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  1. Article ; Online: Simultaneous Clipping of an Ophthalmic Aneurysm and a Laterally Projecting Paraclinoid Aneurysm Through the Endoscopic Endonasal Approach: 2-Dimensional Operative Video.

    Bao, You Yuan / Wang, Xiang Rong / Xiao, Li Min / Hong, Tao

    Operative neurosurgery (Hagerstown, Md.)

    2023  Volume 25, Issue 3, Page(s) e157–e158

    MeSH term(s) Humans ; Aneurysm/surgery ; Endoscopy
    Language English
    Publishing date 2023-06-12
    Publishing country United States
    Document type Video-Audio Media ; Journal Article
    ZDB-ID 2767575-0
    ISSN 2332-4260 ; 2332-4252
    ISSN (online) 2332-4260
    ISSN 2332-4252
    DOI 10.1227/ons.0000000000000789
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: How I do it: a purely endoscopic endonasal approach for anterior clinoidal meningioma.

    Bao, You Yuan / Xiao, Li Min / Tang, Bin / Hong, Tao

    Acta neurochirurgica

    2023  Volume 165, Issue 2, Page(s) 543–548

    Abstract: Background: Surgery for anterior clinoid meningiomas (ACMs) remains challenging due to their tight adhesion to vital neurovascular and has been traditionally performed through a transcranial approach.: Method: We present the key steps of the ... ...

    Abstract Background: Surgery for anterior clinoid meningiomas (ACMs) remains challenging due to their tight adhesion to vital neurovascular and has been traditionally performed through a transcranial approach.
    Method: We present the key steps of the endoscopic endonasal approach (EEA) for ACMs with a video illustration and figures. The relevant surgical anatomy is described along with the indications and limitations of this approach.
    Conclusion: The EEA offers a good treatment option for selected ACMs. It allows for the removal of involved hyperostotic bone and dural attachments, early identification and control of the neurovascular structure, and avoidance of brain retraction.
    MeSH term(s) Humans ; Meningioma/diagnostic imaging ; Meningioma/surgery ; Meningeal Neoplasms/diagnostic imaging ; Meningeal Neoplasms/surgery ; Neurosurgical Procedures ; Nose/surgery ; Brain
    Language English
    Publishing date 2023-01-14
    Publishing country Austria
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80010-7
    ISSN 0942-0940 ; 0001-6268
    ISSN (online) 0942-0940
    ISSN 0001-6268
    DOI 10.1007/s00701-022-05480-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Extended Endoscopic Endonasal Approach for Giant Pediatric Craniopharyngiomas: Technical Note and Case Series.

    Bao, YouYuan / Pan, LaiSheng / Fu, Jun / Wu, Xiao / Xie, ShenHao / Tang, Bin / Hong, Tao

    Operative neurosurgery (Hagerstown, Md.)

    2024  

    Abstract: Background and objectives: Giant pediatric craniopharyngiomas are rare tumors whose clinical and surgical management is extremely challenging. A variety of open transcranial approaches has been used to resect these lesions. Although there has been an ... ...

    Abstract Background and objectives: Giant pediatric craniopharyngiomas are rare tumors whose clinical and surgical management is extremely challenging. A variety of open transcranial approaches has been used to resect these lesions. Although there has been an increasing acceptance of the endoscopic endonasal approach (EEA) for the resection of pediatric craniopharyngiomas in recent years, many surgeons continue to recommend against the use of the EEA for giant pediatric craniopharyngiomas. This study aimed to evaluate the feasibility of extended EEA for giant craniopharyngiomas in the pediatric population.
    Methods: All consecutive pediatric patients with giant craniopharyngiomas (diameter >4 cm) who underwent endoscopic endonasal surgery at our institution were retrospectively reviewed. Data on demographic information, preoperative assessment, imaging features, surgical results, complications, and recurrences were recorded and analyzed.
    Results: A total of 16 pediatric patients with an average age of 12 years were identified. The mean maximum diameter and volume of the tumors were 4.35 cm and 24.1 cm3, respectively. Gross total resection was achieved in 13 patients (81.3%) and subtotal resection in 3 patients (18.7%). Postoperatively, partial or complete anterior pituitary insufficiency occurred in 100% of patients, and 62.5% developed new-onset diabetes insipidus. Visual function improved in 9 patients (56.3%) and remained stable in 7 patients (43.7%). Postoperative cerebrospinal fluid leakage occurred in 2 patients and was successfully repaired through the EEA. During a mean follow-up of 44.3 months, 18.8% of patients had a >9% increase in body mass index, and 93.8% of patients successfully returned to school or work. Two patients (12.5%) suffered a recurrence. Disease control was achieved in 16 patients (100%) at final follow-up.
    Conclusion: The extended EEA allows adequate access to this challenging tumor and enables complete resection and visual improvement with a reasonable approach-related complication rate.
    Language English
    Publishing date 2024-05-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2767575-0
    ISSN 2332-4260 ; 2332-4252
    ISSN (online) 2332-4260
    ISSN 2332-4252
    DOI 10.1227/ons.0000000000001191
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Association of histological subtype with risk of recurrence in craniopharyngioma patients: a systematic review and meta-analysis.

