Nov 2020 Medical Corner

 

PNA Medical Corner: EEET Surgery for Pituitary Tumors

PrevedelloThis month the PNA Medical Corner spotlights an article co-written by Dr. Daniel Prevedello, a member of the PNA Board of Directors. The authors give expert advice on how to best use the extended endoscopic endonasal transtuberculum sellae approach to remove large pituitary tumors with suprasellar extension. The study was published in the peer-reviewed medical journal Acta Neurochirurgica.


Acta Neurochir (Wien) 2020 Nov 6.
doi: 10.1007/s00701-020-04625-x. Online ahead of print.

Surgical anatomy and nuances of the extended endoscopic endonasal transtuberculum sellae approach: pearls and pitfalls for complications avoidance

Giuliano Silveira-Bertazzo 1 2, Thiago Albonette-Felicio 1, Ricardo L Carrau 1 3, Daniel M Prevedello 4 5
• PMID: 33156946
• DOI: 10.1007/s00701-020-04625-x

Abstract

Background: Using the expanded endoscopic transtuberculum approach (EETA), the nuances of this technique have rendered a safe, direct, and feasible ventral corridor for the treatment of extending suprasellar pathologies. This study illustrates surgical landmarks and strategies of paramount importance for complications avoidance.

Methods: This study presents the surgical anatomy and nuances of EETA, which can be used to remove large pituitary adenomas with suprasellar extension. Special references to cadaveric dissections highlight anatomical landmarks and surgical key points for complications avoidance.

Conclusion: The EETA represents a versatile route for the treatment of sellar/suprasellar pathologies. Although, sizeable extrasellar pituitary tumors still pose a threat due to displacement/encasement of surrounding structures, necessitating accurate knowledge of correlative operative anatomy with traditional landmarks. Complete resection of extrasellar components is essential to avoid postoperative apoplexy.

Keywords: Cranial base; Endonasal; Endoscopic; Parasellar; Suprasellar; Transplanum; Transtuberculum.

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