Pituitary apoplexy is a medical condition that needs urgent diagnosis and treatment. It may occur spontaneously or may be precipitated by a variety of reasons including dynamic endocrine tests. Although pituitary apoplexy is usually seen in nonfunctional pituitary adenoma, it can also be seen in ACTH secreting macroadenomas. ACTH secreting adenomas present usually as microadenomas and in these ...

Anterior cerebral artery (ACA) encasement is often considered a contraindication for an endonasal endoscopic transsphenoidal approach. We report a patient with a tuberculum sella meningioma with ACA encasement, in whom a gross total excision was achieved through an endonasal endoscopic transsphenoidal transtuberculum, transplanum approach. The tumor was sharply dissected along the left ACA usin...

Skull base tumors that involve the cavernous sinus (CS) present a challenge to the endoscopic surgeon. Most such lesions arise from sellar pathology that involves the medial wall of the CS, which can be accessed by a transsphenoidal transsellar approach. Tumors that arise primarily in the medial CS may be accessed via a transethmoidal transsphenoidal parasellar approach, which avoids the dissec...

introduction: to reduce incidence of residual cholesteatoma following ear surgery; and to reduce the need for second look “open” mastoidectomy using endoscopic mastoidotomy. ten-year retrospective chart review of 249 primary cholesteatoma cases (1994-2004) with a minimum follow-up of two years.  the first objective was to evaluate the effectiveness of otoendoscopy in reducing the incidence of “...

Endoscopic endonasal transsphenoidal approach to the sellar region yields an alternative to classical microsurgical approaches. Endoscopes provide images that differ from microscopic view. This study aimed to highlight surgical landmarks and their anatomical relationships for pituitary surgery through endoscopic perspective. Ten sides of five adult cadaveric heads with red-colored latex injecte...

BACKGROUND Microscopic and endoscopic transsphenoidal approaches to the sellar are well established. Surgical freedom is an important skull base principle that can be measured objectively and used to compare approaches. OBJECTIVE To compare the surgical freedom of 4 transsphenoidal approaches to the sella turcica to aid in surgical approach selection. METHODS Four transsphenoidal approaches...