Ahead of Print: Endoscopic Transsphenoidal Pituitary Surgery: Evidence of an Operative Learning Curve

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Paul Leach, FRCS, Ahmed A. Abou-Zeid, MD, Tara Kearney, MD, Julian Davis, PhD, Peter Trainer, PhD, Kanna K. Gnanalingham, PhD

BACKGROUND: The use of the fiberoptic endoscope is a recent innovation in pituitary surgery.

OBJECTIVE: To investigate the evidence of an operative learning curve after the introduction of endoscopic transsphenoidal surgery in our unit.

METHODS: The first 125 patients who underwent endoscopic transnasal transsphenoidal surgery for pituitary fossa lesions between 2005 and 2007 performed by 1 surgeon were studied. Changes in a number of parameters were assessed between 2 equal 15-month time periods: period 1 (53 patients) and period 2 (72 patients).

Ahead of Print: Bone Removal With a New Ultrasonic Bone Curette During Endoscopic Endonasal Approach to the Sellar-Suprasellar Area

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Cappabianca, Paolo MD; Cavallo, Luigi M. MD, PhD; Esposito, Isabella MD; Barakat, Mohamed MD; Esposito, Felice MD, PhD

BACKGROUND: Accessing intradural lesions via an extended endoscopic endonasal approach requires a relatively large bony removal over the skull base.

OBJECTIVE: We describe the Sonopet ultrasonic bone curette with a new dedicated endonasal hand-piece.

MATERIALS AND METHODS: We used this ancillary device in 27 nonconsecutive endonasal procedures for different skull base lesions (18 standard pituitary operations and 9 extended approaches for either meningiomas or craniopharyngiomas).