Akademik Veri Yönetim Sistemi
Open Access Journal of Neurology & Neurosurgery, cilt.2022, sa.2022, ss.1-2, 2022 (Hakemli Dergi)
The endoscopic endonasal approach provides the possibility of obtaining early devascularization in sellar, infra and supradiafragmatic and
intraventricular midline lesions without neurovascular retraction or manipulation. In the last two decades, extended endoscopic transsphenoidal
approaches have become increasingly common for sellar zone lesions with suprasellar extension and infundibular lesions. Besides the possibility
of damage to important anatomical structures, the risk of post-operative CSF leakage is higher than in the standard approach. The diaphragma
sellae is an important barrier for CSF leakage. CSF leakage is less likely to occur in surgery in which the diaphragma sellae is preserved. In smallsized suprasellar extension tumors, a window is opened in the diaphragm following the excision of the intrasellar component and the tumor
component that has spread to the suprasellar area is excised from this small diaphragmatic foromen. Instead of the extended approach, we
applied this intrasellar transdiaphragmatic approach to 7 patients (craniopharyngioma, metastasis, 2 acromegaly, 2 cushing disease and rathke
cleft cyst) with suprasellar or infundibular lesions. We presented 4 of these patients. With this method, which is less invasive compared to the
extended transsphenoidal approach, CSF leak repair can be controlled more easily and this technique is predicted to be less likely to damage the
infindibulum and other important neurovascular structures.