Navegando por Palavras-chave "sella turcica"

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    Cirurgia endoscópica transnasal da região selar: estudo dos primeiros 100 casos
    (Academia Brasileira de Neurologia - ABNEURO, 2003-09-01) Gondim, Jackson [UNIFESP]; Schops, Michele [UNIFESP]; Tella Jr, Oswaldo I. [UNIFESP]; Hospital Geral de Fortaleza; Universidade Federal de São Paulo (UNIFESP)
    An endoscopic endonasal transsphenoidal approach to the sella was performed in 100 consecutive patients, with a follow up from 3 to 55 months: 57 females and 43 males, age ranging from 14 and 70 years. 76 cases pituitary adenomas: 22 were acromegaly (7 microadenomas and 15 macroadenomas); 21 null cell adenomas (3 microadenomas and 18 macroadenomas); 19 Cushing disease (11 microadenomas and 8 macroadenomas), 10 prolactinomas (6 microadenomas and 4 macroadenomas), and 4 LH adenomas (4 macroadenomas). In this serie, remission was achieved in 44.8% for macroadenomas, 60% for acromegaly, 27.7% for null cell adenoma, 50% for Cushing disease, 50% for prolactinomas and 50% for LH adenomas, and 81.4% for microadenomas 85% for acromegaly, 100% for null cell adenoma, 81.8% for Cushing disease, 66% for prolactinoma. We had also four craniopharyngiomas, four sphenoidal mucocele, three sphenoidal aspergillus, one Rathke cyst, one hypophysitis, one cavernous aneurysm, one encefalocele, one intrasellar meningioma, one intrasellar tuberculoma and a sphenoid fibrous dysplasia. In this series we also had six fistulas of the anterior base that were completely cured. We had a mortality of 2, one null cell giant adenoma in a 57 years old man and another patient, 38 years old, with a giant craniopharyngioma. The morbidity was: two cured meningitis, three cured fistulas, and two permanent diabetes insipidus. Endoscopic endonasal transsphenoidal surgery in this series resulted with comparable surgical outcomes to conventional microscopic transsphenoidal surgery. The advantages of this technique have been represented by an easier access to the lesion, better visualisation and increased illumination of the surgical sites, microdissection of the tumor with maximum preservation of the pituitary function, and reduction of hospitalization times and coasts. The main limits have been the reduction of field depth, constant need of manual control of the endoscope, and required experience of the endoscope technique.
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    Neuroendoscopic endonasal transseptal approach to the sellar region: study of 30 cases
    (Assoc Arquivos de Neuro- Psiquiatria, 2001-12-01) Gondim, Jackson [UNIFESP]; Pinheiro, Israel; Hosp Geral Fprtaeza; Universidade Federal de São Paulo (UNIFESP)
    An endoscopic endonasal transsphenoidal approach to the sella was performed in 30 patients. the use of endoscope allowed close inspection and differentiation between tumor tissue and glandular remains, resulting in micro dissection of the tumor with maximum preservation of pituitary function. the angled view of the endoscope helps gross total removal of the tumor tissue, from the supra and para sellar extension. the endonasal transseptal endoscopic approach helps from dental problems, and lowers incidence of septal perforation, synechia, and crust formation. However the endoscopic approach has drawbacks. Its decreases the depth of field, needs constant manual control of the endoscope, and requires experience with the endoscope technique.