<b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To report the results of our first series of patients undergoing a pure&...<b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To report the results of our first series of patients undergoing a pure</span><span style="font-family:Verdana;">ly</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> endoscopic endonasal approach for pituitary surgery in Sohag University Hospitals. </span><b><span style="font-family:Verdana;">Patients and Methods: </span></b><span style="font-family:Verdana;">We reviewed 20 consecutive patients during the period from January 2017 to January 2020 with pituitary adenoma who underwent purely endoscopic transsphenoidal resection of their lesions. The patients’ clinical outcomes, degrees of tumor removal, and complications were reported. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">There were 18 primary and 2 recurrent adenomas (19 nonfunctioning and 1 functioning GH secreting adenoma). The average degree of gross total removal for tumors was 70%, C.S.F leak occurred in 20%, diabetes insipidus in 10% and sellar hemorrhage in 5%. There was no post-operative mortality, vascular injury, sphenoiditis, septal perforation, epistaxis or general complication. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">A purely endoscopic approach for pituitary adenoma treatment is a safe and effective alternative to the traditional microscopic procedure.</span></span>展开更多
Objective:Endoscopic approaches for sinus and skull base surgery are increasing in popularity.The objective of this narrative review is to characterize risk factors for internal carotid artery injury in endoscopic end...Objective:Endoscopic approaches for sinus and skull base surgery are increasing in popularity.The objective of this narrative review is to characterize risk factors for internal carotid artery injury in endoscopic endonasal surgery(EES),highlight preventative measures,and illustrate key management principles.Data Sources:Comprehensive literature review.Methods:Relevant literature was reviewed using PubMed/MEDLINE.Results:Carotid artery injury in EES is rare,with most studies reporting an incidence below 0.1%.Anatomic aberrancies,wide dissection margins,as well as specific provider and hospital factors,may increase the risk of injury.Multidisciplinary teams,comprehensive preoperative imaging,patient risk assessment,and formal training in vascular emergencies may reduce the risk.Management protocols should emphasize proper visualization of the injury site,fluid replacement,rapid packing,angiography,and endovascular techniques to achieve hemostasis.Conclusions:While EES is a relatively safe procedure,carotid artery injury is a devastating complication that warrants full consideration in surgical planning.Important preventative measures include identifying patients with notable risk factors and obtaining preoperative imaging.Multidisciplinary teams and management protocols are ultimately necessary to reduce morbidity and mortality.展开更多
文摘<b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To report the results of our first series of patients undergoing a pure</span><span style="font-family:Verdana;">ly</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> endoscopic endonasal approach for pituitary surgery in Sohag University Hospitals. </span><b><span style="font-family:Verdana;">Patients and Methods: </span></b><span style="font-family:Verdana;">We reviewed 20 consecutive patients during the period from January 2017 to January 2020 with pituitary adenoma who underwent purely endoscopic transsphenoidal resection of their lesions. The patients’ clinical outcomes, degrees of tumor removal, and complications were reported. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">There were 18 primary and 2 recurrent adenomas (19 nonfunctioning and 1 functioning GH secreting adenoma). The average degree of gross total removal for tumors was 70%, C.S.F leak occurred in 20%, diabetes insipidus in 10% and sellar hemorrhage in 5%. There was no post-operative mortality, vascular injury, sphenoiditis, septal perforation, epistaxis or general complication. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">A purely endoscopic approach for pituitary adenoma treatment is a safe and effective alternative to the traditional microscopic procedure.</span></span>
文摘Objective:Endoscopic approaches for sinus and skull base surgery are increasing in popularity.The objective of this narrative review is to characterize risk factors for internal carotid artery injury in endoscopic endonasal surgery(EES),highlight preventative measures,and illustrate key management principles.Data Sources:Comprehensive literature review.Methods:Relevant literature was reviewed using PubMed/MEDLINE.Results:Carotid artery injury in EES is rare,with most studies reporting an incidence below 0.1%.Anatomic aberrancies,wide dissection margins,as well as specific provider and hospital factors,may increase the risk of injury.Multidisciplinary teams,comprehensive preoperative imaging,patient risk assessment,and formal training in vascular emergencies may reduce the risk.Management protocols should emphasize proper visualization of the injury site,fluid replacement,rapid packing,angiography,and endovascular techniques to achieve hemostasis.Conclusions:While EES is a relatively safe procedure,carotid artery injury is a devastating complication that warrants full consideration in surgical planning.Important preventative measures include identifying patients with notable risk factors and obtaining preoperative imaging.Multidisciplinary teams and management protocols are ultimately necessary to reduce morbidity and mortality.
