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Stereotactic radiosurgery for pituitary adenomas

Residual and recurrent functioning pituitary adenomas can be difficult to delineate on postoperative MRI scans, making them difficult targets for stereotactic radio surgery. In such cases radiation delivery to the entire sellar has been utilised as a radio surgical equivalent...

Prolactinomas: when to operate

Prolactinomas are the most common functional pituitary adenomas, comprising 40% of all pituitary adenomas. There are consensus guidelines and several common management pathways. This article discusses the role of surgery for these patients. Following diagnosis, the goals of treatment are...

Intraoperative MRI use during pituitary tumour resection

This article provides an overview of intraoperative MRI (iMRI) use in transphenoidal surgery (TSS) for pituitary tumours. Traditionally imaging of the surgical field during surgery involves intraoperative fluoroscopic imaging or neuronavigation which help to avoid injury to critical structures but...

A bittersweet finding

This is an elegant study, documenting the role of, and activation of, nitrous oxide in chronic sinusitis. Bitter taste receptors (TR2) have recently been identified as novel ‘players’ in sinonasal innate immunity and in chronic rhinosinusitis. The receptors are triggered...

Are there any benefits of postoperative antibiotics after endoscopic transsphenoidal surgery for pituitary tumours?

This prospective randomised double-blind multicentre study evaluated whether postoperative antibiotics resulted in improvement in sinonasal quality of life (QoL) compared to placebo in patients undergoing endoscopic endonasal transsphenoidal pituitary surgery. A total of 461 patients were screened for the study...

QoL post-endoscopic hypophysectomy

This prospective study conducted over four years surveyed more than 300 patients after endoscopic pituitary adenoma resection. The authors used the Anterior Skull Base Questionnaire-35 and the Sinonasal Outcome Test-22, and the scores were analysed for quality of life (QoL)...

Recovery room cortisol to predict long-term glucocorticoid supplementation

The authors report the results of using recovery room (RR) cortisol to predict the need for long-term glucocorticoids in patients who underwent transsphenoidal surgery (TSS). They conducted a retrospective study of preoperative morning serum cortisol (MSC), RR cortisol and day...

A lateralised middle turbinate post pituitary surgery and incidence of sinusitis

A common belief amongst pituitary surgeons is that lateralising the middle turbinate to access the sphenoid can result in an iatrogenic sinusitis. This paper attempts to find out whether this is in fact true. Thirty-eight patients fitted the inclusion criteria...

3D endoscopy in pituitary adenoma surgery

Endoscopic approach for pituitary adenoma surgery is well recognised. There has been recent refinement of 3D endoscopy technology which improves on the depth of vision offered and more compact delivery. This may improve visualisation of the critical structures involved in...