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Zoli M, Guaraldi F, Zenesini C, Acciarri N, Sollini G, Asioli S, Faustini-Fustini M, Agati R, Cirillo L, Tonon C, Lodi R, Pasquini E, Mazzatenta D. Role of endoscopic endonasal approach for craniopharyngiomas extending into the third ventricle in adults. Brain Spine 2022; 2:100910. [PMID: 36248121 PMCID: PMC9560538 DOI: 10.1016/j.bas.2022.100910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 05/21/2022] [Accepted: 06/25/2022] [Indexed: 06/16/2023]
Abstract
•EAA is an innovative, promising, safe and effective approach for 3VCPs.•Key of success is surgeon learning curve in endoscopy and patients selection.•With correct indications, EEA gives GTR and morbidity rate similar to other routes.•Clinical, tumoral and anatomical features should be considered for EEA selection.
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Affiliation(s)
- Matteo Zoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi - Pituitary Unit, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Federica Guaraldi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi - Pituitary Unit, Bologna, Italy
| | - Corrado Zenesini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Epidemiology and Statistics Unit, Bologna, Italy
| | - Nicola Acciarri
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi - Pituitary Unit, Bologna, Italy
| | - Giacomo Sollini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi - Pituitary Unit, Bologna, Italy
- Azienda USL di Bologna, ENT Department, Bellaria Hospital, Bologna, Italy
| | - Sofia Asioli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
- Azienda USL di Bologna, Anatomic Pathology Unit, Bellaria Hospital, Bologna, Italy
| | - Marco Faustini-Fustini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi - Pituitary Unit, Bologna, Italy
| | - Raffaele Agati
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neuroradiologia con Tecniche ad Elevata Complessità, Bologna, Italy
| | - Luigi Cirillo
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC di Neuroradiologia, Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, Bologna, Italy
| | - Caterina Tonon
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, Bologna, Italy
| | - Raffaele Lodi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Ernesto Pasquini
- Azienda USL di Bologna, ENT Department, Bellaria Hospital, Bologna, Italy
| | - Diego Mazzatenta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi - Pituitary Unit, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
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Noureldine MHA, Khodmehr S, Sabahi M, Alikhani P, Jallo GI, Arjipour M. Neuroendoscopic Transventricular Approach for Cystic Craniopharyngioma. Cureus 2021; 13:e18123. [PMID: 34692333 PMCID: PMC8528039 DOI: 10.7759/cureus.18123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 11/10/2022] Open
Abstract
The literature is rich with many studies reporting different treatment modalities and approaches for cystic craniopharyngioma (CC), including microsurgery, neuroendoscopic transventricular approach, endoscopic transnasal surgery, stereotactic drainage, and Ommaya reservoir insertion. The goals of this manuscript are to report the successful treatment of an atypical case of CC using the neuroendoscopic transventricular approach (NTVA) as well as discuss the different surgical modalities for these tumors following a comprehensive review of the literature. Our patient is a nine-year-old female with a large CC who was managed using the NTVA. No complications or recurrence occurred over two years of follow-up. Results of our literature review showed lower recurrence and complication rates of the NTVA compared to other surgical modalities.The NTVA is potentially efficient, reliable, and safe for managing CC and cystic-dominant craniopharyngiomas, with low recurrence and complication rates compared to microsurgery and Ommaya reservoir insertion. Future randomized clinical studies comparing the various treatment modalities of CC are needed to solidify these conclusions.
