{"id":"909206a9-5a61-4e1f-ad64-8098dbb9e073","slug":"neurosurgery-concepts-key-perspectives-on-endoscopic-versus-microscopic-resection-for-pituitary-adenomas-surgical-decision-making-in-tuberculum-sellae-meningiomas-optic-nerve-mobilization-during-re","title":"Neurosurgery concepts: Key perspectives on endoscopic versus microscopic resection for pituitary adenomas, surgical decision-making in tuberculum sellae meningiomas, optic nerve mobilization during resection of craniopharyngiomas, and evaluation of headache and quality of life after endoscopic transphenoidal surgery for pituitary adenomas","authors":["Anand V. Germanwala","Ryan Hofler","Carlito Lagman","Lawrance K. Chung","Alexander A. Khalessi","Gabriel Zada","Zachary A. Smith","Nader S. Dahdaleh","Angela M. Bohnen","Jin M. Cho","Chaim B. Colen","Edward Duckworth","Peter Kan","Sandi Lam","Chae-Yong Kim","Gordon Li","Michael Lim","Jonathan H. Sherman","Vincent Y. Wang","Isaac Yang"],"abstract":"Background: This article explores various neurosurgical techniques and decision-making strategies in the management of pituitary adenomas, tuberculum sellae meningiomas, and craniopharyngiomas. It specifically compares endoscopic and microscopic approaches for pituitary adenoma resection, evaluates surgical decision-making for tuberculum sellae meningiomas, and presents a novel technique for optic nerve mobilization during craniopharyngioma resection. Methods: The study reviews a prospectively accrued database of patients undergoing pituitary adenoma resections, comparing outcomes between a less experienced surgeon using an endoscopic technique and a more experienced surgeon using a microscopic approach. Additionally, it retrospectively analyzes surgical outcomes for tuberculum sellae meningiomas managed via transcranial and endoscopic approaches, and describes a technique for optic nerve mobilization during craniopharyngioma resection. Results: The study found no significant differences in the extent of resection between the endoscopic and microscopic groups, although the endoscopic group exhibited a lower rate of posterior gland dysfunction and overall complications. In the tuberculum sellae meningioma cohort, recurrence was observed more frequently in the transcranial group. The optic nerve mobilization technique allowed for complete tumor resection under direct visualization without causing new deficits. Conclusion: The findings suggest that endoscopic resection by a less experienced surgeon can achieve outcomes comparable to those of a more experienced surgeon using a microscopic approach, with added benefits in terms of complications. The study highlights the importance of surgical technique and decision-making in optimizing patient outcomes for various cranial tumors. Keywords: pituitary adenoma, endoscopic surgery, microscopic surgery, meningioma, craniopharyngioma, optic nerve mobilization, surgical outcomes, neurosurgery","thumbnailUrl":null,"publishDate":"2017-04-05T00:00:00.000Z","doi":"10.4103/sni.sni_17_17","categories":["General Neurosurgery","Original Article"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2017/04/8341/SNI-8-52.pdf"}