Advertisement

Extended endoscopic endonasal transsphenoidal approaches to the suprasellar region, planum sphenoidale & clivus

  • P. Cappabianca
  • G. Frank
  • E. Pasquini
  • O. de Divitiis
  • F. Calbucci
Chapter

Abstract

The standard unilateral endoscopic transsphenoidal approach has permitted a very wide vision around the sella, with the possibility of lreating lesions not confined to its strict limits. This possibility does not concern only anatomical studies [1, 2, 3, 4, 6] but dinical cases too, that have undergone surgery both within the suprasellar, and in the dival compartments, besides the parasellar area, that has already been treated above. Relevant series on these extended approach es by means of the endoscopic technique have not yet been presented in the main literature, but sporadic reports are now coming in and we will introduce the main guidelines of the procedure along with some illustrative cases.

Keywords

Sphenoid Sinus Transsphenoidal Approach Suprasellar Region Endoscopic Endonasal Approach Mucoperiosteal Flap 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Alfieri A, Jho HD (2001) Endoscopic endonasal cavernous sinus surgery: an anatomic study. Neurosurgery 48: 827–837PubMedGoogle Scholar
  2. 2.
    Alfieri A, Jho HD (2001) Endoscopic endonasal approaches to the cavernous sinus: surgical approaches. Neurosurgery 49: 354–362PubMedGoogle Scholar
  3. 3.
    Alfieri A, Jho HD, Tschabitscher M (2002) Endoscopic endonasal approach to the ventral cranio-cervical junction: anatomical study. Acta Neurochir (Wien) 144: 219–225CrossRefGoogle Scholar
  4. 4.
    Alfieri A, Jho HD, Schettino R, Tschabitscher M (2003) Endoscopic endonasal approach to the pterygopalatine fossa: anatomic study. Neurosurgery 52: 374–380PubMedCrossRefGoogle Scholar
  5. 5.
    Andrews RJ, Bringas JR (1993) A review of brain retraction and recommendations for minimizing intraoperative brain injury. Neurosurgery 33: 1052–1064PubMedCrossRefGoogle Scholar
  6. 6.
    Cappabianca P, Alfieri A, de Divitiis E, Tschabitscher M (2001) Atlas of endoscopic anatomy for endonasal intracranial surgery. Springer, Wien New York, pp 134CrossRefGoogle Scholar
  7. 7.
    Cappabianca P, Cavallo LM, Esposito F, Valente V, de Divitiis E (2002) Sellar repair in endoscopic endonasal transsphenoidal surgery: results of 170 cases. Neurosurgery 51: 1365–1372PubMedGoogle Scholar
  8. 8.
    Dawson BH (1958) The blood vessels of the human optic chiasma and their relation to those of the hypophysis and hypothalamus. Brain 81: 207–217PubMedCrossRefGoogle Scholar
  9. 9.
    de Divitiis E, Cappabianca P, Cavallo LM (2002) Endoscopic transsphenoidal approach: adaptability of the procedure to different sellar lesions. Neurosurgery 51: 699–707PubMedGoogle Scholar
  10. 10.
    Fahlbusch R, Honegger J, Paulus W, Huk W, Buchfelder M (1999) Surgical treatment of craniopharyngiomas: Experience with 168 patients. J Neurosurg 90: 237–250PubMedCrossRefGoogle Scholar
  11. 11.
    Gay E, Sekhar LN, Rubinstein E, Wright DC, Sen C, Janecka IP, Snyderman CH (1995) Chordomas and chondrosarcomas of the cranial base: results and follow-up of 60 patients. Neurosurgery 36: 887–897PubMedCrossRefGoogle Scholar
  12. 12.
    Hashimoto N, Handa H, Yamagami T (1986) Transsphenoidal extracapsular approach to pituitary tumors. J Neurosurg 64: 16–20PubMedCrossRefGoogle Scholar
  13. 13.
    Hughes B (1958) Blood supply of the optic nerves and chiasma and its dinical significance. Br J Ophthalmol 42: 106–125PubMedCrossRefGoogle Scholar
  14. 14.
    James D, Crockard HA (1991) Surgical access to the base of the skull and upper cervical spine by extended maxillotomy. Neurosurgery 29: 411–416PubMedCrossRefGoogle Scholar
  15. 15.
    Jho HD, Carrau RL, Mc Laughlin ML, Somaza SC (1996) Endoscopic transsphenoidal resection of a large chordoma in the posterior fossa. Neurosurgical Focus 1: 1–7Google Scholar
  16. 16.
    Jho H (1999) endoscopic endonasal skull base surgery for midline lesions from olfactory groove to distal divus. Presented at the 67’h Annual Meeting of the American Association of Neurological Surgeons. New Orleans, Louisiana, April 24-29, 1999Google Scholar
