Endoscopic Pituitary Surgery Endocrine, Neuro-Ophthalmologic, and Surgical Management THM_Schwartz_FM.indd i Manila Typesetting Company 08/06/2011 03:02AM THM_Schwartz_FM.indd ii Manila Typesetting Company 08/06/2011 03:02AM Endoscopic Pituitary Surgery Endocrine, Neuro-Ophthalmologic, and Surgical Management Theodore H. Schwartz, MD, FACS Professor Departments of Neurological Surgery, Otolaryngology-Head and Neck Surgery, and Neurology and Neuroscience Weill Cornell Medical College Attending Neurosurgeon Department of Neurological Surgery New York–Presbyterian Hospital New York, New York Vijay K. Anand, MD, FACS Clinical Professor Department of Otolaryngology-Head and Neck Surgery Weill Cornell Medical College New York–Presbyterian Hospital New York, New York Thieme New York • Stuttgart American Association of Neurosurgeons Rolling Meadows, Illinois THM_Schwartz_FM.indd ii Manila Typesetting Company 08/06/2011 03:02AM THM_Schwartz_FM.indd iii Manila Typesetting Company 08/06/2011 03:02AM Thieme Publishers, Inc. American Association of Neurosurgeons (AANS)* 333 Seventh Ave. 5550 Meadowbrook Drive New York, NY 10001 Rolling Meadows, Illinois 60008-3852 *The abbreviation AANS refers to both the American Association of Neurological Surgeons and the American Association of Neurosurgeons. Executive Editor: Kay D. Conerly Managing Editor: Lauren Henry Editorial Director: Michael Wachinger Production Editor: Print Matters, Inc. International Production Director: Andreas Schabert Vice President, International Marketing and Sales: Cornelia Schulze Vice President, Finance and Accounts: Sarah Vanderbilt President: Brian D. Scanlan Compositor: Manila Typesetting Company Printer: Leo Paper Group Library of Congress Cataloging-in-Publication Data Endoscopic pituitary surgery endocrine, neuro-ophthalmologic, and surgical management / [edited by] Theodore H. Schwartz, Vijay K. Anand. p. ; cm. Includes bibliographical references and index. ISBN 978-1-60406-347-9 (alk. paper) 1. Pituitary gland–Endoscopic surgery. I. Schwartz, Theodore H. II. Anand, Vijay K., 1951- [DNLM: 1. Pituitary Diseases–surgery. 2. Endoscopy–methods. 3. Pituitary Gland–surgery. WK 590] RD599.5.P58E53 2010 617.4’40597--dc22 2010054493 Copyright ©2012 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. 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Neither the content, the use of a specific product in conjunction therewith, nor the exhibition of any materials by any parties coincident with this publication, should be construed as indicating endorsement or approval of the views presented, the products used, or the materi- als exhibited by the AANS, or its Committees, Commissions, or Affiliates. Printed in China 5 4 3 2 1 ISBN 978-1-60406-347-9 TTHHMM__SScchhwwaarrttzz__FFMM..iinndddd iivv MMaanniillaa TTyyppeesseettttiinngg CCoommppaannyy 0088//0066//22001111 0033::0022AAMM THM_Schwartz_FM.indd v Manila Typesetting Company 08/06/2011 03:02AM This book is dedicated to our patients, who have entrusted us with their health and with- out whom this work would not be possible. We would also like to dedicate this book to our wives, Nancy and Nanda, who have stood by our sides all along the way, providing us with unending support. TTHHMM__SScchhwwaarrttzz__FFMM..iinndddd iivv MMaanniillaa TTyyppeesseettttiinngg CCoommppaannyy 0088//0066//22001111 0033::0022AAMM THM_Schwartz_FM.indd v Manila Typesetting Company 08/06/2011 03:02AM THM_Schwartz_FM.indd vi Manila Typesetting Company 08/06/2011 03:02AM THM_Schwartz_FM.indd vii Manila Typesetting Company 08/06/2011 03:02AM Contents Continuing Medical Education Credit Information and Objectives ............................................................................................xi Continuing Medical Education Disclosure ......................................................................................................................................xiii Historical Perspective .............................................................................................................................................................................xv Foreword ................................................................................................................................................................................................xvii Preface .......................................................................................................................................................................................................xix Acknowledgments ...................................................................................................................................................................................xx Contributors ............................................................................................................................................................................................xxi 1 History of Pituitary Surgery ..............................................................................................................................................................1 Edward R. Laws Jr. 2 Anatomy of the Pituitary Gland and Parasellar Region .............................................................................................................9 Ameet Singh, Jonathan Roth, Vijay K. Anand, and Theodore H. Schwartz 3 Endoscopic Equipment .....................................................................................................................................................................23 Paolo Cappabianca, Luigi M. Cavallo, Felice Esposito, and Matteo G. De Notaris 4 Preoperative Endocrine Evaluation ..............................................................................................................................................34 John C. Ausiello and Pamela U. Freda 5 Radiographic Evaluation of Pituitary Tumors ............................................................................................................................43 Prashant Raghavan and C. Douglas Phillips 6 Indications for Surgery on Pituitary Tumors: An Endocrinologist’s Perspective ..............................................................62 David L. Kleinberg and Pietro Ameri 7 Indications for Surgery on Pituitary Tumors: A Neurosurgeon’s Perspective ...................................................................69 Rudolf Fahlbusch and Vincenzo Paternó 8 Histology of Pituitary Tumors ........................................................................................................................................................76 Theresa Scognamiglio and Ehud Lavi 9 Prolactinomas and Apoplexy ..........................................................................................................................................................87 