How I do it: Endoscopic endonasal resection of the medial wall of the cavernous sinus.
Anatomy
Medial wall of cavernous sinus
Medial wall resection
Parasellar ligament
Pituitary surgery
Surgical technique
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
16 Jul 2024
16 Jul 2024
Historique:
received:
08
01
2024
accepted:
26
06
2024
medline:
16
7
2024
pubmed:
16
7
2024
entrez:
15
7
2024
Statut:
epublish
Résumé
Resection of the medial wall of the cavernous sinus (MWCSR) is a growing surgical maneuver for the radical removal of pituitary adenomas. We present a simple modification of the technique following the two dural layers of the floor of the sella turcica, allowing for early identification of the medial wall and simplifying dissection. We support this technique with an anatomical analysis on cadaveric specimens and clarifying dissection images. Recognition and dissection of the dural unfolding of the floor of the sella turcica are "key points" that lower the risk and facilitate the MWCSR.
Sections du résumé
BACKGROUND
BACKGROUND
Resection of the medial wall of the cavernous sinus (MWCSR) is a growing surgical maneuver for the radical removal of pituitary adenomas.
METHOD
METHODS
We present a simple modification of the technique following the two dural layers of the floor of the sella turcica, allowing for early identification of the medial wall and simplifying dissection. We support this technique with an anatomical analysis on cadaveric specimens and clarifying dissection images.
CONCLUSION
CONCLUSIONS
Recognition and dissection of the dural unfolding of the floor of the sella turcica are "key points" that lower the risk and facilitate the MWCSR.
Identifiants
pubmed: 39009772
doi: 10.1007/s00701-024-06177-w
pii: 10.1007/s00701-024-06177-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
298Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.
Références
Cárdenas Ruiz-Valdepeñas E, Kaen A, Tirado Caballero J (2019) Transcavernous sinus pituitary gland transposition: how I do it. Acta Neurochir 161:2123–2127. https://doi.org/10.1007/s00701-019-04012-1
doi: 10.1007/s00701-019-04012-1
pubmed: 31327080
Cohen-Cohen S, Gardner PA, Alves-Belo JT, Truong HQ, Snyderman CH, Wang EW, Fernandez-Miranda JC (2018) The medial wall of the cavernous sinus. Part 2: Selective medial wall resection in 50 pituitary adenoma patients. J Neurosurg 131:131–140. https://doi.org/10.3171/2018.5.jns18595
doi: 10.3171/2018.5.jns18595
pubmed: 30192191
de Macêdo Filho LJM, Diógenes AVG (2022) Endoscopic endonasal resection of the medial wall of the cavernous sinus and its impact on outcomes of pituitary surgery: a systematic review and meta-analysis. 12. https://doi.org/10.3390/brainsci12101354
Labib MA, Prevedello DM, Fernandez-Miranda JC, Sivakanthan S, Benet A, Morera V, Carrau R, Kassam A (2013) The medial opticocarotid recess: an anatomic study of an endoscopic "key landmark" for the ventral cranial base. Neurosurgery 72:66–76; discussion 76. https://doi.org/10.1227/NEU.0b013e318271f614
Mohyeldin A, Katznelson LJ, Hoffman AR, Asmaro K, Ahmadian SS, Eltobgy MM, Nayak JV, Patel ZM, Hwang PH, Fernandez-Miranda JC (2022) Prospective intraoperative and histologic evaluation of cavernous sinus medial wall invasion by pituitary adenomas and its implications for acromegaly remission outcomes. Sci Rep 12:9919. https://doi.org/10.1038/s41598-022-12980-1
doi: 10.1038/s41598-022-12980-1
pubmed: 35705579
pmcid: 9200976
Omar AT, 2nd, Munoz DG, Goguen J, Lee JM, Rotondo F, Kovacs K, Cusimano MD (2020) Resection of the medial wall of the cavernous sinus in functioning pituitary adenomas: Technical note and outcomes in a matched-cohort study. Clin Neurol Neurosurg 106306. https://doi.org/10.1016/j.clineuro.2020.106306
Pontes JPM, Udoma-Udofa OC (2023) Efficacy and safety of cavernous sinus medial wall resection in pituitary adenoma surgery: a systematic review and a single-arm meta-analysis. 26:340-351. https://doi.org/10.1007/s11102-023-01332-5
Rindler RS, Leonel LC, Graepel S, Agosti E, Kerezoudis P, Pinheiro-Neto CD, Peris-Celda M (2022) The endonasal midline inferior intercavernous approach to the cavernous sinus: technical note, cadaveric step-by-step illustration, and case presentation. Acta Neurochir 164:2573–2580. https://doi.org/10.1007/s00701-022-05284-w
doi: 10.1007/s00701-022-05284-w
pubmed: 35737127
Serioli S, Plou P, Leonel L, Graepel S, Buffoli B, Rezzani R, Fontanella MM, Poliani PL, Doglietto F, Link MJ, Pinheiro-Neto CD, Peris-Celda M (2023) The “candy wrapper” of the pituitary gland: a road map to the parasellar ligaments and the medial wall of the cavernous sinus. Acta Neurochir 165:3431–3444. https://doi.org/10.1007/s00701-023-05736-x
doi: 10.1007/s00701-023-05736-x
pubmed: 37594638
Truong HQ, Lieber S, Najera E, Alves-Belo JT, Gardner PA, Fernandez-Miranda JC (2018) The medial wall of the cavernous sinus. Part 1: Surgical anatomy, ligaments, and surgical technique for its mobilization and/or resection. J Neurosurg 131:122–130. https://doi.org/10.3171/2018.3.jns18596
doi: 10.3171/2018.3.jns18596
pubmed: 30192192