Anatomic features of lateral extended transsphenoidal endoscopic endonasal approach

Kalinin P.L.; Sharipov O.I.; Kutin M.A.; Fomichev D.V.; Dobrovolskiyi G.F.; Astaf'eva L.I.

doi:https://doi.org/10.17116/endoskop201723328-31

Kalinin P.L.

NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva

Sharipov O.I.

Burdenko Neurosurgical Institute, Moscow, Russian Federation

Kutin M.A.

NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva

Fomichev D.V.

Burdenko Neurosurgical Institute, Moscow, Russia

Dobrovolskiyi G.F.

Burdenko Neurosurgery Institute, Moscow, Russia

Astaf'eva L.I.

NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva

Anatomic features of lateral extended transsphenoidal endoscopic endonasal approach

Authors:

Kalinin P.L., Sharipov O.I., Kutin M.A., Fomichev D.V., Dobrovolskiyi G.F., Astaf'eva L.I.

More about the authors

Journal: Endoscopic Surgery. 2017;23(3): 28‑31

DOI: 10.17116/endoskop201723328-31

Read: 2912 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Kalinin PL, Sharipov OI, Kutin MA, Fomichev DV, Dobrovolskiyi GF, Astaf'eva LI. Anatomic features of lateral extended transsphenoidal endoscopic endonasal approach. Endoscopic Surgery. 2017;23(3):28‑31. (In Russ.)
https://doi.org/10.17116/endoskop201723328-31

Подписка 2026 Эндоскопическая хирургия (Endoscopic Surgery)

Использование инфографики авторами научных работ

Close metadata

Recommended articles:

Lost anatomical structure — pharyngeal pituitary gland (Hypophysis pharyngealis or Erdheim pituitary gland): a review and case report. Burdenko's Journal of Neurosurgery. 2026;(1):83-91

Abstract:

Objective. Today extended transsphenoidal endoscopic approaches are widely used in neurosurgery for removal tumors of the parasellar region. We performed an anatomic study of the lateral extended transsphenoidal endoscopic approach. Material and methods. We studied anatomy of the lateral extended transsphenoidal endoscopic approach in three adult cadaveric heads in which the arteries and veins were injected with latex. Endoscopic transethmoidal transsphenoidal approach and lateral extended transsphenoidal endoscopic approach through pterygopalatine fossa were also performed. Results and discussion. Lateral extended transsphenoidal endoscopic approach is minimally invasive and can be used to remove tumors located in the paramedian plane. Endoscopic endonasal transethmoidal transsphenoidal approach is a kind of lateral expanded approach, after which the ICA is located at the center of the operating field, and allows working laterally to the ICA more safely. The lateral extended transsphenoidal endoscopic approach through the pterygoid fossa allows toaccess to the CS and the Meckel’s cave, the medial part of the middle cranial fossa. Conclusion. The lateral extended transsphenoidal endoscopic approach allows to resect tumors from the most lateral and anterior cavernous sinus parts, and also makes it possible to remove the tumors are located in the Meckel’s cave, the infratemporal fossa, the medial part of the middle cranial fossa.

Keywords:

endoscopic transsphenoidal surgery

pituitary adenomas

lateral extended transsphenoidal approach

Authors:

Kalinin P.L.

NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva

Sharipov O.I.

Burdenko Neurosurgical Institute, Moscow, Russian Federation

Kutin M.A.

NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva

Fomichev D.V.

Burdenko Neurosurgical Institute, Moscow, Russia

Dobrovolskiyi G.F.

Burdenko Neurosurgery Institute, Moscow, Russia

Astaf'eva L.I.