    Wu, Jie / Wu, Xiao / Yang, You Qing / Ding, Han / Yang, Le / Bao, You Yuan / Zhou, Lin / Yang, Chen Xing / Hong, Tao

    Neurosurgical review

    2021  Volume 45, Issue 1, Page(s) 139–150

    Abstract: It is controversial whether there is a different risk of recurrence between two histological subtypes in craniopharyngioma (CP) patients. Some reported that adamantinomatous craniopharyngioma (ACP) had a higher risk of recurrence than papillary ... ...

    Abstract It is controversial whether there is a different risk of recurrence between two histological subtypes in craniopharyngioma (CP) patients. Some reported that adamantinomatous craniopharyngioma (ACP) had a higher risk of recurrence than papillary craniopharyngioma (PCP), but others reported that there is no significant difference between them. So, we conducted this systematic review and meta-analysis to determine the association between the histological subtype of CP and the rate of recurrence. A comprehensive literature search was undertaken in PubMed, EMBASE, and Web of Science for all English articles published up to November 2020. Recurrence data stratified by ACP and PCP were extracted from studies meeting inclusion criteria. A pooled analysis of the association between the histological subtype of craniopharyngioma and rates of recurrence was performed. Thirteen articles containing 974 patients were included. When stratified by two pathological subtypes, the total recurrence rate of ACP was 26.0% and PCP was 14.1%, which showed ACP associated with a higher risk of tumor recurrence than PCP (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.36, 3.30, P = 0.00). This is the first meta-analysis focusing on histological subtypes of CP. PCP associates with a lower risk of recurrence than ACP, indicating that ACP could act as one of recurrence risk factors for CP patients. Nevertheless, large sample size and well-designed multicenter studies in which the other clinical variables are controlled to determine the histological subtype of CP as an independent recurrence risk factor are needed.
    MeSH term(s) Craniopharyngioma/epidemiology ; Craniopharyngioma/surgery ; Humans ; Pituitary Neoplasms/epidemiology ; Pituitary Neoplasms/surgery
    Language English
    Publishing date 2021-06-22
    Publishing country Germany
    Document type Journal Article ; Meta-Analysis ; Review ; Systematic Review
    ZDB-ID 6907-3
    ISSN 1437-2320 ; 0344-5607
    ISSN (online) 1437-2320
    ISSN 0344-5607
    DOI 10.1007/s10143-021-01563-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Endoscopic Endonasal Supraoptic and Infraoptic Approaches for Complex "Parasuprasellar" Lesions: Surgical Anatomy, Technique Nuances, and Case Series.

    Bao, YouYuan / Yang, YouQing / Zhou, Lin / Xie, ShenHao / Wu, Xiao / Ding, Han / Wu, Jie / Xiao, Limin / Yang, Le / Tang, Bin / Hong, Tao

    Frontiers in oncology

    2022  Volume 12, Page(s) 847250

    Abstract: Objective: The surgical management of lesions involving the lateral area of the suprasellar region, including the lateral aspect of the planum sphenoidale and the tight junction region of the optic canal (OC), anterior clinoid process (ACP), and ... ...

