Navegando por Palavras-chave "sphenoid sinus"
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- ItemAcesso aberto (Open Access)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.
- ItemSomente MetadadadosEndoscopic management of spontaneous meningoencephalocele of the lateral sphenoid sinus Clinical article(Amer Assoc Neurological Surgeons, 2010-05-01) Tabaee, Abtin; Anand, Vijay K.; Cappabianca, Paolo; Stamm, Aldo [UNIFESP]; Esposito, Felice; Schwartz, Theodore H.; Cornell Univ; Univ Naples Federico 2; Universidade Federal de São Paulo (UNIFESP)Object. Spontaneous meningoencephaloceles of the lateral sphenoid sinus are rare lesions that are hypothesized to result from persistence of the lateral craniopharyngeal canal. Prior reports of the management of this lesion have been limited by its relative rarity. the objective of this paper is to report the theoretical etiology, surgical technique, and outcomes in patients undergoing endoscopic repair of spontaneous meningoencephalocele of the sphenoid sinus.Methods. the authors conducted a retrospective review of a multiinstitutional series of 13 cases involving patients who underwent endoscopic repair of spontaneous meningoencephalocele of the lateral sphenoid sinus. the surgical technique and pathophysiological considerations are discussed.Results. the clinical manifestations included CSF rhinorrhea (85%), chronic headache (77%), and a history of meningitis (15%). the endoscopic approaches to the lateral sphenoid sinus were transnasal (39%), transpterygoid (23%), and transethmoid (39%). Two patients (8%) had postoperative CSF leaks, one of which closed spontaneously and one of which required revision endoscopic closure. All patients were free of leak at most recent follow-up. One patient experienced postoperative meningitis in the early postoperative period.Conclusions. Endoscopic endonasal closure is an effective modality in the treatment of spontaneous meningoencephaloceles of the lateral sphenoid sinus. If the sphenoid sinus has extensive lateral pneumatization, adequate exposure may require a transpterygoid approach. (DOI: 10.3171/2009.7.JNS0842)
- ItemAcesso aberto (Open Access)Infrasellar craniopharyngioma - Case report(Assoc Arquivos de Neuro- Psiquiatria, 2001-06-01) Falavigna, Asdrubal [UNIFESP]; Kraemer, Jorge Luiz; Univ Caxias Sul; Universidade Federal de São Paulo (UNIFESP); UFRGSWe report a case of intrasellar craniopharyngioma in a 34 year-old woman who presented with progressive headache and diplopia. Computed tomographic and magnetic resonance images showed a heterogeneous tumor originating from the sphenoid bone with ethmoid sinus and sella turcica extension. A sublabial rhinoseptal transsphenoidal surgery was performed. Craniopharyngiomas with intrasellar development are very rare. Intrasellar craniopharyngioma is uncommon, thirty-five cases has been reported in literature. the embryology, clinical features and radiographic investigation of these tumors are discussed.
- ItemAcesso aberto (Open Access)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.
- ItemAcesso aberto (Open Access)Papiloma invertido isolado em recesso esfenoetmoidal(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2008-02-01) Kosugi, Eduardo Macoto [UNIFESP]; Santos, Rodrigo de Paula [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Tangerina, Rodrigo de Paiva [UNIFESP]; Suguri, Vinícius Magalhães [UNIFESP]; Yamaoka, Wellington Yugo; Gregório, Luiz Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Inverted papilloma is a nasal benign tumor that usually arises from the lateral nasal wall, especially from the middle meatus. It has high local invasive likelihood, high recurrence rates and malignancy potential. Sphenoethmoidal recess involvement is rare and is usually due to sphenoid sinus primary disease. In the literature, no case of isolated sphenoethmoidal recess inverted papilloma has been reported yet. The present report describes an exceptional location of inverted papilloma, arising from the sphenoethmoid recess, without involving the sphenoid sinus.