← All decks

Neurosurgery

Transsphenoidal Approaches to the Sella and Suprasellar Re

Built from Feldman — Neurosurgical Operative Atlas: Neuro-Oncology

The first 25 slides of Transsphenoidal Approaches to the Sella and Suprasellar Re
The first 25 slides, exactly as they appear. The full deck has 51 content slides.

What’s inside

11 sections · 51 slides

  1. 01

    Overview

    • What this chapter teaches

    1 slide

  2. 02

    The problem and the anatomy

    Why go through the nose at all

    • The target: sella and suprasellar region
    • The transsphenoidal idea in one line
    • What these approaches are used to treat

    3 slides

  3. 03

    A century of evolution

    From Schloffer and Cushing to the endoscope

    • How the approach evolved
    • Why the early approaches added a septal dissection
    • The learning curve in numbers

    3 slides

  4. 04

    The three approaches

    Direct endonasal, sublabial, and transseptal

    • Three corridors to the same target
    • How the surgeon chooses
    • Transseptal approach to the sphenoid rostrum

    3 slides

  5. 05

    Before the operation

    Hormones, vision, and the MRI

    • Endocrine and neuro-ophthalmology work-up
    • Reading the preoperative MRI
    • When should you NOT do a transsphenoidal approach?
    • Macroadenoma with suprasellar extension on MRI

    4 slides

  6. 06

    The direct endonasal approach

    Positioning, instruments, and technique

    • Patient positioning
    • Skin prep and packing
    • Instruments for the endonasal route
    • Endonasal pituitary surgery instruments
    • Operating room and patient positioning
    • Navigating the nose to the sphenoid
    • Opening the sphenoid and the sella
    • Opening the dura safely

    8 slides

  7. 07

    Removing the tumor

    Order, landmarks, and pitfalls

    • Recognising and removing a macroadenoma
    • The two big pitfalls
    • Finishing the resection

    3 slides

  8. 08

    Closing up

    Sealing the sella and preventing CSF leak

    • Reconstructing the sella
    • When leaks are big — and final steps
    • The authors' endonasal experience

    3 slides

  9. 09

    Sublabial and transseptal routes

    Wider corridors for larger tumors

    • The sublabial approach step by step
    • Sublabial exposure and a key safety warning
    • The transseptal approach
    • Postoperative nasal packing by approach

    4 slides

  10. 10

    After surgery

    Fluids, sodium, hormones, and vision

    • Watching fluid balance and diabetes insipidus
    • Managing sodium and hormones
    • Hormones, vision, and antibiotics

    3 slides

  11. 11

    Takeaways

    The essence of the transsphenoidal approach

    • Key points to remember
    • What three principles define a successful transsphenoidal operation?
    • References (1/2)
    • References (2/2)
    • Neurosurgical Operative Atlas: Neuro-Oncology

    5 slides