    Abstract Objective: The surgical management of lesions involving the lateral area of the suprasellar region, including the lateral aspect of the planum sphenoidale and the tight junction region of the optic canal (OC), anterior clinoid process (ACP), and internal carotid artery (ICA) and its dural rings, is extremely challenging. Here, these regions, namely, the "parasuprasellar" area, are described from the endonasal perspective. Moreover, the authors introduce two novels endoscopic endonasal supraoptic (EESO) and endoscopic endonasal infraoptic (EEIO) approaches to access the parasuprasellar area.
    Methods: Surgical simulation of the EESO and EEIO approaches to the parasuprasellar area was conducted in 5 silicon-injected specimens. The same techniques were applied in 12 patients with lesions involving the parasuprasellar area.
    Results: The EESO approach provided excellent surgical access to the lateral region of the planum sphenoidale, which corresponds to the orbital gyrus of the frontal lobe. With stepwise bone (OC, optic strut and ACP) removal, dissociation of the ophthalmic artery (OA) and optic nerve (ON), the EEIO approach enables access to the lateral region of the supraclinoidal ICA. These approaches can be used independently or in combination, but are more often employed as a complement to the endoscopic endonasal midline and transcavernous approaches. In clinical application, the EESO and EEIO approaches were successfully performed in 12 patients harboring tumors as well as multiple aneurysms involving the parasuprasellar area. Gross total and subtotal tumor resection were achieved in 9 patients and 1 patient, respectively. For two patients with multiple aneurysms, the lesions were clipped selectively according to location and size. Visual acuity improved in 7 patients, remained stable in 4, and deteriorated in only 1. No postoperative intracranial infection or ICA injury occurred in this series.
    Conclusions: The EESO and EEIO approaches offer original treatment options for well-selected lesions involving the parasuprasellar area. They can be combined with the endoscopic endonasal midline and transcavernous approaches to remove extensive pathologies involving the intrasellar, suprasellar, sphenoid, and cavernous sinuses and even the bifurcation of the ICA. This work for the first time pushes the boundary of the endoscopic endonasal approach lateral to the supraclinoidal ICA and ON.
    Language English
    Publishing date 2022-05-26
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2022.847250
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Nomograms to Predict Endocrinological Deficiency in Patients With Surgically Treated Craniopharyngioma.

    Wu, Jie / Wu, Xiao / Yang, Le / Xie, ShenHao / Tang, Bin / Tong, ZhiGao / Wu, BoWen / Yang, YouQing / Ding, Han / Bao, YouYuan / Zhou, Lin / Hong, Tao

    Frontiers in oncology

    2022  Volume 12, Page(s) 840572

    Abstract: Objective: Postoperative hypopituitarism associated with increased risks of premature mobility and mortality is often encountered in craniopharyngioma patients. The aim of our study is to construct nomograms related to injury types of the hypothalamus- ... ...

    Abstract Objective: Postoperative hypopituitarism associated with increased risks of premature mobility and mortality is often encountered in craniopharyngioma patients. The aim of our study is to construct nomograms related to injury types of the hypothalamus-pituitary axis (HPA) to predict hypopituitarism 1 year after surgery.
    Methods: Craniopharyngioma patients undergoing initial endoscopic endonasal surgery between December 2012 and March 2021 in our center were retrospectively reviewed, and injury types of the HPA were categorized according to intraoperative endoscopic observation. Included patients were randomly divided into a training group and a validation group. Nomograms were established based on the results of multivariate logistic analysis. The predictive performance of the nomograms was evaluated in the training and validation groups.
    Results: A total of 183 patients with craniopharyngioma were enrolled, and seven injury types of the HPA were summarized. Relative to intact HPA, exclusive hypothalamus injury significantly increased the risk of anterior (OR, 194.174; 95% CI, 21.311-1769.253; p < 0.001) and posterior pituitary dysfunction (OR, 31.393; 95% CI, 6.319-155.964; p < 0.001) 1 year after surgery, while exclusively sacrificing stalk infiltrated by tumors did not significantly increase the risk of anterior (OR, 5.633; 95% CI, 0.753-42.133; p = 0.092) and posterior pituitary dysfunction (OR, 1.580; 95% CI, 0.257-9.707; p = 0.621) 1 year after surgery. In the training group, the AUCs of nomograms predicting anterior and posterior pituitary dysfunction 1 year after surgery were 0.921 and 0.885, respectively, compared with 0.921 and 0.880 in the validation group.
    Conclusions: Intact hypothalamus structure is critical in maintaining pituitary function. Moreover, our preliminary study suggests that the pituitary stalk infiltrated by craniopharyngioma could be sacrificed to achieve radical resection, without substantially rendering significantly worse endocrinological efficiency 1 year after surgery. The user-friendly nomograms can be used to predict hypopituitarism 1 year after surgery.
    Language English
    Publishing date 2022-05-19
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2022.840572
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Single-stage endoscopic endonasal approach for the complete removal of trigeminal schwannomas occupying both the middle and posterior fossae.

