Author/Editor		Dolenc, Vinko V
Title		Transcranial epidural approach to pituitary tumors extending beyond the sella
Type		članek
Source		Neurosurgery
Vol. and No.		Letnik 41, št. 3
Publication year		1997
Volume		str. 542-50
Language		eng
Abstract		OBJECTIVE: The treatment of residual and/or recurrent pituitary tumors, initially operated on through transsphenoidal and/or transcranial approaches, required a new single approach that would make it possible to excise the tumor from the sella and from the neighboring regions. Surgical complications, such as pneumatocephalus, cerebrospinal fluid leak, mechanical lesion of the internal carotid artery and/or visual apparatus, and failure to remove the tumor completely, supported the need for an approach that would guarantee a much higher rate of completeness of resection of tumors and also avoid the risk of occurrence of complications. This report does not address endocrinological disorders before surgical treatment of pituitary tumors nor is its aim to present the functional efficacy of surgical treatment relating to hormones. METHODS: The anatomic relationships of the sellar and parasellar regions were studied using central cranial base specimens (8). Previous anatomic studies of the triangles of the lateral wall of the cavernous sinus (including anteromedial, paramedial, and Parkinson's triangles) and practical experience dealing with tumors in the region led to the use of the triangular windows as key accesses to the pituitary tumors in the enlarged sella and in the neighboring area(s). RESULTS: During the past 15 years, 210 patients with pituitary tumors extending into the parasellar and other regions beyond the sella were operated on using the transcranial approach. In Group I (consisting of 120 patients), complete removal was achieved in 66.5% of the patients by using the classical approach. Postoperative cerebrospinal fluid leak occurred in 8% and impairment of the visual function in 6% of the patients. (Abstract trunceted at 2000 characters).
Descriptors		PITUITARY NEOPLASMS CRANIOTOMY HYPOPHYSECTOMY NEOPLASM RECURRENCE, LOCAL NEOPLASM, RESIDUAL EPIDURAL SPACE SELLA TURCICA POSTOPERATIVE COMPLICATIONS REOPERATION RISK FACTORS VISUAL ACUITY VISUAL FIELDS TREATMENT OUTCOME