{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T09:19:40Z","timestamp":1770887980720,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,7,19]],"date-time":"2013-07-19T00:00:00Z","timestamp":1374192000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Selective adenomectomy remains the first\u2010line treatment for <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ushing's disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>), until recently by microscopic transsphenoidal pituitary surgery. Endonasal transsphenoidal endoscopic surgery (<jats:styled-content style=\"fixed-case\">ETES<\/jats:styled-content>) is emerging as a novel, less invasive treatment for pituitary adenomas and has become the optimal surgical approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>There are no published series for the treatment of paediatric <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> by <jats:styled-content style=\"fixed-case\">ETES<\/jats:styled-content>, and we report our centre's preliminary results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Six paediatric patients (median age 15\u00b78\u00a0years; range 11\u00b77\u201317\u00b70\u00a0years) fulfilled standard diagnostic criteria for <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>. Preoperatively, no abnormality was identified on pituitary <jats:styled-content style=\"fixed-case\">MR<\/jats:styled-content> scanning in 3 (50%) patients, one had a macroadenoma. Bilateral petrosal sinus sampling demonstrated central <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> secretion (<jats:styled-content style=\"fixed-case\">IPS<\/jats:styled-content>\/P <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> ratio \u22653\u00b70, post\u2010<jats:styled-content style=\"fixed-case\">CRH<\/jats:styled-content>) in 3\/6 (50%) patients. The same neurosurgeon and endoscopic nasal surgeon undertook all the operations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome measures<\/jats:title><jats:p>Therapeutic outcome and rate of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clinical recovery and biochemical \u2018cure\u2019 were achieved in 5 (83%) patients, and a corticotroph adenoma was confirmed histologically in all cured cases. One case developed post\u2010operative <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> leak requiring lumbar drain insertion and patching. At a mean interval of 4\u00b77\u00a0years (0\u00b71\u201310\u00b78\u00a0years) post\u2010operatively, cured patients have shown no recurrence. One patient, with a large diffuse adenoma requiring more extensive surgery, has panhypopituitarism, and another patient has <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> and gonadotrophin deficiencies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our experience shows that <jats:styled-content style=\"fixed-case\">ETES<\/jats:styled-content> for removing corticotroph adenomas in children, in most cases not visualized on <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>, is minimally invasive and gave excellent post\u2010operative recovery\/results. In skilled hands, this technique provides an alternative to conventional transsphenoidal microscopic surgery in managing paediatric <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12275","type":"journal-article","created":{"date-parts":[[2013,6,26]],"date-time":"2013-06-26T07:16:57Z","timestamp":1372231017000},"page":"270-276","source":"Crossref","is-referenced-by-count":37,"title":["Endonasal endoscopic transsphenoidal pituitary surgery: early experience and outcome in paediatric <scp>C<\/scp>ushing's disease"],"prefix":"10.1111","volume":"80","author":[{"given":"Helen L.","family":"Storr","sequence":"first","affiliation":[{"name":"Centre for Endocrinology William Harvey Research Institute Barts and the London School of Medicine and Dentistry Queen Mary University of London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William M.","family":"Drake","sequence":"additional","affiliation":[{"name":"Department of Endocrinology St Bartholomew's Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Evanson","sequence":"additional","affiliation":[{"name":"Department of Radiology St Bartholomew's Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Matson","sequence":"additional","affiliation":[{"name":"Department of Radiology St Bartholomew's Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan M.","family":"Berney","sequence":"additional","affiliation":[{"name":"Department of Histopathology St Bartholomew's Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley B.","family":"Grossman","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology William Harvey Research Institute Barts and the London School of Medicine and Dentistry Queen 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