title: Application of the endoscopic transsphenoidal approach to true type transsellar transsphenoidal meningoencephalocele in an adult: a case report and literature review.
abstract: Of the transsellar transsphenoidal meningoencephaloceles (TTSMEs), the true type presents with the hernial sac extending from the intracranium to the epipharynx through the sellar floor. The true type is the most serious and difficult to manage, especially when the hernial sac contains vital structures, such as the anterior cerebral artery, pituitary gland, optic nerve, hypothalamus, and third ventricle. Surgical outcome for true type TTSME is reported to be poor. We describe a successful case of endoscopic repair for a 36-year-old man with true type TTSME. Our success with endoscopic repair for true type TTSME in an adult is the first reported case. We believe that the endoscopic transsphenoidal approach allows less invasive surgery and provides an acceptable operative outcome in comparison with other microsurgical approaches.
authors.affiliation: Department of Neurosurgery, Keio University School of Medicine, 35 Shinano-machi, Shinjnku-ku, Tokyo, 160-8582, Japan. s.katsuya@hotmail.co.jp
authors.forename: Katsuya
authors.initials: K
authors.lastname: Saito
authors.forename: Masahiro
authors.initials: M
authors.lastname: Toda
authors.forename: Keisho
authors.initials: K
authors.lastname: Sano
authors.forename: Toshiki
authors.initials: T
authors.lastname: Tomita
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ogawa
authors.forename: Kazunari
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D004677:Encephalocele / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000601:surgery*; D016896:Treatment Outcome