Jeroen R. Coppens and William T. Couldwell 10 Acromegaly ..........................................................................................................................................................................................97 Brian J. Snyder and Kalmon D. Post 11 Cushing’s Disease ............................................................................................................................................................................109 Charles A. Sansur, Stephen J. Monteith, and Edward H. Oldfield vii THM_Schwartz_FM.indd vi Manila Typesetting Company 08/06/2011 03:02AM THM_Schwartz_FM.indd vii Manila Typesetting Company 08/06/2011 03:02AM viii viii Contents 12 Thyroid-Stimulating Hormone Tumors ...................................................................................................................................119 Stephen J. Monteith, Jonathan H. Sherman, John A. Jane Jr., and Edward R. Laws Jr. 13 Clinical Management of Nonfunctioning Pituitary Adenomas ..........................................................................................126 Gabriel Zada, Jeroen R. Coppens, William T. Couldwell, and Martin H. Weiss 14 Neuro-Ophthalmologic Considerations ...................................................................................................................................132 Jacqueline M. S. Winterkorn, Richard L. Levy, and Marc J. Dinkin 15 Endoscopic Transsphenoidal Approach to the Sella ..............................................................................................................146 Lewis Z. Leng, Vijay K. Anand, and Theodore H. Schwartz 16 Clinical Pearls in Endoscopic Pituitary Surgery: A Neurosurgeon’s Perspective ...........................................................161 Paolo Cappabianca, Felice Esposito, Luigi M. Cavallo, and Isabella Esposito 17 Clinical Pearls in Endoscopic Pituitary Surgery: An Otolaryngologist’s Perspective ...................................................168 Dharambir S. Sethi and Beng Ti Ang 18 Virtual Endoscopy in Endoscopic Pituitary Surgery .............................................................................................................181 Stefan Wolfsberger and André Neubauer 19 3D Stereoendoscopic Pituitary Surgery ...................................................................................................................................195 Seth Brown, Vijay K. Anand, Jonathan Roth, and Theodore H. Schwartz 20 Endoscope-Assisted Transsphenoidal Surgery .......................................................................................................................202 Joshua R. Dusick, Manoel de Paiva Neto, Nasrin Fatemi, and Daniel F. Kelly 21 Endoscopic Pituitary Surgery in the Cavernous Sinus .........................................................................................................212 Giorgio Frank and Ernesto Pasquini 22 Microscopic versus Endoscopic Transsphenoidal Pituitary Surgery ................................................................................227 Jonathan H. Sherman, Stephen J. Monteith, Edward R. Laws Jr., and John A. Jane Jr. 23 Microscopic and Endoscopic Transsphenoidal Pituitary Surgery: A Reasoned and Balanced Dialectic ...........................................................................................................................................237 Nathan C. Rowland, Ammara Abbasi, David V. LaBorde, and Nelson M. Oyesiku 24 Extended Endonasal, Endoscopic Transsphenoidal Approach versus Craniotomy for Giant Pituitary Macroadenomas ................................................................................................................................................248 Christoph P. Hofstetter, Yaron Moshel, Michael Nanaszko, Vijay K. Anand, and Theodore H. Schwartz 25 Stereotactic Radiosurgery and Fractionated Radiation for Pituitary Tumors................................................................262 Bruce E. Pollock and Paul D. Brown 26 Atypical Adenoma, Pituitary Carcinoma, and the Role of Chemotherapy in the Management of Refractory Pituitary Adenoma...............................................................................................................................................272 Tannaz Moin, William H. Yong, and Anthony Heaney 27 The Utility of Intraoperative MRI in Pituitary Surgery ........................................................................................................283 Rudolf Fahlbusch and Vincenzo Paternó 28 Limited Utility of Intraoperative MRI in Endoscopic Pituitary Surgery ..........................................................................295 Ilya Laufer, Vijay K. Anand, and Theodore H. Schwartz 29 The Role of Stereotactic Navigation in Endoscopic Pituitary Surgery ..............................................................................305 Abtin Tabaee, Vijay K. Anand, and Theodore H. Schwartz 30 Anesthesia Considerations .........................................................................................................................................................313 Patricia Fogarty Mack 31 Managing Postoperative Sinusitis ..............................................................................................................................................321 Ameet Singh, Madeleine R. Schaberg, Gurston G. Nyquist, and Vijay K. Anand TTHHMM__SScchhwwaarrttzz__FFMM..iinndddd vviiiiii MMaanniillaa TTyyppeesseettttiinngg CCoommppaannyy 0088//0066//22001111 0033::0022AAMM THM_Schwartz_FM.indd ix Manila Typesetting Company 08/06/2011 03:02AM Contents ix ix 32 Managing Carotid Injury During Transsphenoidal Surgery ................................................................................................328 Jared Knopman, Athos Patsalides, Y. Pierre Gobin, and Howard A. Riina 33 Managing Postoperative CSF leak ..............................................................................................................................................335 Paul A. Gardner, Carl Snyderman, and Juan Fernandez-Miranda 34 Postoperative and Neurocritical Care Management of Patients after Endonasal Endoscopic Transsphenoidal Pituitary Surgery ...........................................................................................................................................340 Jeffrey P. Greenfield and Theodore H. Schwartz Index ........................................................................................................................................................................................................348 TTHHMM__SScchhwwaarrttzz__FFMM..iinndddd vviiiiii MMaanniillaa TTyyppeesseettttiinngg CCoommppaannyy 0088//0066//22001111 0033::0022AAMM THM_Schwartz_FM.indd ix Manila Typesetting Company 08/06/2011 03:02AM