    Wu, Xiao / Xie, Shen Hao / Tang, Bin / Yang, Le / Xiao, Li Min / Ding, Han / Bao, You Yuan / Tong, Zhi Gao / Hong, Tao

    Neurosurgical review

    2020  Volume 44, Issue 1, Page(s) 607–616

    Abstract: To introduce a purely endoscopic endonasal trans-Meckel's cave approach or a transclival approach for trigeminal schwannomas (TSs) involving both the middle and posterior fossae. This retrospective study reviewed the medical records and intraoperative ... ...

    Abstract To introduce a purely endoscopic endonasal trans-Meckel's cave approach or a transclival approach for trigeminal schwannomas (TSs) involving both the middle and posterior fossae. This retrospective study reviewed the medical records and intraoperative videos of 8 patients with TSs occupying both the middle and posterior fossae who underwent an endoscopic endonasal approach (EEA) between January 2017 and October 2019. All 8 patients received total resection under a single-stage EEA. Six patients underwent endoscopic endonasal resection via a purely trans-Meckel's cave approach, and 2 patients underwent endoscopic endonasal resection via a trans-Meckel's cave approach combined with a transclival approach. There was no surgical-related hemorrhage or mortality and no cerebrospinal fluid leakage. All headache symptoms completely improved postoperatively (n = 3 patients). All cranial nerve (CN) symptoms (CN IX and CN VI) improved postoperatively. The most common preoperative symptom was facial numbness (n = 5 patients); 2 of these 5 patients showed a partial improvement, 1 patient experienced worsening, and 2 patients remained unchanged at the last follow-up. Four patients developed postoperative complications, including CN VI palsy (n = 2), dry eye (n = 2), mastication weakness (n = 1), and facial numbness (n = 2). All complications except for dry eye were relieved at the last follow-up, but the patients with dry eye did not develop corneal keratopathy. The endoscopic endonasal trans-Meckel's cave and transclival approaches provide adequate exposure and improve the rate of total resection for TSs occupying both the middle and posterior fossae with minimal invasion. It may be possible to use these approaches as a safe alternative to conventional surgical approaches.
    MeSH term(s) Adult ; Cranial Fossa, Middle ; Cranial Fossa, Posterior ; Cranial Nerve Neoplasms/pathology ; Cranial Nerve Neoplasms/surgery ; Female ; Humans ; Male ; Middle Aged ; Natural Orifice Endoscopic Surgery/adverse effects ; Natural Orifice Endoscopic Surgery/methods ; Neurilemmoma/pathology ; Neurilemmoma/surgery ; Postoperative Complications/epidemiology ; Retrospective Studies ; Trigeminal Nerve Diseases/pathology ; Trigeminal Nerve Diseases/surgery ; Young Adult
    Language English
    Publishing date 2020-02-19
    Publishing country Germany
    Document type Case Reports ; Journal Article
    ZDB-ID 6907-3
    ISSN 1437-2320 ; 0344-5607
    ISSN (online) 1437-2320
    ISSN 0344-5607
    DOI 10.1007/s10143-020-01266-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Identification of the Extradural and Intradural Extension of Pituitary Adenomas to the Suprasellar Region: Classification, Surgical Strategies, and Outcomes.

