Neuroendoscope-assisted microsurgery in patients with pituitary adenoma via pterional keyhole approach / 中华神经医学杂志

Objective To explore the role of neuroendoscopy in microsurgery in patients with pituitary adenoma via pterional keyhole approach.Methods Thirty-three patients with pituitary adenomas in the sellar region were performed microscope-assisted microsurgery and neuroendoscope-assisted microsurgery via pterional keyhole approach.The data of these patients and the total removal rate of these 2 strategies were analyzed and compared.Results Of the 33 patients,20 achieved total removal of the pituitary adenoma with microscope-assisted microsurgery via pterional keyhole approach and 13 got subtotal removal.Then,these 13 patients were performed neuroendoscope-assisted microsurgery via pterional keyhole approach:total removal was received in 8 and subtotal removal in 5.The total removal percentage that was got under the help of neuroendoscope-assisted microsurgery(28/33)was significantly higher as compared with that using microsurgery(20/33,P<0.05).Conclusion Neuroendoscope-assisted microsurgery via pterional keyhole approach,being able to enlarge the visible field in the microsurgery in patients with pituitary adenoma,increases the complete resection rate,protects the pituitary stalk and decreases the happening of complications.

Microsurgical treatment of intramedullary tumor in the superior cervical spinal cord / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the curative effect of microsurgery for intramedullary tumor in the superior cervical spinal cord.</p><p><b>METHODS</b>The clinical manifestations, microsurgical methods and results were reviewed retrospectively in 12 patients with intramedullary tumors in the superior cervical spinal cord.</p><p><b>RESULTS</b>No death occurred in these cases after the operations. The intramedullary tumors were totally resected in 10 patients including 8 with ependymomas and 2 with astrocytomas, and subtotally in 2 patients with astrocytomas. The spinal functions of patients, graded by McCormick scale system 3 months after the operations, were improved in 8 cases and remained unchanged in 4 cases. Nine patients were followed up for 1-3 years after the operations, and no tumor recurrence was found in 8 cases with total tumor resection.</p><p><b>CONCLUSION</b>Radical microneurosurgery is currently the best choice for the treatment of intradullary tumor in the superior cervical spinal cord.</p>

Applied endoscopic anatomy study of operative fissures in sellar region via pterional keyhole approach / 中华神经医学杂志

Objective To study the neuroendoscopic anatomy of operative fissures in sellar region via pterional keyhole approach, providing an anatomical basis for neuroendoscope-assisted microneurosurgery (EAM) via this approach. Methods A total of 15 cadaveric heads were dissected via pterional keyhole approach and the anatomical structure of the five operative fissures were studied with neuroendoscope. Results Microanatomy of the operative fissures in sellar region was observed well by neuroendoscope, especially the minute structures, such as the superior hypophyseal artery (SHA)and the perforating arteries, backside hidden but important structures of which were inspected with angle endoscope "bypassing" the nerves or arteries. Conclusion An endoscope can be applied to enlarge the visible field of microsurgical anatomy in sellar region via peterional keyhole approach microsurgery.The neuroendoscope-assisted microsurgery can reduce intraoperative distraction of brain tissues and focal vessels or nerves in skull bottom, and complications to improve the efficacy of microsurgery in sellar region.