Article
Medicine, General & Internal
Chao Tao, Gang Cheng, Yunxiang Chen, Peiyuan Gu, Weixing Hu
Summary: This study retrospectively reviewed the tumor characteristics and surgical outcomes of a consecutive series of endoscopic endonasal approach pituitary adenomas resection mainly performed by a single author between March 2018 and June 2019. The results demonstrated that EEA is an effective and safe approach for resecting pituitary adenomas with satisfactory gross total resection rate, near-total resection rate, and endocrinological remission rate, while maintaining minimal nasal injury.
Article
Oncology
Marta Araujo-Castro, Alberto Acitores Cancela, Carlos Vior, Eider Pascual-Corrales, Victor Rodriguez Berrocal
Summary: The study aimed to compare the accuracy of the Knosp, revised-Knosp, and Hardy-Wilson classifications in predicting surgical outcomes for pituitary adenomas (PAs) undergoing endoscopic endonasal transsphenoidal (EET) surgery. The results showed that the Knosp classification had the highest diagnostic accuracy in predicting surgical cure and the risk of complications, while the invasion Hardy-Wilson classification lacked utility in this regard.
FRONTIERS IN ONCOLOGY
(2022)
Article
Surgery
Jinxiang Huang, Xinjie Hong, Zheng Cai, Qian Lv, Ying Jiang, Wei Dai, Guohan Hu, Yong Yan, Juxiang Chen, Xuehua Ding
Summary: This study aimed to investigate the learning curve of endoscopic transsphenoidal surgery for pituitary adenoma. The results showed that complex operations might require a prolonged learning curve.
FRONTIERS IN SURGERY
(2023)
Article
Clinical Neurology
Akihiro Inoue, Satoshi Suehiro, Takanori Ohnishi, Naoya Nishida, Taro Takagi, Hironobu Nakaguchi, Teruki Miyake, Seiji Shigekawa, Hideaki Watanabe, Bunzo Matsuura, Riko Kitazawa, Takeharu Kunieda
Summary: This retrospective analysis investigated suitable imaging features for surgical methods and pitfalls in simultaneous combined surgery for giant pituitary adenoma. Both endoscopic endonasal transsphenoidal surgery alone and simultaneous combined endonasal and transcranial surgery showed good results when matched with suitable imaging features. However, tumors with extensive multi-directional extension and full encasement of neurovascular structures were not effectively resected even with combined surgery.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2022)
Article
Neurosciences
Domenico Solari, Luigi Maria Cavallo, Chiara Graziadio, Sergio Corvino, Ilaria Bove, Felice Esposito, Paolo Cappabianca
Summary: Giant pituitary adenomas present a surgical challenge due to their growth patterns and locations. There is no consensus on the optimal surgical strategy, but transcranial or transsphenoidal approaches are commonly used. Endoscopic endonasal approach is preferred, but transcranial approach is more suitable when the tumor has significant intracranial extension. Accurate preoperative evaluation and individualized treatment plans are crucial for long-term effectiveness.
Article
Clinical Neurology
Salomon Cohen-Cohen, Desmond A. Brown, Benjamin T. Himes, Lydia P. Wheeler, Michael W. Ruff, Brittny T. Major, Naykky M. Singh Ospina, John L. D. Atkinson, Fredric B. Meyer, Irina Bancos, William F. Young Jr, Jamie J. Van Gompel
Summary: In patients with MEN1, the prevalence of pituitary adenomas is higher in females than in males. Functional adenomas, especially prolactin-secreting adenomas, are more common than nonfunctional ones. Most asymptomatic nonfunctional adenomas can be safely followed, with only a small percentage progressing to require surgery.
JOURNAL OF NEUROSURGERY
(2021)
Article
Endocrinology & Metabolism
Nasrin Al-Shamkhi, Katarina Berinder, Henrik Borg, Pia Burman, Per Dahlqvist, Charlotte Hoybye, Daniel S. Olsson, Oskar Ragnarsson, Bertil Ekman, Britt Eden Engstrom
Summary: Objective data on pituitary function before and after transsphenoidal surgery in nonfunctioning pituitary adenomas were inconsistent. This study found that adrenocorticotrophic hormone deficiency increased significantly at 1 year postoperatively, while other axis function changes were not significant. Therefore, continuous individual evaluations are needed during longer follow-up of patients operated for NFPA.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2023)
Article
Clinical Neurology
Zhijie Pei, Jiaxing Wang, Shuwen Mu, Tianshun Feng, Meina Wang, Shentong Yu, Liangfeng Wei, Yi Fang, Shousen Wang
Summary: The study found that factors such as Knosp grade 3-4, a greater proportion of suprasellar tumor volume, and evidence of invasion of the cavernous sinus during surgery make it more difficult to completely remove giant pituitary adenomas.