    Yang, YouQing / Bao, YouYuan / Xie, ShenHao / Tang, Bin / Wu, Xiao / Yang, Le / Wu, Jie / Ding, Han / Li, ShaoYang / Zheng, SuYue / Hong, Tao

    Frontiers in oncology

    2021  Volume 11, Page(s) 723513

    Abstract: Objective: Suprasellar pituitary adenomas (PAs) can be located in either extradural or intradural spaces, which impacts surgical strategies and outcomes. This study determined how to distinguish these two different types of PAs and analyzed their ... ...

    Abstract Objective: Suprasellar pituitary adenomas (PAs) can be located in either extradural or intradural spaces, which impacts surgical strategies and outcomes. This study determined how to distinguish these two different types of PAs and analyzed their corresponding surgical strategies and outcomes.
    Methods: We retrospectively analyzed 389 patients who underwent surgery for PAs with suprasellar extension between 2016 to 2020 at our center. PAs were classified into two main grades according to tumor topography and their relationships to the diaphragm sellae (DS) and DS-attached residual pituitary gland (PG). Grade 1 tumors were located extradurally and further divided into grades 1a and 1b, while grade 2 tumors were located intradurally.
    Results: Of 389 PAs, 292 (75.1%) were surrounded by a bilayer structure formed by the DS and the residual PG and classified as grade 1a, 63 (16.2%) had lobulated or daughter tumors resulting from the thinning or absence of the residual PG and subsequently rendering the bilayer weaker were classified as Grade 1b, and the remaining 34 (8.7%) PAs that broke through the DS or traversed the diaphragmic opening and encased suprasellar neurovascular structures were classified as Grade 2. We found that the gross total removal of the suprasellar part of grade 1a, 1b, and 2 PAs decreased with grading (88.4%, 71.4%, and 61.8%, respectively). The rate of major operative complications, including cerebrospinal fluid leakage, hemorrhage, and death, increased with grading.
    Conclusions: It is essential to identify whether PAs with suprasellar extension are located extradurally or intradurally, which depends on whether the bilayer structure is intact. PAs with an intact bilayer structure were classified as grade 1. These were extradural and usually had good surgical outcomes and lower complications. PAs with no bilayer structure surrounding them were classified as grade 2. These were intradural, connected to the cranial cavity, and had increased surgical complications and a lower rate of gross total removal. Different surgical strategies should be adopted for extradural and intradural PAs.
    Language English
    Publishing date 2021-07-20
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2021.723513
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Hypothalamic injury patterns after resection of craniopharyngiomas and correlation to tumor origin: A study based on endoscopic observation.

    Yang, Le / Xie, ShenHao / Tang, Bin / Wu, Xiao / Tong, ZhiGao / Fang, Chao / Ding, Han / Bao, YouYuan / Zheng, SuYue / Hong, Tao

    Cancer medicine

    2020  Volume 9, Issue 23, Page(s) 8950–8961

    Abstract: The precise understanding of hypothalamic injury (HI) patterns and their relationship with different craniopharyngioma (CP) classifications remains poorly addressed. Here, four HI patterns after CP resection based on endoscopic observation were ... ...

