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Modifications of transnasal and transoral stereotactic procedures--technical notes.

Stereotactic transnasal and transoral procedures have been reported by different authors in the past. In this paper, several modifications of these methods are described. The modifications are: transnasal approach to the frontal skull base and suprasellar regions; and transoral approaches to the clivus, the petroclival junction, medial part of the cerebellopontine angle and the lateral mass of C-1. Eleven patients were operated on using these modifications. The procedures were for biopsy and brachytherapy. No complications resulted from the procedures.

Adolescent↗

Size and erosive features of the sella turcica in acromegaly as predictors of therapeutic response to supervoltage irradiation.

Basal growth hormone levels and the sella turcica of patients with acromegaly were evaluated. Fifty of these patients were followed up, with fasting growth hormone levels determined at several intervals within 10 or more years after supervoltage pituitary irradiation. Prior to therapy, basal growth hormone levels were positively correlated with an estimate of tumor size, as reflected by sella abnormalities. Sella abnormality criteria, developed by Hardy et al., were used as the correlating factor. The percentage of fall in growth hormone levels after radiotherapy was indistinguishable in these patients, regardless of sella grade. However, since the larger, more erosive, tumors were associated with higher pre-therapy plasma growth hormone levels, the median growth hormone levels were higher at various intervals after treatment of this group. We suggest that the size and erosive features of the bony sella offer a crude, but possibly useful, predictor of response to supervoltage irradiation in acromegaly.

Acromegaly↗