Enrico de Divitiis - Böcker

Currently, surgical management provides the definitive treatment of choice for most pituitary adenomas, craniopharyngiomas and meningiomas of the sellar region. The elegant minimally invasive transnasal endoscopic approach to the sella turcica and the anterior skull base has added a new dimension of versatility to pituitary surgery and can be adapted to many lesions in the region. In this multi-author book with numerous color illustrations the main aspects of the endonasal endoscopic approach to the skull base are presented, starting with a clear description of the endoscopic anatomy, the panoramic view afforded by the endoscope and the development of effective instruments and adjuncts. After the diagnostic studies, the strictly surgical features are considered in detail. The standard technique is described and particular aspects are treated, including the new extended approaches to the cavernous sinus, spheno-ethmoid planum and clival regions.

It is only recently that the use of the endoscope as the sole visualizing tool has been introduced in transsphenoidal pituitary surgery with its favorable related implications and minimal operative trauma. Of course, microscopic and endoscopic anatomy are basically the same, but the optical distorsion of endoscopic images is quite substantial compared with microscopic depictions. An endoscope lens produces images with maximal magnification at its center and severe contraction at its periphery. Nearer images are disproportionally enlarged and remote images are falsely miniaturized. This optical illusion may disorientate a surgeon who is not familiar with this peculiar condition at the skull base. This atlas acts as a guide through the endoscopic anatomy and gives detailed descriptions of the preoperative management and the surgical procedures.