was no evidence of recurrence. Conclusion The infrasellar endoscopic endonasal approach is safe and effective for pituitary adenomas extending into the third ventricle, with anterior displacement of the pituitary gland.The link to the video can be found at: https://youtu.be/zp_06mEyRvY.

scholarly journals Extended Endoscopic Endonasal Resection of a Suprasellar and Third Ventricular Retrochiasmatic Craniopharyngioma with a Narrow Pituitary Gland–Optic Chiasm Interval: Techniques to Optimize Resection

2018 ◽  
Vol 79 (S 03) ◽  
pp. S252-S253
Author(s):  
Tyler Kenning ◽  
Carlos Pinheiro-Neto
Keyword(s):  
Pituitary Gland ◽  
Third Ventricle ◽  
Mass Effect ◽  
Optic Chiasm ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Posterior Aspect ◽  
Endoscopic Endonasal ◽  
The Third ◽  
Extended Endoscopic Approach

AbstractThe extended endoscopic endonasal approach can be utilized to surgically treat pathology within the suprasellar space. This relies on a sufficient corridor and interval between the superior aspect of the pituitary gland and the optic chiasm. Tumors located in the retrochiasmatic space and within the third ventricle, however, may not have a widened interval through which to work. With mass effect on the superior and posterior aspect of the optic chiasm, the corridor between the chiasm and the pituitary gland might even be further narrowed. This may negate the possibility of utilizing the endoscopic endonasal approach for the management of pathology in this location. We present a case of a retrochiasmatic craniopharyngioma with a narrow resection corridor that was treated with the extended endoscopic approach and we review techniques to potentially overcome this limitation.The link to the video can be found at: https://youtu.be/ogRZj-aBqeQ.

Extended Endoscopic Endonasal Approach to the Third Ventricle: Multimodal Anatomical Study with Surgical Implications

2015 ◽  
Vol 84 (2) ◽  
pp. 267-278 ◽  
Author(s):  
Luigi Maria Cavallo ◽  
Alberto Di Somma ◽  
Matteo de Notaris ◽  
Alberto Prats-Galino ◽  
Salih Aydin ◽  
...  
Keyword(s):  
Third Ventricle ◽  
Anatomical Study ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
The Third

The endoscopic endonasal approach for the management of craniopharyngiomas involving the third ventricle

2012 ◽  
Vol 36 (1) ◽  
pp. 27-38 ◽  
Author(s):  
Luigi Maria Cavallo ◽  
Domenico Solari ◽  
Felice Esposito ◽  
Paolo Cappabianca
Keyword(s):  
Third Ventricle ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
The Third

Outcomes of the endoscopic endonasal approach for tumors in the third ventricle or invading the third ventricle

2021 ◽  
Vol 90 ◽  
pp. 302-310
Author(s):  
Youngbeom Seo ◽  
Yong Hwy Kim ◽  
Jung Hee Kim ◽  
Doo-Sik Kong ◽  
Yun-Sik Dho ◽  
...  
Keyword(s):  
Third Ventricle ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
The Third

Endoscopic endonasal approach for brainstem cavernous malformation

2019 ◽  
Vol 1 (2) ◽  
pp. V2
Author(s):  
Ezequiel Goldschmidt ◽  
Andrew S. Venteicher ◽  
Maximiliano Nuñez ◽  
Eric Wang ◽  
Carl Snyderman ◽  
...  
Keyword(s):  
Cavernous Malformation ◽  
Motor Evoked Potentials ◽  
Lateral Displacement ◽  
Third Ventricle ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
High Definition ◽  
Endoscopic Endonasal ◽  
Transcallosal Approach ◽  
Postoperative Mri

This 25-year-old woman presented after a second hemorrhage from a mesencephalic cavernous malformation. High-definition fiber tracking demonstrated lateral displacement of the corticospinal tracts, making a midline approach ideal. The lesion appeared to present to the third ventricle, but a transcallosal approach was abandoned due to the posterior third ventricular location and after FIESTA imaging revealed a superior and medial rim of normal parenchyma that would have to be transgressed to access the malformation. An endoscopic endonasal approach with interdural pituitary hemitransposition was performed. The interpeduncular cistern was accessed and the thalamoperforating arteries dissected to access the cavernous malformation that was completely removed in a piecemeal fashion. The patient’s preexisting internuclear ocular palsies and hemiparesis were slightly worsened after surgery as predicted by a drop in anterior tibialis motor evoked potentials. Postoperative MRI showed no infarct, and the hemiparesis was back to baseline at 1-month follow-up.The video can be found here: https://youtu.be/e6203R9HHmk.

Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum

2008 ◽  
Vol 108 (4) ◽  
pp. 715-728 ◽  
Author(s):  
Amin B. Kassam ◽  
Paul A. Gardner ◽  
Carl H. Snyderman ◽  
Ricardo L. Carrau ◽  
Arlan H. Mintz ◽  
...  
Keyword(s):  
Classification Scheme ◽  
Third Ventricle ◽  
Optic Chiasm ◽  
Tumor Classification ◽  
Type I ◽  
Endonasal Approach ◽  
Transnasal Approach ◽  
Endoscopic Endonasal ◽  
The Third ◽  
Expanded Endonasal Approach

Object Craniopharyngiomas are notoriously difficult to treat. Surgeons must weigh the risks of aggressive resection against the long-term challenges of recurrence. Because of their parasellar location, often extending well beyond the sella, these tumors challenge vision and pituitary and hypothalamic function. New techniques are needed to improve outcomes in patients with these tumors while decreasing treatment morbidity. An endoscopic expanded endonasal approach (EEA) is one such technique that warrants understanding and evaluation. The authors explain the techniques and approach used for the endoscopic endonasal resection of suprasellar craniopharyngiomas and introduce a tumor classification scheme. Methods The techniques and approach used for the endoscopic, endonasal resection of suprasellar craniopharyngiomas is explained, including the introduction of a tumor classification scheme. This scheme is helpful for understanding both the appropriate expanded approach as well as relevant involved anatomy. Results The classification scheme divides tumors according to their suprasellar extension: Type I is preinfundibular; Type II is transinfundibular (extending into the stalk); Type III is retroinfundibular, extending behind the gland and stalk, and has 2 subdivisions (IIIa, extending into the third ventricle; and IIIb, extending into the interpeduncular cistern); and Type IV is isolated to the third ventricle and/or optic recess and is not accessible via an endonasal approach. Conclusions The endoscopic EEA requires a thorough understanding of both sinus and skull base anatomy. Moreover, in its application for craniopharyngiomas, an understanding of tumor growth and extension with respect to the optic chiasm and infundibulum is critical to safely approach the lesion via an endonasal route.

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