  17. 17.
    Kaptain GJ, Vincent DA, Sheehan JP, Laws ER Jr (2001) Transsphenoidal approaches for extracapsular resection of midline suprasellar and anterior cranial base lesions. Neurosurgery 49: 94–101PubMedGoogle Scholar
  18. 18.
    Kato T, Sawamura J, Abe H, Nagashima M (1998) Transsphenoidal-transtuberculum sellae approach for supradiaphragmatic tumours: technical note. Acta Neurochir (Wien) 140: 715–719CrossRefGoogle Scholar
  19. 19.
    Kelley DF, Oskouian RJ, Fineman I (2001) Collagen sponge repair of small cerebral fluid leaks obviates tissue grafts and cerebrospinal fluid diversion after pituitary surgery. Neurosurgery 49: 885–890Google Scholar
  20. 20.
    Kelley TF, Stankiewicz JA, Chow JM, Origitano TC (1999) Endoscopic transsphenoidal biopsy of the sphenoid and dival mass. Am J Rhinol 13: 17–21PubMedCrossRefGoogle Scholar
  21. 21.
    Kim J, Choe I, Bak K, Kim C, Kim N, Yang Y (2000) Transsphenoidal supradiaphragmatic intradural approach: technical note. Minim Invasive Neurosurg 43: 33–37PubMedCrossRefGoogle Scholar
  22. 22.
    Kouri JG, Chen MY, Watson JC, Odfield EH (2000) Resection of suprasellar tumors by using a modified transsphenoidal approach. J Neurosurg 92: 1028–1035PubMedCrossRefGoogle Scholar
  23. 23.
    Lang J (1995) Transsphenoidal approach to the hypophysis, dinical anatomy, In: Lang J (ed) Skull base and related structures: atlas of dinical anatomy. Schattauer, Stuttgart, pp 203–206Google Scholar
  24. 24.
    Laws ER Jr (1980) Transsphenoidal microsurgery in the management of craniopharyngioma. J Neurosurg 52: 661–666PubMedCrossRefGoogle Scholar
  25. 25.
    Laws ER Jr (1993) Clivus chordomas. In: Sekhar LN, Janecka IP (eds) Surgery of cranial base tumors. Raven Press, New York, pp 679–685Google Scholar
  26. 26.
    Laws ER Jr (2001) Comment to the artide: Cappabianca P, Cavallo LM, Mariniello G, de Divitiis O, Becerra Romero ADC, de Divitiis E: Easy sellar reconstruction in endoscopic transsphenoidal surgery with polyester-silicone dural substitute and fibrin glue: technical note. Neurosurgery 49: 475–476Google Scholar
  27. 27.
    Maira G, Anile C, Rossi GF, Colosimo C (1995) Surgical treatment of craniopharyngiomas: An evaluation of the transsphenoidal and pteryonal approaches. Neurosurgery 36: 715–724PubMedCrossRefGoogle Scholar
  28. 28.
    Maira G, Pallini R, Anile C, Fernandez E, Salvinelli F, La Rocca LM, Rossi GF (1996) Surgical treatment of dival chordomas: the transsphenoidal approach revisited. Neurosurgery 85: 784–792CrossRefGoogle Scholar
  29. 29.
    Mason RB, Nieman LK, Doppman JL, Oldfield EH (1997) Selective excision of adenomas originating in or extending into tne pituitary stalk with preservation of pituitary function. J Neurosurg 87: 343–351PubMedCrossRefGoogle Scholar
  30. 30.
    Miyagi A, Maeda K, Sugawara T (1998) Usefulness of neuroendoscopy and a neuronavigator for removal of dival chordoma. No Shinkei Geka 26: 169–175PubMedGoogle Scholar
  31. 31.
    Renn WH, Rhoton AI Jr (1975) Microsurgical anatomy of the sellar region. J Neurosurg 43: 288–298PubMedCrossRefGoogle Scholar
  32. 32.
    Rhoton AL Jr, Harris FS, Renn WH (1977) Microsurgical anatomy of the sellar region and cavernous sinus. In: Glaser JS (ed) Neuro-Ophthalmology. CV Mosby, St. Louis, vol 9, pp 75–105Google Scholar
  33. 33.
    Schaller C, Klemm E, Haun D, Schramm J, Meyer B (2002) The transsylvian approach is “minimally invasive” but not “atraumatic”. Neurosurgery 51: 971–977PubMedGoogle Scholar
  34. 34.
    Steele EJ, Blunt MJ (1956) The blood supply of the optic nerve and chiasma in man. Case report. J Anat 90: 486–493Google Scholar
  35. 35.
    Weiss M.H. (1987) The transnasal transsphenoidal approach. In: Apuzzo MLJ (ed) Surgery of the third ventride. Williams & Wilkins, Baltimore, pp 476–494Google Scholar

Copyright information

© Springer-Verlag Wien 2003

Authors and Affiliations

  • P. Cappabianca
  • G. Frank
  • E. Pasquini
  • O. de Divitiis
  • F. Calbucci

There are no affiliations available

Personalised recommendations