title: Endoscopic transphenoidal approach for fibrous dysplasia of clivus, tuberculum sellae and sphenoid sinus; report of three cases.
abstract: OBJECTIVE
  Fibrous dysplasia is a benign disease in which medullary bone is replaced     by fibro-osseous tissue, and causes distortion and overgrowth of the involved     bone and represents about 3% of all bone tumors. There is variability in the     manifestation of Fibrous Dysplasia lesions with imaging techniques due to their     proportional variations of fibrous to osseous tissue. Radiological differential     diagnoses include meningioma, chordoma on MRI and Paget disease on CT imagings.
  
  
  METHODS
  We report three cases of monostotic fibrous dysplasia,     affecting clivus, tuberculum sellae, and sphenoid sinus through the     pterygopalatine fossa. We performed pure endoscopic transphenoidal approach for     those three cases with the guide of neuronavigation. Extended approach was used     via binostril for fibrous dysplasia of clivus and Tuberculum sellae.
  
  
  RESULTS
  Radiologic report revealed chordoma and meningioma for the two cases and fibrous     dysplasia for the last case. Total resection of tuberculum sellae, subtotal     resection of clivus and partial resection of sphenoid sinus lesions were     performed. Pathology diagnosis were fibrous dysplasia in all three patients.
  
  
  CONCLUSIONS
  Histopathological sampling provided by surgical approach should be     obtained to establish the final diagnosis. Endoscopic approaches are convenient     for skull base lesions even for biopsy or curative resections providing     panoramic view and avoid brain retraction.
authors.affiliation: Kocaeli University, Faculty of Medicine, Pituitary Research Centre and Department of Neurosurgery, Kocaeli, Turkey. drianik@yahoo.com
authors.forename: Ihsan
authors.initials: I
authors.lastname: Anik
authors.forename: Kenan
authors.initials: K
authors.lastname: Koc
authors.forename: Burak
authors.initials: B
authors.lastname: Cabuk
authors.forename: Savas
authors.initials: S
authors.lastname: Ceylan
mesh_terms: D000293:Adolescent; D003388:Cranial Fossa, Posterior / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005357:Fibrous Dysplasia of Bone / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D019635:Neurosurgical Procedures / Q000379:methods*; D012658:Sella Turcica / Q000473:pathology / Q000601:surgery*; D013100:Sphenoid Bone / Q000601:surgery*; D013101:Sphenoid Sinus / Q000473:pathology / Q000601:surgery*; D016683:Supine Position; D013575:Syncope / Q000209:etiology