Endonasal Endoscopic Surgery for Pituitary Adenoma

Abstract BACKGROUND AND IMPORTANCE A pituitary adenoma patient who underwent surgery in our department was diagnosed with COVID-19 and 14 medical staff were confirmed infected later. This case has been cited several times but without accuracy or entirety, we feel obligated to report it and share our thoughts on the epidemic among medical staff and performing endonasal endoscopic surgery during COVID-19 pandemic. CLINICAL PRESENTATION The patient developed a fever 3 d post endonasal endoscopic surgery during which cerebrospinal leak occurred, and was confirmed with SARS-CoV-2 infection later. Several medical staff outside the operating room were diagnosed with COVID-19, while the ones who participated in the surgery were not. CONCLUSION The deceptive nature of COVID-19 results from its most frequent onset symptom, fever, a cliché in neurosurgery, which makes it hard for surgeons to differentiate. The COVID-19 epidemic among medical staff in our department was deemed as postoperative rather than intraoperative transmission, and attributed to not applying sufficient personal airway protection. Proper personal protective equipment and social distancing between medical staff contributed to limiting epidemic since the initial outbreak. Emergency endonasal endoscopic surgeries are feasible since COVID-19 is still supposed to be containable when the surgeries are performed in negative pressure operating rooms with personal protective equipment and the patients are kept under quarantine postoperatively. However, we do not encourage elective surgeries during this pandemic, which might put patients in conditions vulnerable to COVID-19.

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Lumbar Drains Decrease the Risk of Post-Operative Cerebrospinal Fluid (CSF) Leak Following Extended Endonasal Endoscopic Surgery for Suprasellar Meningiomas in Patients with High BMI

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0036-1579969 ◽

2016 ◽

Vol 77 (S 01) ◽

Cited By ~ 1

Author(s):

Salomon Cohen ◽

Theodore Schwartz ◽

Vijay Anand

Keyword(s):

Cerebrospinal Fluid ◽

Endoscopic Surgery ◽

Csf Leak ◽

Endonasal Endoscopic Surgery ◽

High Bmi

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Symptom assessment after nasal irrigation with xylitol in the postoperative period of endonasal endoscopic surgery

Brazilian Journal of Otorhinolaryngology ◽

10.1016/j.bjorl.2020.05.023 ◽

2020 ◽

Author(s):

Caroline Feliz Fonseca Sepeda da Silva ◽

Flávia Emilly Rodrigues da Silva ◽

Henrique Furlan Pauna ◽

Johann Gustavo Guilhermo Melcherts Hurtado ◽

Marco Cesar Santos

Keyword(s):

Endoscopic Surgery ◽

Postoperative Period ◽

Symptom Assessment ◽

Nasal Irrigation ◽

Endonasal Endoscopic Surgery

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A Case of Endonasal Endoscopic Surgery for Intraorbital Metastasis of Gastric Ring Cell Carcinoma

Ear Nose & Throat Journal ◽

10.1177/0145561320943372 ◽

2020 ◽

pp. 014556132094337

Author(s):

Yukinori Tsuruta ◽

Yohei Maeda ◽

Yoshiyuki Kitaguchi ◽

Masaki Hayama ◽

Satoshi Nojima ◽

...

Keyword(s):

Cell Carcinoma ◽

Endoscopic Surgery ◽

Vision Loss ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Orbital Decompression ◽

Endonasal Endoscopic Surgery ◽

Orbital Wall ◽

Signet Ring ◽

Ring Cell

Gastric signet ring cell carcinoma has well-known metastatic features, including peritoneal dissemination and carcinomatous lymphangitis of the lung, but no intraorbital metastases were reported previously. A woman in her 60s developed left eye pain, sudden vision loss, and headache 12 years after gastric cancer treatment. Symptoms did not improve despite steroid pulses. Craniotomy showed no malignant findings. The patient was referred to our department for symptomatic relief and biopsy due to the lack of a definitive diagnosis and no improvement in her ocular pain. Endonasal endoscopic surgery was performed for diagnostic purposes and to relieve symptoms through orbital decompression. Preoperative computed tomography examination revealed a tumor at the left medial orbit, extending to the orbital apex. Orbital decompression through the open left medial orbital wall was performed with biopsy of the intraorbital tumor. Pathological findings were consistent with metastatic signet ring cell carcinoma. Pain and subjective improvement of visual acuity were noted the day after surgery. Twelve months postoperatively, diplopia remains, but there has been no worsening of symptoms.

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Endonasal endoscopic surgery for squamous cell carcinoma of the sinonasal cavities and skull base: Oncologic outcomes based on treatment strategy and tumor etiology

Head & Neck ◽

10.1002/hed.23731 ◽

2014 ◽

Vol 37 (8) ◽

pp. 1163-1169 ◽

Cited By ~ 35

Author(s):

John R. de Almeida ◽

Shirley Y. Su ◽

Maria Koutourousiou ◽

Francisco Vaz Guimaraes Filho ◽

Juan C. Fernandez Miranda ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Skull Base ◽

Squamous Cell ◽

Endoscopic Surgery ◽

Treatment Strategy ◽

Oncologic Outcomes ◽

Endonasal Endoscopic Surgery

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Endonasal Endoscopic Surgery in the Management of Sinonasal and Anterior Skull Base Malignancies

Head and Neck Pathology ◽

10.1007/s12105-016-0687-8 ◽

2016 ◽

Vol 10 (1) ◽

pp. 13-22 ◽

Cited By ~ 18

Author(s):

Christopher R. Roxbury ◽

Masaru Ishii ◽

Jeremy D. Richmon ◽

Ari M. Blitz ◽

Douglas D. Reh ◽

...