NII neĭrokhirurgii im. N.N. Burdenko RAMN, Moskva

Close metadata

References:

Kassam AB, Prevedello DM, Carrau RL, Snyderman CH, Thomas A, Gardner P, Zanation A, Duz B, Stefko ST, Byers K, Horowitz MB. Endoscopic endonasal skull base surgery: analysis of complications in the authors’ initial 800 patients. J Neurosurg. 2011;114(6):1544-1568. https://doi.org/10.3171/2010.10
Kalinin PL, Fomichev DV, Kutin MA, Kadashev BA, Astaf’eva LI, Shkarubo AN, Alekseev SN, Fomochkina LA. Endoscopic endonasal surgery of pituitary adenomas (experience of 1700 operations). Vopr Neirokhir. 2012;3:26-33. (In Russ.)
Kalinin PL. Endoskopicheskaya transsfenoidal’naya khirurgiya adenom gipofiza i drugikh opukholei okolosellyarnoi lokalizatsii: Dis... d-ra med. nauk. M. 2009. (In Russ.)
Cappabianca P, Cavallo LM, Esposito F, De Divitiis O, Messina A, De Divitiis E. Extended endoscopic endonasal approach to the midline skull base: the evolving role of transsphenoidal surgery. Adv Tech Stand Neurosurg. 2008;33:151-199. https://doi.org/10.1007/978-3-211-72283-1_4
Alfieri A, Jho HD. Endoscopic endonasal approaches to the cavernous sinus: surgical approaches. Neurosurgery. 2001;49(2):354-360. https://doi.org/10.1227/00006123-200108000-00017
Kalinin PL, Sharipov OI, Shkarubo AN, Fomichev DV, Kutin MA, Alekseev SN, Kadashev BA, Iakovlev SB, Dorokhov PS, Bukharin EIu, Kurnosov AB, Popugaev KA. Damage to the cavernous segment of internal carotid artery intranssphenoidal endoscopic removal of pituitary adenomas (reportof 4 cases). Vopr Neirokhir. 2013;77(6):28-38. (In Russ.)
Dusick JR, Esposito F, Malkasian D, Kelly DF. Avoidance of carotid artery injuries in transsphenoidal surgery with the Doppler probe and micro-hook blades. Neurosurgery. 2007;60:4(suppl 2):322-328; discussion 328-329. https://doi.org/10.1227/01.neu.0000255408.84269.a8
Sharipov OI, Kutin MA, Kalinin PL, Fomichev DV, Lukshin VA, Kurnosov AB. The use of intraoperative Doppler ultrasound in endoscopic transsphenoidal surgery. Vopr neirokhir. 2016;80(2):15-20. (In Russ.)
Knosp E, Steiner E, Kitz K, Matula C. Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings. Neurosurgery. 1993;33(4):610-617. https://doi.org/10.1097/00006123-199310000-00008
Kalinin PL, Sharipov OI, Pronin IN, Kutin MA, Fomichev DV, Kadashev BA, Shkarubo AN, Alekseev SN, Astaf’eva LI, Tropinskaya OF, Dobrovol’skiy GF, Shul’ts EI, Andreev DN, Voronina IA, Kurnosov AB. Endoscopic transsphenoidal resectionofpituitary adenomasinvadingthecavernous sinus. Vopr neirokhir. 2016;80(4): 63-74. (In Russ.)
Zhao B, Wei YK, Li GL, Li YN, Yao Y, Kang J, Ma WB, Yang Y, Wang RZ. Extended transsphenoidal approach for pituitary adenomas invading the anterior cranial base, cavernous sinus, and clivus: a single-center experience with 126 consecutive cases. J Neurosurg. 2010;112(1):108-117. https://doi.org/10.3171/2009.3
Nishioka H, Fukuhara N, Horiguchi K, Yamada S. Aggressive transsphenoidal resection of tumors invading the cavernous sinus in patients with acromegaly: predictive factors, strategies, and outcomes. J Neurosurg. 2014;121(3):505-510. https://doi.org/10.3171/2014.3
Kitano M, Taneda M. Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors. Technicalnote. J Neurosurg. 2001;94(6):999-1004. https://doi.org/10.3171/jns.2001.94.6.0999
Couldwell WT, Weiss MH, Rabb C, Liu JK, Apfelbaum RI, Fukushima T. Variations on the standard transsphenoidal approach to the sellar region, with emphasis on the extended approaches and parasellar approaches: surgical experience in 105 cases. Neurosurgery. 2004;55(3):539-547. https://doi.org/10.1227/01.neu.0000134287.19377.a2