TY - JOUR
T1 - Ultra-Early Treatment of Neurosurgical Emergencies with Endoscopic Endonasal Approach: Experience from Three Italian Referral Centers
AU - Mattogno, Pier Paolo
AU - Zoli, Matteo
AU - D'Alessandris, Quintino Giorgio
AU - Bongetta, Daniele
AU - Caccavella, Valerio Maria
AU - Rigante, Mario
AU - Della Pepa, Giuseppe Maria
AU - Mazzatenta, Diego
AU - Lauretti, Liverana
AU - Olivi, Alessandro
AU - Spena, Giannantonio
AU - Zoia, Cesare
PY - 2023
Y1 - 2023
N2 - Purpose: the aim of this multicenter study is to preliminarily assess the role of the Endoscopic Endonasal Approach (EEA) in ultra-early (i.e., within 12 h) management of selected neurosurgical emergencies in terms of clinical and radiological outcomes. Methods: 26 patients affected by sellar/parasellar pathologies with rapid progression of symptoms were managed with EEA within 12 h from diagnosis in three Italian tertiary referral Centers from January 2016 to December 2019. Both clinical and radiological data have been collected preoperatively as well as post-operatively in order to perform retrospective analysis. Results: The average time from admission to the operating room was 5.5 h (±2.3). The extent of resection was gross-total in 20 (76.9%), subtotal in 6 (23.1%) patients. One patient experienced re-bleeding after a subtotal removal of a hemorrhagic lesion. Patients with a longer time from admission (>4 h) to the operatory room (OR) experienced stable impairment of the visual acuity (p = 0.033) and visual field (p = 0.029) in the post-operative setting. Conclusions: The Endoscopic Endonasal Approach represents a safe, effective technique that can be efficiently used with good results in the management of selected neurosurgical emergencies in centers with adequate experience.
AB - Purpose: the aim of this multicenter study is to preliminarily assess the role of the Endoscopic Endonasal Approach (EEA) in ultra-early (i.e., within 12 h) management of selected neurosurgical emergencies in terms of clinical and radiological outcomes. Methods: 26 patients affected by sellar/parasellar pathologies with rapid progression of symptoms were managed with EEA within 12 h from diagnosis in three Italian tertiary referral Centers from January 2016 to December 2019. Both clinical and radiological data have been collected preoperatively as well as post-operatively in order to perform retrospective analysis. Results: The average time from admission to the operating room was 5.5 h (±2.3). The extent of resection was gross-total in 20 (76.9%), subtotal in 6 (23.1%) patients. One patient experienced re-bleeding after a subtotal removal of a hemorrhagic lesion. Patients with a longer time from admission (>4 h) to the operatory room (OR) experienced stable impairment of the visual acuity (p = 0.033) and visual field (p = 0.029) in the post-operative setting. Conclusions: The Endoscopic Endonasal Approach represents a safe, effective technique that can be efficiently used with good results in the management of selected neurosurgical emergencies in centers with adequate experience.
KW - endoscopic technique
KW - transnasal endoscopy
KW - pituitary apoplexy
KW - neurosurgical emergencies
KW - endoscopic technique
KW - transnasal endoscopy
KW - pituitary apoplexy
KW - neurosurgical emergencies
UR - http://hdl.handle.net/10807/289642
U2 - 10.3390/jcm12175471
DO - 10.3390/jcm12175471
M3 - Article
SN - 2077-0383
VL - 12
SP - 5471
EP - 5471
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
ER -