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On February 23, 2018, PubMed Central Canada (PMC Canada) will be taken offline permanently. No author manuscripts will be deleted, and the approximately 2,900 manuscripts authored by Canadian Institutes of Health Research (CIHR)-funded researchers currently in the archive will be copied to the National Research Council’s (NRC) Digital Repository over the coming months. These manuscripts along with all other content will also remain publicly searchable on PubMed Central (US) and Europe PubMed Central, meaning such manuscripts will continue to be compliant with the Tri-Agency Open Access Policy on Publications.

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1.  An Effective Technique for Endoscopic Resection of Advanced Stage Angiofibroma 
In recent years, the surgical management of angiofibroma has been greatly influenced by the use of endoscopic techniques. However, large tumors that extend into difficult anatomic sites present major challenges for management by either endoscopy or an open-surgery approach which needs new technique for the complete en block resection.
Materials and Methods:
In a prospective observational study we developed an endoscopic transnasal technique for the resection of angiofibroma via pushing and pulling the mass with 1/100000 soaked adrenalin tampons. Thirty two patients were treated using this endoscopic technique over 7 years. The mean follow-up period was 36 months. The main outcomes measured were tumor staging, average blood loss, complications, length of hospitalization, and residual and/or recurrence rate of the tumor.
According to the Radkowski staging, 23,5, and 4 patients were at stage IIC, IIIA, and IIIB, respectively. Twenty five patients were operated on exclusively via transnasal endoscopy while 7 patients were managed using endoscopy-assisted open-surgery techniques. Mean blood loss in patients was 1261± 893 cc. The recurrence rate was 21.88% (7 cases) at two years following surgery. Mean hospitalization time was 3.56 ± 0.6 days.
Using this effective technique, endoscopic removal of more highly advanced angiofibroma is possible. Better visualization, less intraoperative blood loss, lower rates of complication and recurrence, and shorter hospitalization time are some of the advantages.
PMCID: PMC3915066  PMID: 24505571
Angiofibroma; Complication; Endoscopy; Nasal; Novel technique; Outcome; Recurrence; Tampon; Technique
2.  Endoscopic endonasal resection of craniopharyngiomas: a case series and review of the literature 
Transcranial approaches were historically the first established routes for craniopharyngiomas resection. Transcranial approaches commonly entail some degree of brain retraction as well as manipulation of neurovascular structures, located between the surgeon and the pathogenic region. A more direct route to the sellar -suprasellar region is provided by the transsphenoidal approach. Introduction of extended approaches offered a safe alternative technique for reaching suprasellar craniopharyngiomas. The next stage of development was incorporation of the endoscope in the extended approach which increased the field of view and illumination. There is a limited body of literature on the outcome of endoscopic endonasal approach in resection of craniopharyngiomas. Therefore, the present study aims to assess the outcome of endoscopic endonasal approach in resection of craniopharyngiomas.
Eight patients underwent surgery at Loghman-Hakim and Day General Hospitals (Tehran, Iran). One patient had recurrent lesion. The gross-total resection (GTR) was attempted in 6 surgeries. Indications for intended subtotal resection included advanced age, medical comorbidities, preservation of pituitary function, and hypothalamic invasion.
The average size of tumor diameter was 2.8 cm. GTR in 6 cases and near-total resection in 2 cases were achieved. The average follow-up period was 30 months during which one recurrence in near resection cases was observed. Vision was improved by 80%. Four cases developed diabetes insipidus (unrelated to diabetes mellitus) and 3 cases developed panhypopituitarism postoperatively. Furthermore, postoperative cerebrospinal fluid (CSF) leaks occurred in 2 patients, one of them needed reoperation for CSF leak management. In addition, postoperative bacterial meningitis occurred in one patient.
Endoscopic, endonasal surgery for craniopharyngioma can be accompanied by high rates of GTR with low rates of CSF leak.
Craniopharyngioma, Endonasal, Endoscopic
PMCID: PMC3571548

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