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Affiliation(s)
| | - Sajjad Khodmehr
- Neurosurgery Research Group (NRG) Student Research Committee, Hamadan University of Medical Sciences, Hamadan, IRN
| | - Mohammadmahdi Sabahi
- Neurological Surgery, Neurosurgery Research Group (NRG) Student Research Committee, Hamadan University of Medical Sciences, Hamadan, IRN
| | - Puya Alikhani
- Neurosurgery and Brain Repair, University of South Florida, Tampa, USA
| | - George I Jallo
- Neurosurgery, Johns Hopkins All Children's Hospital, Baltimore, USA
| | - Mahdi Arjipour
- Neurosurgery, Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IRN.,Neurosurgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, IRN
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Locatelli D, Balbi S, Veiceschi P. The endoscopic diving technique in endonasal transsphenoidal surgery: how I do it. Acta Neurochir (Wien) 2020; 162:2111-2114. [PMID: 32377949 DOI: 10.1007/s00701-020-04369-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/21/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The endoscopic diving technique (EDT) is a procedure utilized in endonasal endoscopy, which consists of irrigating the surgical cavity during tumor removal, with a continuous flow of pressurized saline solution. METHODS The authors provide a detailed step-by-step description of the technique, shedding light on surgical tips and pitfalls. Advantages, disadvantages, and the most useful application of the technique are clarified and showed with a high-quality endoscopic video. CONCLUSION EDT represents an effective and safe procedure. It allows a wide exploration of the surgical cavity, providing tumor hydro-dissection, assisting in bleeding control, and optimizing the efficacy of endoscopic transsphenoidal surgery.
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Affiliation(s)
- Davide Locatelli
- Department of Biotechnology and Life Sciences, Division of Neurosurgery, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Viale Luigi Borri, 57, 21100, Varese, Italy
| | - Sergio Balbi
- Department of Biotechnology and Life Sciences, Division of Neurosurgery, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Viale Luigi Borri, 57, 21100, Varese, Italy
| | - Pierlorenzo Veiceschi
- Department of Biotechnology and Life Sciences, Division of Neurosurgery, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Viale Luigi Borri, 57, 21100, Varese, Italy.
- Department of Neurosurgery, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
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Wang S, Nie Q, Wu Z, Zhang J, Wei L. MRI and pathological features of Rathke cleft cysts in the sellar region. Exp Ther Med 2020; 19:611-618. [PMID: 31897104 PMCID: PMC6923755 DOI: 10.3892/etm.2019.8272] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 10/11/2019] [Indexed: 12/28/2022] Open
Abstract
The aim of the present study was to investigate the MRI and pathological features of Rathke cleft cysts (RCC) in the sellar region. A total of 45 RCC cases were retrospectively analyzed. RCC size, location, intracyst nodules and general signals, as well as the posterior pituitary bright spot (PPBS) were analyzed using MRI-T1 weighted images (T1WI) and T2WI. The relationship between the presence of PPBS and histopathological features was additionally evaluated. On T1WI, there were 18 cases of isointense signal, 16 cases of hyperintense signal, 9 cases of hypointense signal, 1 case of heterogeneous signal and 1 case with a stratification effect, with isointense signal in the upper part and hyperintense signal in the lower part. On T2WI, there were 5 cases of isointense signal, 27 cases of hyperintense signal, 11 cases of hypointense signal and 1 case of the stratification effect. There were 10 cases of PPBS+ and 35 cases of PPBS-. There were no significant differences in the age, sex, cyst location and size between PPBS+ and PPBS- cases. However, PPBS+ cases had significantly lower inflammation than PPBS- cases. A total of 20 cases of intracystic nodules were identified on MRI scans, most of which exhibited T2 -hypointense signals. The shape of RCC nodules varied and there were 17 cases where the nodules were non-adherent to the cyst wall. The MRI signals of RCCs varied and most nodules were floating within cysts. Intracystic nodules are characteristic features of RCCs when observed by MRI and thus are of high diagnostic value. Most patients with RCC were also PPBS-, which may be associated with an increased inflammatory response.
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Affiliation(s)
- Shousen Wang
- Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Qun Nie
- Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Zhifeng Wu
- Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Jianhe Zhang
- Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
| | - Liangfeng Wei
- Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University, Fuzhou, Fujian 350025, P.R. China
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