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Superior Turbinectomy: Role for a Two-surgeon Technique in Endoscopic Endonasal Transsphenoidal Surgery—Technical Note
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- FUJIMOTO Yasunori
- Department of Neurosurgery, Osaka Neurological Institute
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- RAMOS Henrique F.
- Department of Otorhinolaryngology, Hospital das Clínicas, University of São Paulo School of Medicine
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- MARIANI Pedro P.
- Department of Neurosurgery, Hospital de Transplantes Euryclides de Jesus Zerbini
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- ROMANO Fabrizio R.
- Department of Neurosurgery, Hospital de Transplantes Euryclides de Jesus Zerbini
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- CUKIERT Arthur
- Department of Neurosurgery, Hospital de Transplantes Euryclides de Jesus Zerbini
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- BOR-SENG-SHU Edson
- Divison of Neurological Surgery, Hospital das Clínicas, University of São Paulo School of Medicine
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- WAKAYAMA Akatsuki
- Department of Neurosurgery, Osaka Neurological Institute
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- YOSHIMINE Toshiki
- Department of Neurosurgery, Osaka University Graduate School of Medicine
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Description
We describe a practical technique of superior turbinectomy followed by posterior ethmoidectomy as a less invasive procedure for two-surgeon technique on endoscopic endonasal transsphenoidal surgery. After identification of the superior turbinate and the sphenoid ostium, the inferior third portion of the superior turbinate was coagulated and resected. This partial superior turbinectomy procedure exposed the posterior ethmoidal sinus. Resection of the bony walls between the sphenoid and posterior ethmoid sinuses provided more lateral and superior exposure of the sphenoid sinus. This technique was performed in 56 patients with midline skull base lesions, including 49 pituitary adenomas and 7 other lesions. Meticulous manipulation of instruments was performed in all cases without surgical complications such as permanent hyposmia/anosmia or nasal bleeding. Our findings suggested that the partial superior turbinectomy followed by retrograde posterior ethmoidectomy is a simple and safe technique providing a sufficient surgical corridor for two-surgeon technique to approaching midline skull base regions, mainly involving pituitary adenomas.
Journal
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- Neurologia medico-chirurgica
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Neurologia medico-chirurgica 55 (4), 345-350, 2015
The Japan Neurosurgical Society