A 26-year-old man was admitted with complaints of worsening of vision for one month. Investigations revealed a large sellar and parasellar tumor mass invading into both the cavernous sinuses. The tumor invaded the clivus and both petrous apices. It was radically but partially resected through a transsphenoidal approach. Following surgery, the patient showed symptomatic improvement. The residual...

INTRODUCTION Spontaneous cerebrospinal fluid leakage is usually caused by developmental abnormalities and is rare, accounting for approximately 5% of the cases of cerebrospinal fluid (CSF) leakage. To the best of our knowledge, clival dysplasia-caused CSF rhinorrhea has never been reported in the neurosurgical field. CONCLUSION Spontaneous cerebrospinal fluid rhinorrhea is often treated by su...

p 16 Materials and Methods p 17 Results p 22 Discussion p 29 Conclusions p 33 Second study: pituitary tumor surgery Pituitary tumor surgery via transsphenoidal approach. Part I: A study comparing otorhinolaryngologists and neurosurgeons operating by transnasal route, using recording of surgical processes p 35 Abstract p 36 Materials and Methods p 37 Results p 43 Discussion p 50 Conclusions p 52...

Chordomas in the clival-cervical region present challenges to the neurosurgical team due to their encroaching nature, proximity to critical neurovascular structures and often large size due to late presentation. This report illustrates the utility of a staged approach when confronted with such a pervasive tumour. We describe the adaptive combination of two approaches, the endoscopic endonasal t...

OBJECTIVE Rathke's cleft cysts (RCCs) are quite uncommon sellar lesions that can extend or even arise in the suprasellar area. The purpose of this study is to evaluate the effectiveness of both standard and extended endoscopic endonasal approaches in the management of different located RCCs. METHODS We retrospectively analyzed a series of 29 patients (9 males, 20 females) complaining of a RCC...

RATIONALE Microbial infection should be regarded in the differential diagnosis of neurosurgical complications after transnasal transsphenoidal pituitary microsurgery, albeit cryptococcal meningitis is rare. This article will discuss the risk factors of cryptococcal meningitis in patients underwent transnasal transsphenoidal pituitary microsurgery, and summary the potential origins of infection....

The transsphenoidal approach has been utilized in intrasellar craniopharyngioma surgeries. However, the advent of endoscopic extended transsphenoidal approach (EETSA) has expanded its indication to suprasellar craniopharyngiomas. We compared the indication and limitations of EETSA to those of unilateral basal interhemispheric approach (UBIHA), which presents similar indications for surgery. We ...

AIM This study aimed to assess the efficacy of endoscopic endonasal surgery, conducted by a team of neurosurgeons and otolaryngologists. MATERIAL AND METHODS We studied 40 patients who were undergoing surgery for primary non-functional pituitary adenomas with Knosp grades 1 to 3, at Keio University Hospital between 2005 and 2012. We compared the endoscopic endonasal transsphenoidal approach (...