No shinkei geka. Neurological surgery
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Case Reports
[Endoscopic endonasal surgery for extrasellar tumors: case presentation and its future perspective].
Endoscopic endonasal transsphenoidal surgery has been performed because of its advantages such as less invasive surgical management and more aggressive tumor removal of extrasellar lesions. In 2003, we began endoscope-assisting surgery. In 2006, we completely switched to the endoscopic endonasal approach without microscope or nasal specula. ⋯ Selection of patients is also important. This also needs collaboration with ENT (ear, nose, throat) doctors. To be acknowledged as a safe and successful procedure in skull base surgery, this complex procedure may be preferably carried out only in center hospitals, which deal with many patients with a skull base lesion.
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Colloid cysts are benign intracranial lesions located at the anterior roof of the third ventricle, which can result in the obstruction of the foramen of Monro and subsequent hydrocephalus or sudden death. Colloid cysts have been treated by microsurgical resection or by stereotactic aspiration. More recently, the use of rigid neuroendoscopy for colloid cysts has been attempted, but the efficacy of the flexible neuroendoscopic system is undetermined except for limited reports. ⋯ In the second case, endoscopic removal of the cyst wall and the evacuation of the cyst content were attempted using a high-definition flexible endoscopic system which resulted in the improvement of hydrocephalus and marked shrinkage of the third ventricle lesion observed in postoperative MRI. There was no recurrence in either patient. We recommend endoscopic treatment for colloid cysts using the high-definition neuroendoscopic system, which enables safe and thorough manipulation of the lesion and surrounding structures.