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Pituitary Adenomas: Endoscopic Endonasal Transphenoidal Technique

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Tumors of the Central Nervous System, Volume 10

Part of the book series: Tumors of the Central Nervous System ((TCNS,volume 10))

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Abstract

Endoscopic endonasal transsphenoidal surgery has gained increasing acceptance by neurosurgeons. In many centers throughout the world, this technique is now routinely used for the same indications as the conventional microsurgical technique. In 1963, Guiot and colleagues (La Presse Medicale 71:1225–1228, 1963) first proposed the use of an endoscope as part of a transnasorhinoseptal microsurgical approach. Endoscopic pituitary surgery differs from microscopic surgery, because it requires a steep learning curve for endoscopic skills and two-dimensional visualization. Gaining experience with the endoscope, some changes of the standard approaches have been performed satisfactorily for pituitary adenoma in parasellar and suprasellar location.

Treatment of pituitary adenomas invading the cavernous sinus is one of the great challenges in neurosurgical practice. Expanded surgical techniques should be performed for the removal of the cavernous sinus component in pituitary adenomas invading the cavernous sinus. Extended approaches are essential for reaching the area from lamina cribrosa to the cranio-cervical junction. Extended transsphenoidal approach was originally described by Weiss (Transnasal transsphenoidal approach. In: Apuzzo MLJ (ed) Surgery of the third ventricle, Williams and Wilkins, Baltimore, pp 476–494, 1987). Expanded and extended endoscopic approaches were reported overtime. The endoscopic transsphenoidal approach has been reported in the literature as a useful tool to treat sellar and parasellar lesions. Improved visualization with 0° and angled endoscopes allow the surgeon to identify anatomic landmarks. Angled endoscopes especially provide great advantages on the removal of tumor ­remnants at superior and lateral recesses. Different ­treatment modalities should be considered to achieve remission during the follow-up period in patients with secretuar pituitary adenomas.

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Authors and Affiliations

  1. Department of Neurosurgery, School of Medicine, Kocaeli University, Eski Istanbul Yolu 10.Km, 41380 Umuttepe, Izmit, Kocaeli, Turkey

    Savas Ceylan & Ihsan Anik

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  1. Savas Ceylan
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  2. Ihsan Anik
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Correspondence to Savas Ceylan .

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  1. , Kean University, Room 213, Library building, Morris Avenue 1000, Union, 07083, New Jersey, USA

    M.A. Hayat

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Ceylan, S., Anik, I. (2013). Pituitary Adenomas: Endoscopic Endonasal Transphenoidal Technique. In: Hayat, M. (eds) Tumors of the Central Nervous System, Volume 10. Tumors of the Central Nervous System, vol 10. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5681-6_23

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  • DOI: https://doi.org/10.1007/978-94-007-5681-6_23

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  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-007-5680-9

  • Online ISBN: 978-94-007-5681-6

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