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Reducing readmission rates after transsphenoidal pituitary surgery
This retrospective study provides an outpatient care pathway to screen and manage delayed hyponatremia which the study identified as the primary cause of readmission following transsphenoidal pituitary surgery. Of the 303 patients who were studied, 27 were readmitted within 30...
The increasingly favourable outcomes from endoscopic endonasal approaches for the management of pituitary adenomas
Historically, pituitary tumours have been surgically managed with an open, transcranial approach. Although this approach still has its merits in large intracranial adenomas, technological advancement has allowed smaller tumours to be debulked via a transseptal microscopic technique. These days, the...
Endoscope assisted removal of jugular foramen schwannomas
This article, written by a renowned surgeon with extensive experience in removal of jugular foramen and skull base lesions, describes a new classification for jugular foramen schwannomas (JFS) and a template for selection of surgical approach for endoscope assisted removal....
How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?
Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...
Surgical anatomy for central auditory device implantation
This cadaveric study by researchers in the USA and Japan examined the cerebellopontine angles with the aid of the surgical microscope and 45o endoscope via the retrosigmoid and translabyrinthine approach. Using fibre dissection technique, the ascending auditory pathways between the...
Rare, aggressive pituitary adenomas
This is a review article on published cases of the rare Crooke’s pituitary adenoma. These tumors are usually invasive and may be clinically aggressive; they may be endocrinologically silent or may produce adrenocorticotropic hormone causing Cushing’s disease. They often recur...
Clival chordoma recurrence
Chordomas are generally slow growing and are histologically considered low grade tumours. Their high recurrence rate even after postoperative radiation renders them difficult to treat. This is particularly true for clival chordomas whose deep anatomic location and proximity to vital...
Choosing Wisely!
This article focuses on the prickly topic of healthcare costs and specifically on reducing spending on neuroimaging for headaches. Epidemiological studies indicate that the prevalence of lifetime headaches is 93 to 99% and accounts for 1.5% of all primary care...
Comparing surgical freedom of four transsphenoidal approaches to the sella
Four transspenoidal approaches to the sella were performed and studied by the authors on eight silicon-injected cadaveric heads. Surgical freedom, that is, the ability of the surgeon to move his or her hands in a fixed space, was determined with...
Argh! Facial pain! What to do??
We often come across patients with presentation of facial pain, but unless this is sinugenic in origin, our understanding and management of it can often be found wanting. Craniofacial pain is in fact highly complex and encompasses a wide range...
Outcomes after facial nerve preservation surgery for large vestibular schwannomas
Large vestibular schwannomas (Koos grade three or four) are traditionally treated by surgical resection. Gross total resection of such large tumours often results in facial nerve dysfunction. Hence facial nerve preservation surgery was introduced in which maximal surgical resection is...
