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Surgery of Pituitary Neoplasms:

Endovideomonitoring in Transsphenoidal Surgery of Pituitary Neoplasms

V.Yu. Cherebillo, V.R. Gofman, A.V. Polezhaev, V.A. Manukovsky

Chair of Neurosurgery, Medicomilitary Academy, Saint Petersburg, Russia


Introduction


Striving for total selective removal of adenoma and a smaller rate of intraoperative damage of the cavernous sinuses, optic nerves and sella diaphragm has led to use of endoscopic devices, applied earlier only in transsphenoidal interventions for diseases of accessory sinuses [1,4,6,9].


Obtained results are indicative of such main advantages of the method, as a panoramic view of the sphenoid sinus cavity, precise differentiation of neoplastic and intact tissue of the pituitary body, early diagnosis and elimination of liquorrhea. Rigid and fiber endoscopes, having different diameters and angular views, are used at various stages of an operation both in combination with a surgery microscope and without it. In contrast to a limited tubular examination with a microscope, an optic system of an endoscope with a lateral and retrograde view of 0-120o allows to examine supra- and retrosellar structures, to identify extrasellar areas of a tumor and to perform radical removal of adenoma with maximum preservation of intact adenohypophyseal tissue [3,5,8].


Today endoscopic systems are used widely. Endoscopic videomonitoring in a transseptal transsphenoidal approach to the pituitary gland is not only possible, but also expedient, as this method permits to visualize main anatomic landmarks of the sphenoid sinus in a panoramic examination of its cavity and to ensure optimum access to the saddle fundus and structures [2,7,8].

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REFERENCES

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  3. Gamea A., Fathi M., EL-Guindy A. The use of the rigid endoscope in transsphenoidal pituitary surgery // J. Laryngol. Otol.- 1994.- Vol. 108, N 1.- P. 19-22.

  4. Guiot G. Transsphenoidal spproach in surgical treatment of pituitary adenomas: general principles and indications in nonfunctioning adenoma. In: Kohler P.O., Ross G.T. Diagnosis and treatment of pituitary tumors. Amsterdam: Exepta Medica, International Congress Series N 303.- 1973.- P. 159-178.

  5. Hardy J. Transsphenoidal hypophysectomy: neurosurgical techniques // J. Neurosurg.- 1971.- Vol. 34.- P. 582-594.

  6. Heilman C.B., Shucart W.A., Rebeiz E.E. Endoscopic sphenoidotomy approach to the sella // Neurosurgery.- 1997.- Vol. 41, N 3.- P. 602- 607.

  7. Jankowski R., Auque J., Simon C. et al. Endoscopic pituitary tumor surgery // Laryngoscope.- 1992.- Vol.102, N 2.- P. 198-202.

  8. Jho H.D., Carrau R.L., Ko Y., Daly M.A. Endoscopic pituitary surgery: an early experience // Surg. Neurol.- 1997.- Vol. 47, N 3.- P. 213-223.

  9. Rodziewicz G.S., Kelley R.T., Kellman R.M., Smith M.V. Transnasal endoscopic surgery of the pituitary gland: technical note // Neurosurgery.- 1996.- Vol. 39, N 1.- P. 189 - 193.

Growth hormone (GH) is also called somatropin and somatotropin (British: somatotrophin). hGH refers to human growth hormone and is used as an abbreviation for human GH measured in the blood or extracted from human pituitary glands. In 1985, biosynthetic human growth hormone replaced pituitary-derived human growth hormone for therapeutic use in the U.S. and other countries. Biosynthetic human growth hormone, also referred to as recombinant human growth hormone, is also called somatropin (British: somatrophin) and abbreviated as rhGH. Since the mid-1990s the abbreviation HGH has begun to carry paradoxical connotations and now rarely refers to real GH used for indicated purposes. See articles on GH treatment and HGH quackery for fuller discussions of GH therapy and the HGH issue.
(human growth hormone)

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Endocrinology:

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Endocrine system
Pituitary gland
Pituitary adenoma
Pharmacologic Treatment of Acromegaly
Pituitary tumors- clinical features, diagnosis


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Endovideomonitoring in Transsphenoidal Surgery of Pituitary Neoplasms
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