Image-guided endoscopic transnasal removal of recurrent pituitary adenomas

Giovanni Lasio, Paolo Ferroli, Giovanni Felisati, Giovanni Broggi, Carl B. Heilman, Kalmon D. Post, Edward R. Laws, Jeff Laurent, Raul Marino

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To assess the role that neuronavigation plays in assisting endoscopic transsphenoidal reoperations for recurrent pituitary adenomas. METHODS: During a 45-month period, 19 endoscopic endonasal transsphenoidal reoperations were performed for recurrent pituitary adenomas. In 11 of 19 patients, the procedure was performed with the aid of an optically guided system. Clinical records were reviewed retrospectively, with attention to the following: comparison of baseline clinical data, the duration of surgery, and the postoperative course and complications of both image-guided and nonimage-guided endoscopic reoperations. In addition, to test the reliability of the neuronavigation system, we made measurements of intraoperative accuracy in five additional transnasal endoscopic procedures in "virgin" noses and sphenoidal sinuses. RESULTS: In both groups studied, we found no difference with regard to either morbidity or mortality, which were null. The mean setup time was 13 minutes shorter in non-image-guided procedures (P = 0.021), and the operative time was 36 minutes shorter in image-guided procedures (P = 0.038). No other statistically significant differences were found between the two groups. In all cases, we found that the system performed without malfunction. Continuous information regarding instrument location and trajectory was provided to the surgeon. Measurements of the intraoperative accuracy in the axial, coronal, and sagittal planes indicated a mean intraoperatively verified system error of 1.6 ± 0.6 mm. CONCLUSION: Neuronavigation can be applied during endonasal transsphenoidal endoscopic surgery and requires a minimal amount of time. It makes reoperation easier, faster, and probably safer.

Original languageEnglish
Pages (from-to)132-137
Number of pages6
JournalNeurosurgery
Volume51
Issue number1
DOIs
Publication statusPublished - Jul 1 2002

Fingerprint

Pituitary Neoplasms
Neuronavigation
Reoperation
Operative Time
Nose
Morbidity
Mortality

Keywords

  • Endoscopy
  • Neuronavigation
  • Pituitary adenoma
  • Recurrences
  • Transsphenoidal surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Image-guided endoscopic transnasal removal of recurrent pituitary adenomas. / Lasio, Giovanni; Ferroli, Paolo; Felisati, Giovanni; Broggi, Giovanni; Heilman, Carl B.; Post, Kalmon D.; Laws, Edward R.; Laurent, Jeff; Marino, Raul.

In: Neurosurgery, Vol. 51, No. 1, 01.07.2002, p. 132-137.

Research output: Contribution to journalArticle

Lasio, G, Ferroli, P, Felisati, G, Broggi, G, Heilman, CB, Post, KD, Laws, ER, Laurent, J & Marino, R 2002, 'Image-guided endoscopic transnasal removal of recurrent pituitary adenomas', Neurosurgery, vol. 51, no. 1, pp. 132-137. https://doi.org/10.1097/00006123-200207000-00020
Lasio, Giovanni ; Ferroli, Paolo ; Felisati, Giovanni ; Broggi, Giovanni ; Heilman, Carl B. ; Post, Kalmon D. ; Laws, Edward R. ; Laurent, Jeff ; Marino, Raul. / Image-guided endoscopic transnasal removal of recurrent pituitary adenomas. In: Neurosurgery. 2002 ; Vol. 51, No. 1. pp. 132-137.
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