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[Extradural temporopolar approach for giant pituitary adenomas invading the cavernous sinus and parasellar regions].
No Shinkei Geka. 1998 Sep; 26(9):803-11.NS

Abstract

OBJECTIVE

An extradural temporopolar approach has recently been used in the treatment of the parasellar, infrachiasmatic, or intracavernous regions. In this approach, the temporal (superficial) dural layer is separated from the deep layer (inner cavernous membrane) to expose the cavernous sinus extradurally. We report our experiences with 5 cases in which a giant pituitary adenoma invading the cavernous sinus and parasellar regions was resected via the extradural temporopolar approach.

PATIENTS AND METHODS

Between January 1995 and December 1997, 60 patients with pituitary adenomas were operated on at Okayama University Hospital. The extradural temporopolar approach was used for 5 patients who had a giant pituitary adenoma invading the cavernous sinus and parasellar regions. The 5 patients were women aged from 32 to 62 years and presented with a visual dysfunction. Four patients had hormonally non-functioning pituitary adenomas and one had a growth-hormone secreting pituitary adenoma.

RESULTS

The operations resulted in 1 total, 3 subtotal and 1 partial removal. There was no operative mortality or major morbidity. Transient oculomotor palsy occurred in 2 cases postoperatively. This approach provided excellent exposure of the tumor, relevant cranial nerves and arteries in and around the cavernous sinus through extradural retraction of the temporal lobe, allowing for sufficient resection of the intracavernous and parasellar portion of the tumor. Tumors invading the inferior portion of the clivus or the contralateral cavernous sinus could not be removed through this approach.

CONCLUSION

Our findings suggest that the extradural temporopolar approach is useful for resection of giant pituitary adenomas invading the cavernous sinus and parasellar regions.

Authors+Show Affiliations

Tamiya T
Department of Neurological Surgery, Okayama University Medical School, Japan.
Ono Y
No affiliation info available
Date I
No affiliation info available
Kawauchi M
No affiliation info available
Matsumoto K
No affiliation info available
Ohmoto T
No affiliation info available

MeSH

AdenomaAdultCavernous SinusFemaleHumansHypophysectomyMicrosurgeryMiddle AgedNeoplasm InvasivenessPituitary NeoplasmsSkull Base NeoplasmsVascular Neoplasms

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

9757457

Citation

Tamiya, T, et al. "[Extradural Temporopolar Approach for Giant Pituitary Adenomas Invading the Cavernous Sinus and Parasellar Regions]." No Shinkei Geka. Neurological Surgery, vol. 26, no. 9, 1998, pp. 803-11.
Tamiya T, Ono Y, Date I, et al. [Extradural temporopolar approach for giant pituitary adenomas invading the cavernous sinus and parasellar regions]. No Shinkei Geka. 1998;26(9):803-11.
Tamiya, T., Ono, Y., Date, I., Kawauchi, M., Matsumoto, K., & Ohmoto, T. (1998). [Extradural temporopolar approach for giant pituitary adenomas invading the cavernous sinus and parasellar regions]. No Shinkei Geka. Neurological Surgery, 26(9), 803-11.
Tamiya T, et al. [Extradural Temporopolar Approach for Giant Pituitary Adenomas Invading the Cavernous Sinus and Parasellar Regions]. No Shinkei Geka. 1998;26(9):803-11. PubMed PMID: 9757457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Extradural temporopolar approach for giant pituitary adenomas invading the cavernous sinus and parasellar regions]. AU - Tamiya,T, AU - Ono,Y, AU - Date,I, AU - Kawauchi,M, AU - Matsumoto,K, AU - Ohmoto,T, PY - 1998/10/3/pubmed PY - 1998/10/3/medline PY - 1998/10/3/entrez SP - 803 EP - 11 JF - No shinkei geka. Neurological surgery JO - No Shinkei Geka VL - 26 IS - 9 N2 - OBJECTIVE: An extradural temporopolar approach has recently been used in the treatment of the parasellar, infrachiasmatic, or intracavernous regions. In this approach, the temporal (superficial) dural layer is separated from the deep layer (inner cavernous membrane) to expose the cavernous sinus extradurally. We report our experiences with 5 cases in which a giant pituitary adenoma invading the cavernous sinus and parasellar regions was resected via the extradural temporopolar approach. PATIENTS AND METHODS: Between January 1995 and December 1997, 60 patients with pituitary adenomas were operated on at Okayama University Hospital. The extradural temporopolar approach was used for 5 patients who had a giant pituitary adenoma invading the cavernous sinus and parasellar regions. The 5 patients were women aged from 32 to 62 years and presented with a visual dysfunction. Four patients had hormonally non-functioning pituitary adenomas and one had a growth-hormone secreting pituitary adenoma. RESULTS: The operations resulted in 1 total, 3 subtotal and 1 partial removal. There was no operative mortality or major morbidity. Transient oculomotor palsy occurred in 2 cases postoperatively. This approach provided excellent exposure of the tumor, relevant cranial nerves and arteries in and around the cavernous sinus through extradural retraction of the temporal lobe, allowing for sufficient resection of the intracavernous and parasellar portion of the tumor. Tumors invading the inferior portion of the clivus or the contralateral cavernous sinus could not be removed through this approach. CONCLUSION: Our findings suggest that the extradural temporopolar approach is useful for resection of giant pituitary adenomas invading the cavernous sinus and parasellar regions. SN - 0301-2603 UR - https://www.unboundmedicine.com/medline/citation/9757457/[Extradural_temporopolar_approach_for_giant_pituitary_adenomas_invading_the_cavernous_sinus_and_parasellar_regions]_ DB - PRIME DP - Unbound Medicine ER -