Since 2005, all pituitary tumours at Groote Schuur Hospital have been approached via a minimally invasive transnasal transsphenoidal
endoscopic approach and 60 endoscopic pituitary procedures have been performed.
Daniel Kelly, a UCLA neurosurgeon, removed the lesion under ultrasound guidance through a transsphenoidal
Daniel Kelly a UCLA neurosurgeon, removed the lesion under ultrasound guidance through a transsphenoidal
adenectomy has yielded good results in elderly patients (6), none of our patients was deemed fit for neurosurgical intervention.
The most widely used treatment is removal of the tumor by surgery, known as transsphenoidal
The sphenoidal sinus septum is a significant surgical landmark when endoscopic endonasal transsphenoidal
approaches are performed, as it may attach to crucial structures such as the optic canal and internal carotid artery (Chong et al., 1998; Unal et al., 2006; Idowu et al., 2009; Kapur et al.; Awadalla et al., 2015).
The patient underwent transsphenoidal
resection in August 2013 (Figure 1).
surgery is the treatment of choice in these patients; nevertheless, some cases require adjuvant therapy with postoperative radiotherapy .
These include trans-lamina terminalis, bifrontal basal interhemispheric approach, transsphenoidal
and extended transsphenoidal
, pterional, orbitozygomatic, interhemispheric transcallosal and the transcortical/trans ventricular approach.
The surgical resection of clival chordomas describes a variety of conventional surgical approaches (transcranial, transsphenoidal
, trans-oropharyngeal and maxillary osteotomy).
In our center, patients with TSHoma are started on short-term preoperative SST analog to restore euthyroidism before transsphenoidal
surgery as a definitive therapy.
The 14 capabilities polled were intracranial pressure monitoring, arterial blood pressure monitoring, central venous pressure monitoring, hourly neurological checks, management of external ventricular drains, management of lumbar drains, post-tPA monitoring, post-operative craniotomy monitoring, postoperative transsphenoidal
monitoring, care of subarachnoid hemorrhage patients starting at day 5, titration of labetalol, nicardipine, diltiazem, and esmolol.