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Transcranial Surgery

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Management of Pituitary Tumors

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Abstract

Although there was once a debate about the merits of transsphenoidal and transcranial surgeries, this argument is now outdated. The introduction of selective microadenomectomy by Hardy has focused the attention of the subsequent generation of neurosurgeons upon the intrasellar aspects of pituitary surgery (1). Removal of a microadenoma is unarguably better performed from below and, therefore, the number of transsphenoidal procedures wordwide has risen up dramatically since the 1960s. With this accumulation of experience, the transsphenoidal operation has been increasingly applied where it was formerly contraindicated, especially to suprasellar tumors (2–6). In our practice, transsphenoidal surgery is the first option for the majority of tumors at first presentation, even for those with a large suprasellar component.

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References

  1. Hardy J. Transsphenoidal microsurgery of the normal and pathological pituitary gland. In: Microsurgery as Applied to Neurosurgery. Germany: Thieme Verlag Co; 1969; 180–194.

    Google Scholar 

  2. Couldwell WT, Weiss MH. The transnasal transsphenoidal approach. In: Apuzzo Mil, ed. Surgery of the Third Ventricle. 2nd ed. Baltimore: Williams and Wilkins; 1998.

    Google Scholar 

  3. Fahlbusch R, Honegger J. Extended transsphenoidal approach to the pituitary region and upper clivus. In: Operative Skull Base Surgery. Torrens M, Al-Mefty O, Kobayashi S, eds. Edinburgh, UK: Churchill Livingstone; 1997.

    Google Scholar 

  4. Kouri JG, Chen MY, Watson JC, Oldfield EH. Resection of suprasellar tumors by using a modified transsphenoidal approach: report of four cases. J Neurosurg 2000; 92: 1028–1035.

    Article  PubMed  CAS  Google Scholar 

  5. Kitano M, Taneda M. Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors. J Neurosurg 2001; 94 (6): 999–1004.

    Article  PubMed  CAS  Google Scholar 

  6. Kaptain GJ, Vinvent DA, Sheehan JP, Laws ER. Trans-sphenoidal approaches for the extra-capsular resection of midline suprasellar and anterior cranial base lesions. Neurosurgery 2001; 49: 94–101.

    PubMed  CAS  Google Scholar 

  7. Henderson WR. The pituitary adenomata. A follow-up study of the surgical results in 338 cases (Dr Harvey Cushing’s series). Br J Surg 1939; 26: 811–921.

    Article  Google Scholar 

  8. Laws ER, Jr, Trautmann JC, Hollenhorst RW, Jr. Trans-sphenoidal decompression of the optic nerve and chiasm. Visual results in 62 patients. J Neurosurg 1977; 46: 717–722.

    Article  PubMed  Google Scholar 

  9. Cohen AR, Cooper PR, Kupersmith MJ, Flamm ES, Ransohoff J. Visual recovery after transsphenoidal removal of pituitary adenomas. Neurosurgery 1985; 17: 446–452.

    Article  PubMed  CAS  Google Scholar 

  10. Dolenc VV. Transcranial epidural approach to pituitary tumors extending beyond the sella. Neurosurgery 1997; 41 (3): 542–550.

    PubMed  CAS  Google Scholar 

  11. Adams CBT. A Neurosurgeon’s Notebook. Oxford: Blackwell Science; 1999; 147.

    Google Scholar 

  12. Snow RB, Johnson CE, Morgello S, Lavyne MH, Patterson RH. Is magnetic resonance imaging useful in guiding the operative approach to large pituitary tumors? Neurosurgery 1990; 26 (5): 801–803.

    Article  PubMed  CAS  Google Scholar 

  13. Esiri M, Bevan JS, Burke CW, Adams CB. Effect of bromocriptine treatment on the fibrous tissue content of prolactin-secreting and nonfunctioning macroadenomas of the pituitary gland. J Clin Endocrinol Metab 1986; 63 (2): 383–388.

    Article  PubMed  CAS  Google Scholar 

  14. Barkan AL, Lloyd RV, Chandler WF, et al. Preoperative treatment of acromegaly with long-acting somatostatin analog SMS 201–995: shrinkage of invasive pituitary macroadenomas and improved surgical remission rate. J Clin Endocrinol Metab 1988; 67: 1040–1048.

    Article  PubMed  CAS  Google Scholar 

  15. Ezzat S, Horvath E, Harris AG, Kovacs K. Morphological effects of octreotide on growth hormone-producing pituitary adenomas J Clin Endoc and Metab 1994; 79: 113–118.

    CAS  Google Scholar 

  16. Patterson RH. The role of transcranial surgery in the management of pituitary adenoma. Acta Neurochir 1996;(Suppl 65 ): 16–17.

    Google Scholar 

  17. Abe T, Iwata T, Kawamura N, lzumiyama H, Ikeda H, Matsumoto K. Staged transsphenoidal surgery for fibrous nonfunctioning pituitary adenomas with suprasellar extension. Neurol Med Chir (Tokyo) 1997;37(11):830–835; discussion 835–837.