Keyword(s):

Skull Base ◽

Endoscopic Surgery ◽

Anterior Skull Base ◽

Endonasal Endoscopic Surgery

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Precision Postoperative Radiotherapy in Sinonasal Carcinomas after Endonasal Endoscopic Surgery

Cancers ◽

10.3390/cancers13194802 ◽

2021 ◽

Vol 13 (19) ◽

pp. 4802

Author(s):

Juliette Thariat ◽

Florent Carsuzaa ◽

Pierre Yves Marcy ◽

Benjamin Verillaud ◽

Ludovic de Gabory ◽

...

Keyword(s):

Endoscopic Surgery ◽

Malignant Tumors ◽

Postoperative Radiotherapy ◽

Intensity Modulated Radiotherapy ◽

Particle Therapy ◽

Sinonasal Cancer ◽

Endonasal Endoscopic Surgery ◽

Charged Particle Therapy ◽

Recent Developments ◽

Oncological Results

Radiotherapy plays an important role in the treatment of sinonasal cancer, mainly in the adjuvant setting after surgical resection. Many technological approaches have been described, including intensity-modulated radiotherapy, concomitant chemoradiotherapy, charged particle therapy or combined approaches. The choice is based on general criteria related to the oncological results and morbidity of each technique and their availability, as well as specific criteria related to the tumor (tumor extensions, pathology and quality of margins). The aims of this review are: (i) to provide an overview of the radiotherapy techniques available for the management of sinonasal malignant tumors and (ii) to describe the constraints and opportunities of radiotherapy owing to the recent developments of endonasal endoscopic surgery. The indication and morbidity of the different techniques will be discussed based on a critical literature review.

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Summary Endonasal Endoscopic Surgery for Pituitary Tumor

JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY ◽

10.5106/jjshns.8.69 ◽

1998 ◽

Vol 8 (1) ◽

pp. 69-73 ◽

Cited By ~ 1

Author(s):

Shin-ichi Haruna ◽

Masaya Fukami ◽

Hiroshi Moriyama ◽

Masami Kamio

Keyword(s):

Endoscopic Surgery ◽

Pituitary Tumor ◽

Endonasal Endoscopic Surgery

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Mucoperichondrial Flap as a Closure Technique for Expanded Endonasal Endoscopic Surgery

Skull Base ◽

10.1055/s-2011-1274288 ◽

2011 ◽

Vol 21 (S 01) ◽

Author(s):

Stephan Munich ◽

Andrew Fabiano ◽

Nestor Rigual ◽

Rohan Wijewickrama ◽

Robert Fenstermaker

Keyword(s):

Endoscopic Surgery ◽

Closure Technique ◽

Endonasal Endoscopic Surgery

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Expanded Endonasal Endoscopic Surgery in Suprasellar Craniopharyngiomas: A Retrospective Analysis of 43 Surgeries Including Recurrent Cases

Operative Neurosurgery ◽

10.1093/ons/opy356 ◽

2019 ◽

Vol 17 (2) ◽

pp. 132-142 ◽

Cited By ~ 8

Author(s):

Ivan Radovanovic ◽

Amir R Dehdashti ◽

Mazda K Turel ◽

Joao Paulo Almeida ◽

Bruno L Godoy ◽

...

Keyword(s):

Diabetes Insipidus ◽

Endoscopic Surgery ◽

Anterior Pituitary ◽

Cohort Analysis ◽

Cerebrospinal Fluid Leak ◽

Pituitary Insufficiency ◽

Total Resection ◽

Endoscopic Endonasal ◽

Repeat Surgery ◽

Endonasal Endoscopic Surgery

AbstractBACKGROUNDThe role of expanded endonasal endoscopic surgery for primary and recurrent craniopharyngioma is not yet fully established.OBJECTIVETo report and evaluate our experience with the endoscopic endonasal approach (EEA) for the resection of primary and recurrent craniopharyngiomas.METHODSThis is a retrospective cohort analysis of 43 consecutive EEA procedures in 40 patients operated from September 2006 to February 2012 for suprasellar craniopharyngiomas. In 21 patients (48.8%) the disease was recurrent. We have assessed the surgical results, visual, endocrinological, and functional outcomes and resection rates in this patient cohort.RESULTSAt presentation, 31 (72.1%) patients had visual deficits, 15 patients (34.9%) complained of headaches, 25 patients (58.1%) had anterior pituitary insufficiency, and 14 (32.5%) had diabetes insipidus. Total resection was achieved in 44.2% surgeries, of which 77.3% were in primary lesions and 9.5% in recurrent lesions (P < .001). Vision improved in 92.6% patients and worsened in 2.3%. Complications other than vision were encountered in 25.6% including 9/43 cerebrospinal fluid leak, 2/43 meningitis. A total of 51.9% of patients with preoperative residual anterior pituitary function had new anterior pituitary deficiencies and 42.8% had new diabetes insipidus. There was no mortality. Six patients (14%) had recurrence of disease during the follow-up period (mean 56.8 mo), 5 of which required repeat surgery.CONCLUSIONThe EEA can be integrated in the overall management of both primary and recurrent craniopharyngiomas with good results; however, in our series recurrent surgery was associated with significantly lower rates of gross total resection.

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