To understand the natural changes in the CT appearance of a pituitary mass after transsphenoidal hypophysectomy of a pituitary tumor, we obtained CT follow-up studies in 12 patients with pituitary adenoma. The heights of the pituitary masses on the coronal sections of each CT study were measured. It was found that the height of the pituitary mass did not return to normal immediately after the o...

404 Petrous apex cholesterol granulomas are relatively rare lesions. They are usually unilocular and treated with simple fenestration. However, lobulated lesions require total removal of debris inside the cysts. Herein, we report a first case with a lobulated petrous apex cholesterol granuloma. The lesion extended from cerebello-pontine angel to the clivus. It was lobulated and contained debris...

A 54-year-old woman presented with a 3-month-history of blurred vision and refractory headache. Examination revealed severe bilateral visual acuity compromise, normal campimetry and bilateral papilledema. As a mean to investigate raised intracranial pressure, neuroimaging studies were performed and showed extensive sellar mass (Figure). Patient underwent transsphenoidal approach for resection o...

Most, but not all, sellar abnormalities are pituitary adenomas. We recently reviewed our series of transsphenoidal procedures done between 1998 and 2009 to determine the incidence and characteristics of non-pituitary sellar lesions (1). Over this period, 1,469 transsphenoidal procedures were performed. One hundred sixteen cases (7.9%) were not pituitary tumors. These were divided into four majo...

Intraoperative neurophysiologic monitoring (INM) is effective method to prevent operation-related nerve damage in various kinds of neurosurgery. In skull base surgery, there a possibility iatrogenic extraocular cranial nerves (EOCNs), which can be prevented with proper INM. We report case chondroma involving clivus and compressing pons who had intraoperative EOCN using the percutaneous needle i...

The risk of fatal injury of the internal carotid artery (ICA) and surrounding anatomy during transsphenoidal surgery for pituitary adenoma is the most severe potential complication associated with this particular approach. We present a case in which iatrogenic injury to a patient's ICA and resultant carotid cavernous fistula and massive hemorrhage was successfully managed with the emergency pla...

Accepted 16 October 1995 A 44-year-old man had suffered from headache, general fatigue and impotence for three months. Physical examination revealed a bitemporal visual field defect. Skull X-ray films showed ballooning of the sella turcica. Magnetic resonance imaging (MRI) revealed an intrasellar cystic mass compressing optic chiasma (figure). The cyst was removed by a transsphenoidal approach....

Televised fluoroscopy during surgery has been an important factor in the resurgence and ref inement of the transsphenoidal approach to se llar lesions. It provides continuous control of placement of instruments, and permits further rad io logic evaluation of the extent of the lesion . Intraoperative pneumoencephalography has been used to delineate sellar tumors [1], but the image obtained is of...