    Google Scholar 

  18. Massoud AF, Powell M, Williams RA, Hindmarsh PC, Brook CG. Transsphenoidal surgery for pituitary tumors. Arch Dis Child 1997; 76 (5): 398–404.

    Article  PubMed  CAS  Google Scholar 

  19. Dawson BH. The blood vessels of the human optic chiasma and their relation to those of the hypophysis and thalamus. Brain 1958; 81: 207–217.

    Article  PubMed  CAS  Google Scholar 

  20. Van Alphen HAM. Microsurgical fronto-temporal approach to pituitary adenomas with extrasellar extension Clin Neurol Neurosurg 1975; 4: 246–256.

    Google Scholar 

  21. Frazier CH. Lesions of the hypophysis from the viewpoint of the surgeon. Surg Gynecol Obstet 1913; 17: 724–736.

    Google Scholar 

  22. Symon L. Intracranial approaches to tumors in the area of the sella turcica. In: Rob and Smith’s Operative Surgery: Neurosurgery. 4th ed. Symon L, Thomas DGT, Clark K, eds., London: Chapman and Hall Medical; 1988.

    Google Scholar 

  23. Ray BS. Intracranial hypophysectomy. J Neurosurg 1968; 28: 180–186.

    Article  PubMed  CAS  Google Scholar 

  24. Dandy W. The brain. In: Dean Lewis’s Practice of Surgery. Birmingham, AL. Classics of Neurology Library. Reprinted 1987; 591.

    Google Scholar 

  25. Choux M, Lena G. Craniopharyngioma. In: Apuzzo MJ, ed. Surgery of the Third Ventricle. Baltimore: Williams and Wilkins 1998; 1143–1181.

    Google Scholar 

  26. Fahlbusch R, Honnegger J, Paulus W, Buchfelder M. Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 1999; 90 (2): 237–250.

    Article  PubMed  CAS  Google Scholar 

  27. Perneczky A. Keyhole Concept in Neurosurgery. Stuttgart, Germany: Thieme; 1999.

    Google Scholar 

  28. Snow RB, Patterson RH. Craniotomy for pituitary tumors. In: Kaye AH, Black P, eds. Brain Tumors. 2nd ed. Stuttgart, Germany: Thieme; 1999.

    Google Scholar 

  29. Cushing H. Surgical experiences with pituitary disorders. JAMA 1914; 63: 1515.

    Article  Google Scholar 

  30. Symon L, Sprich W. Radical excision of craniopharyngioma: results in 20 patients. J Neurosurg 1985; 62: 174–181.

    Article  PubMed  CAS  Google Scholar 

  31. Symon L, Jackubowski J, Kendall B. Surgical treatment of giant pituitary adenomas. J Neurol Neurosurg Psychiatry 1979; 42: 973–982.

    Article  PubMed  CAS  Google Scholar 

  32. Symon L, Jakubowski J. Transcranial management of pituitary tumors with suprasellar extension. J Neurol Neurosurg Psychiatry 1979; 42: 123–133.

    Article  PubMed  CAS  Google Scholar 

  33. King TT. Removal of intraventricular craniopharyngiomas throught the lamina terminali. Acta Neurochir (Wien) 1979; 45: 277–286.

    Article  CAS  Google Scholar 

  34. Bhagwati SN, Deopujari CE, Parulekar GD. Lamina terminalis approach for retrochiasmal craniopharyngiomas. Childs Nery Syst 1990; 6: 425–429.

    Article  CAS  Google Scholar 

  35. Suzuki J. The bifrontal anterior interhemispheric approach. In: Apuzzo MLJ, ed. Surgery of the Third Ventricle. 2nd ed. Baltimore: Williams and Wilkins; 1998.

    Google Scholar 

  36. Ture U, Yasargil MG, Al-Mefty O. The transcallosal-transforaminal approach to the third ventricle with regard to the venous variations in this region. J Neurosurg 1997; 87: 706–715.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Michael P. Powell MB, BS, FRCS
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  2. Jonathan R. Pollock MB, BCh, FRCS (S/N)
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Editor information

Editors and Affiliations

  1. The National Hospital for Neurology and Neurosurgery, London, UK

    Michael P. Powell MB, BS, FRCS (Consultant Neurosurgeon) (Consultant Neurosurgeon)

  2. University Research Centre for Neuroendocrinology, University of Bristol; Bristol Royal Infirmary, Bristol, UK

    Stafford L. Lightman MB, BChir, PhD, FRCP, FMedSci (Professor of Medicine) (Professor of Medicine)

  3. Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA

    Edward R. Laws Jr. MD, FACS (Professor of Neurological Surgery and Medicine) (Professor of Neurological Surgery and Medicine)

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© 2003 Springer Science+Business Media New York

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Powell, M.P., Pollock, J.R. (2003). Transcranial Surgery. In: Powell, M.P., Lightman, S.L., Laws, E.R. (eds) Management of Pituitary Tumors. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-390-3_9

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  • DOI: https://doi.org/10.1007/978-1-59259-390-3_9

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-327-5

  • Online ISBN: 978-1-59259-390-3

  • eBook Packages: Springer Book Archive

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