Neurochirurgie
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Over the last few decades, the scientific literature has acquired over 100 publications on pituitary surgery. Most of these papers contain a brief historical review of the work of the pioneers who contributed to operative modalities (Landolt et al., 1996; Liu et al., 2001; Walker, 1951; Welbourne, 1986). Several have been only experimental explorations on cadavers, used on a few patients, but were eventually abandoned, retaining only anecdotal value. ⋯ The inferior trans-sphenoidal approach currently maintains two modalities: (1) endonasal lateral submucosal or Kocher-Hirsch extramucosal and (2) sublabial midline rhinoseptal of Halstead-Cushing. Further development with various instruments has improved the operative procedure. Microsurgical exploration of the hypophysis can now identify intrapituitary microadenomas, thus allowing selective microadenomectomy, which constitutes the ultimate achievement in the surgical treatment of endocrinological hyperpituitarism syndromes.
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Heterotopic ossification (HO) is common in head-injured patients. Ulnar nerve compression by HO at the elbow is rare. The purpose of this study was to establish a strategy for the management of ulnar nerve compression secondary to HO at the elbow. ⋯ It seems that HO is not the direct cause of ulnar nerve compression, but its impairment may be increased by the nerve tension and elbow fixation that it causes. When HO is mature, neurolysis can be combined with elbow release. However, when HO maturation is not achieved early neurolysis associated with anterior transposition should be done without elbow release.