OBJECT The extended transsphenoidal approach is a less invasive method for removing purely suprasellar lesions compared with traditional transcranial approaches. Most advocates have used a sublabial incision and a microscope and have reported a significant risk of cerebrospinal fluid (CSF) leakage. The authors report on a series of purely endoscopic endonasal surgeries for resection of suprasel...

INTRODUCTION The large increase in the number of transnasal endoscopic skull base surgeries is a consequence of greater knowledge of the anatomic region, the development of specific materials and instruments, and especially the use of the nasoseptal flap as a barrier between the sinus tract (contaminated cavity) and the subarachnoid space (sterile area), reducing the high risk of contamination....

The diaphragma sellae (DS) is a fold of dura that forms a partial roof over the pituitary gland. The foramen of the diaphragma sellae (FDS) is thereby a pathway for suprasellar extension of pituitary tumors. The purpose of this study was to describe the anatomical dimensions of the DS and FDS and to understand the relationship of FDS with the overlying optic chiasma. The study was conducted in ...

Vertebrate dopaminergic neurons develop in distinct neural territories to constitute one of the major neuromodulatory systems. We have identified a zebrafish mutation in the bHLH-PAS family member arnt2, based on a strong reduction in cell number of specific dopaminergic neuron groups in the hypothalamus and posterior tuberculum. Knockdown of sim1 causes a dopaminergic phenotype similar to arnt...

Aneurysms protruding into sellae may mimic pituitary tumors by compressing adjacent cranial nerves. Carotid-Cavernous aneurysms are rarely associated with mortality, and surgical intervention is recommended especially for neuro-ophthalmologic progression. In this report we presented a 51-year-old woman who had severe headache and neuro-ophthalmologic signs with the initial diagnosis of pituitar...

The tuberculum sphenoidalis (TS) is an anatomical structure of variable form located at the anterior extremity of the infratemporal crest of the greater wing of the sphenoid. The object of this study was to analyse the morphology and frequency of the TS in macerated skulls. We examined 304 macerated skulls belonging to individuals of both sexes, Amerindian and Caucasian. The TS were classified ...

PURPOSE The aim of this study was to compare the behavioral uptake of a normal gland and a pituitary adenoma and to assess the ability to diagnose pituitary adenoma by means of technetium-99m-hexakis-2-methoxy-isobutyl-isonitrile (MIBI) single photon emission computed tomography (SPECT). METHODS The study included 15 patients with pituitary adenomas (mean age = 44.0 years, range 19-63) and 15...

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...

BACKGROUND Suprasellar meningiomas often invade the optic canals (OCs). The feasibility of removing these tumors through a minimal-access endonasal route has been demonstrated, but the importance, safety, and timing of OC exploration and decompression are not well described. OBJECTIVE To create a simple decision-tree algorithm for OC exploration and decompression in the endonasal endoscopic s...

The appearance of the diaphragma sellae is described in cryomicrotomic sections and on MR in patients with and without intraand suprasellar masses. On MR, it appears as a thin band of negligible signal that is best shown when adjacent CSF or a mass has greater signal intensity. Its position or absence can be used to differentiate intrasellar masses with suprasellar components from suprasellar m...