Minimal invasive neurosurgery of infiltrative tumours extending around the sellar region: advantage of combined methods.
Most of the infiltrative tumoural lesions located around the sellar region compromise the cavernous sinus, cranial nerves, vascular neighboured structures and the hypothalamus. Minimal invasive neurosurgery (MIN) employing microsurgery, neuroendoscopy, neuronavigation and intraoperative radioscopy are reported to increase gross total tumour resection reducing the operative trauma. We combined at least 3 of these techniques in 32 patients with solid and 8 patients with cystic tumours of this region. Thirty tumours were approached in a transphenoidal manner, ten were via a single burr hole craniotomy in a transcortico-ventricular approach. In 36 cases the tumours were adequately removed with only six cases suffering a transitory and one with a permanent deterioration of a preoperatively diagnosed neurological deficit. In our experience, the use of combined techniques, particularly in these patients, reduces the operative trauma and improves the accuracy in planning the access, angle and extension of tumour removal. It also protects the patient from secondary damage to neighboured structures.
Carvi y Nievas
M N
MN
Neurosurgical Clinic, Städtische Kliniken Frankfurt a. M.-Höchst, Akademisches Lehrkrankenhaus der Johann-Wolfgang-Goethe-Universität Frankfurt, Gotenstrasse 6-8, 65929 Frankfurt a. M-Höchst, Germany. MCNievas@t-online.de
Schneider
H
H
Höllerhage
H G
HG
Haas
E
E
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D044583:Neuroendoscopy; D038361:Neuronavigation; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D012658:Sella Turcica / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome