A review of the endoscopic approach to the pituitary through the sphenoid sinus

Author(s):  
Marc R. Rosen ◽  
Kapil Saigal ◽  
James Evans ◽  
William M. Keane

1995 ◽  
Vol 113 (2) ◽  
pp. P168-P168
Author(s):  
Alan Keyes ◽  
William E. Bolger ◽  
Donald C. Lanza


2020 ◽  
Vol 134 ◽  
pp. 211-214
Author(s):  
Mohammad Ghorbani ◽  
Christoph J. Griessenauer ◽  
Christoph Wipplinger ◽  
Hesam Abdolhoseinpour ◽  
Reza Bahrami ◽  
...  


2014 ◽  
Vol 128 (9) ◽  
pp. 791-796 ◽  
Author(s):  
A S Elhamshary ◽  
H E Romeh ◽  
M F Abdel-Aziz ◽  
S M Ragab

AbstractObjective:To develop an algorithm for selecting the optimal endoscopic approach for benign sphenoid lesions.Methods:Charts of 392 patients were reviewed and categorised according to disease nature and extent as follows: group 1 comprised isolated sphenoid sinus lesion cases, group 2 consisted of pansinus lesion cases and group 3 comprised lateral sphenoid recess lesion cases. Surgical approaches, difficulties and complications were noted.Results:A transnasal approach was employed in 40.8 per cent of cases (23.2 per cent were group 1 patients, 16.1 per cent were group 2 patients and 1.5 per cent were group 3 patients), a transethmoidal approach was utilised in 54.3 per cent of cases (group 2 patients) and a transpterygopalatine fossa approach was selected in 4.9 per cent of cases (group 3 patients). Surgical difficulties were encountered in 11.9, 10.8 and 0 per cent of patients in whom transnasal, transethmoidal or transpterygopalatine approaches were utilised, respectively.Conclusion:Radio-pathological categorisation provided a means of developing an algorithm for selecting the most appropriate endoscopic approach. Transnasal sphenoidotomy should be the first choice of approach whenever applicable. Lateral sphenoid recess non-inflammatory diseases should be managed through a transpterygopalatine fossa approach. Revision surgery does not play a key role in the algorithm.



1998 ◽  
Vol 12 (4) ◽  
pp. 283-288 ◽  
Author(s):  
Michelle R. Aust ◽  
Thomas V. McCaffrey ◽  
John Atkinson

The transseptal/transsphenoidal approach to the pituitary gland has been the most commonly used approach for resection of pituitary adenomas for the last 50 years. This procedure has a low morbidity and provides direct midline access to the sella and pituitary gland. Recent advancements in endoscopic surgery, however, suggest that a lower morbidity approach to the sella would be possible via transnasal endoscopic route. Prior reports have confirmed effectiveness of this approach to the pituitary gland and we report here an early series of endoscopic transnasal pituitary surgery from our institution. We report seven cases of transnasal endoscopic pituitary surgery. Our technique consists of endoscopic exposure of the sphenoid ostium unilaterally, excision of the posterior septum anterior to the rostrum of the sphenoid sinus with resection of the sphenoid rostrum for bilateral exposure of the sphenoid sinus. A specially designed nasal speculum is positioned to displace the posterior septum and lateralize the middle turbinates, permitting direct midline exposure of the sphenoid sinus and sella. We have progressively modified the technique over the seven cases that we present and will discuss our specific instrumentation, indications, and technique for this procedure. We have encountered one cerebrospinal fluid leak in this series. Patient satisfaction has been high and hospitalization is less than with the conventional transseptal approach, averaging 1 day. Our impression is that the transnasal endoscopic approach to pituitary adenomas is a safe technique with reduced morbidity permitting shortened hospital stay.



2021 ◽  
Vol 15 (9) ◽  
pp. 2876-2879
Author(s):  
Ikram Ullah ◽  
Anees Ur Rehman ◽  
Saulat Sarfraz ◽  
Sarfraz Latif ◽  
Zia Us Salam Qazi ◽  
...  

Background: Anatomical position of sphenoid sinus, sellar and parasellar regions are located in the skull base having difficulty to approach due to presence of vital structures in its proximity. The presence of carotid artery and optic nerve in its lateral wall make the situation difficult due to lack of illumination and visual limitation. In the past traditional techniques to approach this region like external ethmoidectomy, transseptal transsphenoidal routes were used causing significant trauma, bleeding and risk of possible complication in skull base region. Aim: to access the efficacy and safety of the endonasal endoscopic approach to the sphenoid sinus Method: This study was done in the department of ENT Shaikh Zayed hospital Lahore, 33 patients who were diagnosed to have lesions involving sphenoid sinus. Detailed history, thorough ENT examination, relative investigations were done and all were managed naso-endoscopically. Results: The review of these cases showed that the endoscopic technique was found to have the advantages of being minimally invasive with no external incisions. There is less trauma to the patient, no need for operating microscope or intraoperative image intensifier. Conclusion: The conclusion of our study showed that naso-endoscopes are excellent tools for better visualization due to availability of different angled scopes and good illumination. The disease is better assessed and cleared identifying landmarks with quicker postoperative recovery and lesser overall morbidity. Over the last few years, endoscopic approach to these regions has gained much popularity because of advances in optics, endoscopes and illumination. Keywords: Endoscopic sinus surgery, sphenoid sinus



2003 ◽  
Vol 24 (5) ◽  
pp. 317-322 ◽  
Author(s):  
ToddT Kingdom ◽  
John M DelGaudio


1997 ◽  
Vol 8 (3) ◽  
pp. 159-163 ◽  
Author(s):  
Frank A. Papay ◽  
Jeannine M. Stein ◽  
R. L. Patrick Rhoten ◽  
Mark Luciano ◽  
James Zins ◽  
...  


2018 ◽  
Vol 79 (S 01) ◽  
pp. S1-S188
Author(s):  
Joao Mangussi-Gomes ◽  
Huy Truong ◽  
Joao Belo ◽  
Paul Gardner ◽  
Eric Wang ◽  
...  


1999 ◽  
Vol 120 (3) ◽  
pp. 308-313 ◽  
Author(s):  
William E. Bolger ◽  
Alan S. Keyes ◽  
Donald C. Lanza


2016 ◽  
Vol 8 (2) ◽  
pp. 84-87
Author(s):  
Gauri Belsare ◽  
Archana S Nair ◽  
Snehal Sakhale

ABSTRACT Intraorbital foreign body extending to sinuses is rare; often such cases are associated with multiple ocular and orbital morbidities. Retained organic foreign bodies can cause severe inflammation and are detected earlier, whereas inorganic foreign bodies are inert and well tolerated except copper. The management of posteriorly located orbital foreign bodies is a therapeutic dilemma. We report an unusual case of posterior orbital foreign body extending to the ethmoids and sphenoid sinus exclusively removed by transnasal endoscopic approach. Transnasal endoscopic approach can be used as an effective and efficient approach for the removal of orbital foreign bodies lodged on the medial side of the orbit. This approach is recommended in all the cases of foreign bodies in the craniofacial region provided that it is approachable through endoscope and expertise and facilities are available. How to cite this article Belsare G, Nair AS, Sakhale S. Orbitoethmoid Metallic Foreign Body. Int J Otorhinolaryngol Clin 2016;8(2):84-87.



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