Biomedical subjects

John A Jr Jane

Publications and source records attributed to John A Jr Jane.

4 recordsLinked to original sources

PubMed2006

Extended transsphenoidal approach.

Transsphenoidal surgery is well established as an effective primary treatment for tumors of the sellar region. The technique of transsphenoidal surgery has evolved over the years with many prominent surgeons contributing to its present state of refinement. The transsphenoidal approach can be modified in various ways to permit resection of parasellar tumors that otherwise would require a transcranial or transbasal operation. Our experience with these 'extended' techniques has primarily involved the transtuberculum sella approach in which bone is removed from the tuberculum sellae and the posterior portion of the planum sphenoidale. Experience with this technique continues to burgeon, and offers an excellent alternative to transcranial surgery in dealing with a difficult constellation of tumors. Meticulous attention to detail, particularly with respect to reconstruction and closure of the sellar floor, is necessary for its effective application.

Humans↗

PubMed2006

Image guidance in pituitary surgery.

Image guidance in pituitary surgery has evolved since diagnostic imaging of the sellar region was first introduced at the turn of the 20th century. These advances have played a key role in the decrease in morbidity and mortality once associated with pituitary surgery. This chapter details the history of sellar imaging as a preoperative diagnostic aide, and then examines the subsequent development of image guidance systems and intraoperative imaging. The utility and limitations of common intraoperative aides including video fluoroscopy, frameless stereotaxy, ultrasound, and magnetic resonance imaging are reviewed.

Humans↗

PubMed2006

Diagnosis and management of pediatric sellar lesions.

Pituitary region tumors in pediatric patients are largely comprised of craniopharyngiomas and pituitary adenomas, each with their unique considerations. Craniopharyngiomas account for the majority of pediatric sellar masses. Pituitary adenomas are relatively uncommon during childhood, although the incidence increases during adolescence. The diagnosis of sellar lesions involves a multidisciplinary effort, and detailed endocrinologic, ophthalmologic and neurologic testing are critical. The management of pituitary tumors varies depending on the entity. For most tumors, other than prolactinomas, transsphenoidal resection remains the mainstay of treatment. Less invasive modalities such as endoscopic transsphenoidal surgery, and stereotactic radiosurgery have shown promise as primary and adjuvant treatment modalities, respectively.

Adolescent↗

PubMed2006

Rathke's cleft cysts.

Rathke's cleft cysts are typically regarded as benign cystic lesions of the sella that may affect the pituitary gland and on occasion the visual apparatus. They are most commonly incidental and rarely of clinical significance. As medical neuroimaging and surgical technologies have rapidly advanced, so too has the discovery, experience, knowledge, and intrigue concerning this relatively rare disease entity. Nevertheless, numerous controversies still exist regarding its natural history, recurrence rate, predictive variables, and optimal surgical management. This chapter aims to review the pathogenesis, symptomatologic manifestations, radiographic, morphologic and histopathological characteristics, treatment strategies and outcomes in the cysts of Rathke's cleft.

Central Nervous System Cysts↗