FRONTIERS IN NEUROLOGY
(2022)
Article
Clinical Neurology
Janelle Cyprich, Dhiraj J. Pangal, Martin Rutkowski, Daniel A. Donoho, Mark Shiroishi, Chia-Shang Jason Liu, John D. Carmichael, Gabriel Zada
Summary: The study found that patients presenting to safety-net hospitals were more likely to be uninsured or on Medicaid, had larger and more advanced pituitary tumors, and were more likely to present with symptoms such as headaches and vision loss.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Austin C. Robbins, K. Austin Winter, Zachary P. Smalley, Saniya Godil, Gustavo Luzardo, Chad W. Washington, Daniel M. Prevedello, Scott P. Stringer, Marcus Zachariah
Summary: This study describes the use of a side-firing ultrasound probe in the resection of giant pituitary macroadenomas. The side-firing ultrasound probe allows for identification of the diaphragma sellae, confirmation of optic chiasm decompression, identification of vascular structures related to tumor invasion, and maximizing extent of resection in giant pituitary macroadenomas.
WORLD NEUROSURGERY
(2023)
Article
Clinical Neurology
Alexander Micko, Matthew S. Agam, Andrew Brunswick, Ben A. Strickland, Martin J. Rutkowski, John D. Carmichael, Mark S. Shiroishi, Gabriel Zada, Engelbert Knosp, Stefan Wolfsberger
Summary: The aim of this study is to assess the treatment strategies and outcomes of giant pituitary adenomas (GPAs) in the era of endoscopic transsphenoidal surgery (ETS). The study found that the extent of resection is dependent on the morphology of the GPA. Treatment strategies for residual pituitary adenoma include early transcranial reoperation, delayed endoscopic transsphenoidal/transcranial reoperation, and adjuvant radiosurgery.
JOURNAL OF NEUROSURGERY
(2022)
Editorial Material
Clinical Neurology
Baha'eddin A. Muhsen, Edinson Najera, Zachary Cappello, Hamid Borghei-Razavi, Pablo F. Recions
Summary: This article discusses the surgical challenges and higher surgical complications associated with giant pituitary adenoma compared to non-giant pituitary adenoma. Symptoms arise from compression of neighboring structures as well as hypopituitarism. The endoscopic endonasal approach is an effective method for tumor resection, but the treatment of high-flow cerebrospinal fluid leak should be taken into consideration.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2023)
Article
Clinical Neurology
Denise Loeschner, Andrei Enciu, Geralf Kellner, Almuth Meyer, Henri Wallaschofski, Anna Cecilia Lawson McLean, Ruediger Gerlach
Summary: This retrospective study analyzed the perioperative course and clinical outcome of patients with large and giant pituitary adenoma who underwent endoscopic endonasal transsphenoidal surgery. The study found that there was no significant difference in resection rates between two-dimensional and three-dimensional endoscopic systems. Visual improvement, CSF leak, surgical complications, and patient mortality were not associated with the surgical visualization and technique.
NEUROSURGICAL REVIEW
(2023)
Article
Oncology
Salvatore Chibbaro, Francesco Signorelli, Davide Milani, Helene Cebula, Antonino Scibilia, Maria Teresa Bozzi, Raffaella Messina, Ismail Zaed, Julien Todeschi, Irene Ollivier, Charles Henry Mallereau, Guillaume Dannhoff, Antonio Romano, Francesco Cammarota, Franco Servadei, Raoul Pop, Seyyid Baloglu, Giovanni Battista Lasio, Florina Luca, Bernard Goichot, Francois Proust, Mario Ganau
Summary: Giant pituitary adenomas are highly invasive tumors, with surgery being the mainstay of treatment. Extended endoscopic endonasal approaches may offer a valuable treatment option for these challenging lesions, with high resection rates, visual improvement, and low complication rates.
Article
Surgery
Junyong Wu, Binbin Zhang, Dongqi Shao, Shuxin Ji, Yu Li, Shan Xie, Zhiquan Jiang
Summary: This study investigated the use and effectiveness of endoscopic transnasal, transsphenoidal surgery for the treatment of macroadenomas and giant pituitary adenomas. The surgical results of 429 patients were evaluated, and the experiences and lessons learned from treatment complications were assessed. The study found that neuroendoscopic treatment is a safe and effective method, with improved clinical symptoms and hormone levels post-surgery.
FRONTIERS IN SURGERY
(2022)