    Abstract The precise understanding of hypothalamic injury (HI) patterns and their relationship with different craniopharyngioma (CP) classifications remains poorly addressed. Here, four HI patterns after CP resection based on endoscopic observation were introduced. A total of 131 CP cases treated with endoscopic endonasal approach (EEA) were reviewed retrospectively and divided into four HI patterns: no-HI, mild-HI, unilateral-HI and bilateral-HI, according to intraoperative findings. The outcomes were evaluated and compared between groups in terms of weight gain, endocrine status, electrolyte disturbance and neuropsychological function before and after surgery. A systematic correlation was found between CP origin and subsequent HI patterns. The majority of intrasellar and suprasellar stalk origins lead to a no-HI pattern, the central-type CP mainly develops a mild or bilateral HI pattern, and the majority of tumors with hypothalamic stalk origins result in unilateral HI and sometimes bilateral HI patterns. The proportion of tumors with a maximum diameter >3 cm in the no-HI group was higher than that in the mild-HI group, BMI and quality of life in the no-HI group showed better results than those in the other groups. The incidence of new-onset diabetes insipidus in the bilateral-HI group was significantly higher than that in the other groups. Memory difficulty was observed mainly in the unilateral-HI and bilateral-HI groups. However, the outcomes of electrolyte disturbance, sleep, and cognitive disorder in the unilateral-HI group were significantly better than those in the bilateral-HI group. This study suggests the possibility of using pre- and intraoperative observation of CP origin to predict four HI patterns and even subsequent outcomes after tumor removal.
    MeSH term(s) Adolescent ; Adult ; Aged ; Child ; Craniopharyngioma/complications ; Craniopharyngioma/diagnostic imaging ; Craniopharyngioma/pathology ; Craniopharyngioma/surgery ; Female ; Humans ; Hypothalamus/diagnostic imaging ; Hypothalamus/pathology ; Hypothalamus/physiopathology ; Hypothalamus/surgery ; Male ; Middle Aged ; Natural Orifice Endoscopic Surgery/adverse effects ; Neoplasm Invasiveness ; Pituitary Neoplasms/complications ; Pituitary Neoplasms/diagnostic imaging ; Pituitary Neoplasms/pathology ; Pituitary Neoplasms/surgery ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/etiology ; Postoperative Complications/physiopathology ; Postoperative Complications/psychology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2020-11-03
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2659751-2
    ISSN 2045-7634 ; 2045-7634
    ISSN (online) 2045-7634
    ISSN 2045-7634
    DOI 10.1002/cam4.3589
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Pituitary adenoma with posterior area invasion of cavernous sinus: surgical anatomy, approach, and outcomes.

    Wu, Xiao / Xie, Shen Hao / Tang, Bin / Yang, You Qing / Yang, Le / Ding, Han / Bao, You Yuan / Lan, Shi Hai / Zhou, Lin / Hong, Tao

    Neurosurgical review

    2020  Volume 44, Issue 4, Page(s) 2229–2237

    Abstract: We found a series of Knosp grade 3A-4 pituitary adenomas in the posterior areas of the cavernous sinus (CS), a triangular-like structure on axial MRI. In this study, we dissected the surrounding neurovascular structure, discussed the surgical approach, ... ...

    Abstract We found a series of Knosp grade 3A-4 pituitary adenomas in the posterior areas of the cavernous sinus (CS), a triangular-like structure on axial MRI. In this study, we dissected the surrounding neurovascular structure, discussed the surgical approach, and analyzed outcomes for patients with this invasion into this area. Eight embalmed adult cadaveric specimens were prepared for this study to demonstrate in detail the surgical anatomy related to this triangular-like structure. We used the "two points and one line" method to determine the surgical approach, and 35 cases with this area invasion were retrospectively reviewed. According to the endoscopic and microsurgical anatomy, the triangular-like structure appearing on the axial MRI is correlated with a square-based pyramid structure in the CS, and the upper surface is the posterior portion of the oculomotor triangle. A total of 37 posterior areas of the CS were involved in 35 patients. The accuracy of the "two points and one line" method in predicting the surgical approach is 86.5% (32/37). All three patients with Knosp 3A underwent gross total resection (GTR). Twenty (62.5%) patients with Knosp 4 underwent GTR, 9 (28.1%) patients underwent subtotal resection, and 3 (9.4%) patients underwent partial resection. Preoperative symptoms were alleviated to varying degrees, and no worsening occurred. Postoperative complications included two (5.7%) cases of cerebrospinal fluid leakage, one (2.9%) case of meningitis, two (5.7%) cases of permanent diabetes insipidus, and three (8.6%) cases of transient cranial nerve palsy. The "two points and one line" method is of great value in predicting the surgical approach of pituitary adenomas with CS invasion. The anatomic description of this particular square-based pyramid structure in the CS refines the understanding of pituitary adenomas with CS invasion.
    MeSH term(s) Adenoma/diagnostic imaging ; Adenoma/surgery ; Adult ; Cavernous Sinus/diagnostic imaging ; Cavernous Sinus/surgery ; Humans ; Magnetic Resonance Imaging ; Pituitary Neoplasms/diagnostic imaging ; Pituitary Neoplasms/surgery ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2020-10-02
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 6907-3
    ISSN 1437-2320 ; 0344-5607
    ISSN (online) 1437-2320
    ISSN 0344-5607
    DOI 10.1007/s10143-020-01404-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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