Overview Retropharyngeal approaches to the upper cervical spine are anterior approaches directed through the fascial planes of the neck. The main advantage of anterior approaches is the direct route to…
Overview A variety of surgical approaches have been developed for lesions located at the craniovertebral junction (CVJ). Access to the CVJ can be achieved via anterior, anterolateral, lateral, posterolateral, and…
Overview Pathology of the craniocervical junction remains technically difficult to access, but because of advancements in instruments, the operating microscope, endoscopic techniques, and materials to repair skull base defects, these…
Overview The clivus, craniovertebral junction (CVJ), and ventral upper cervical spine are relatively inaccessible, and surgical approaches to these structures are intimidating; however, a wide range of pathologic lesions can…
Introduction Various classifications of pituitary tumors have been proposed on the basis of size, radiographic appearance, cytogenesis, staining properties, and endocrine function. There is no consensus regarding the terminology to…
“The most formidable of intracranial tumors” Harvey Cushing (1932) Introduction The introduction of the transsphenoidal approach to the pituitary fossa by Schloffer in 1907 revolutionized the management of pituitary pathology….
History Herman Schloffer, according to Liu et al, performed the first successful modern transsphenoidal approach for a pituitary tumor in March of 1907. It was a tedious three-stage procedure, with…
Introduction Although pituitary and sellar region tumors are relatively rare in infancy and childhood (overall incidence rate of approximately 0.5 per 100,000 person years), these tumors still account for up…
Introduction Pituitary metastases are an uncommon manifestation of systemic cancer and usually a marker of terminal disease. With improved survival for various types of cancer and with the use of…
Anatomy If a thin endoscope (1 to 2 mm in diameter) is inserted into the nasal cavity and through the sphenoid ostium, it can reach the sellar floor without touching…
