{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T23:28:19Z","timestamp":1780788499667,"version":"3.54.1"},"reference-count":43,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,7]]},"abstract":"\nObject<\/jats:title>\nStereotactic radiosurgery and fractionated stereotactic radiotherapy are commonly used in the treatment of residual or recurrent benign tumors of the skull base and cavernous sinus. A major risk associated with radiosurgical or radiotherapy treatment of residual or recurrent tumors adjacent to normal functional pituitary gland is radiation of the pituitary, which frequently leads to the development of hypopituitarism. The authors have used a technique of pituitary transposition to reduce the radiation dose to the normal pituitary gland in cases of planned radiosurgical treatment of residual tumor within the cavernous sinus. Here, the authors analyze the long-term endocrinological outcomes in patients with residual and recurrent tumors who undergo hypophysopexy and adjuvant radiosurgical or conformal fractionated radiotherapy treatment.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nPituitary transposition involves placement of a fat graft between the normal pituitary gland and residual tumor in the cavernous sinus. A sellar exploration for tumor resection is performed, the pituitary gland is transposed from the region of the cavernous sinus, and the graft is interposed between the pituitary gland and the residual tumor. The residual tumor may then be treated with stereotactic radiosurgery or conformal fractionated radiation therapy. The authors evaluated endocrinological outcome, safety of the procedure, and postoperative complications in patients who underwent this procedure during a 7-year period.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nHypophysopexy has been used in 34 patients with nonfunctioning pituitary adenomas (19), functional pituitary adenomas (8), chordomas (2), meningiomas (2), chondrosarcoma (1), hemangiopericytoma (1), or hemangioma (1) involving the sella and cavernous sinus. Follow-up (radiographic and endocrinological) has been performed yearly in all patients. Two patients experienced postoperative endocrine deficits before radiosurgery (1 transient), but none of the patients developed new hypopituitarism during the median 4-year follow-up (range 1\u20138 years) after radiosurgery or fractionated stereotactic radiotherapy.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nThe increased distance between the normal pituitary gland and the residual tumor facilitates treatment of the tumor with radiosurgery or radiotherapy and effectively reduces the incidence of radiation injury to the normal pituitary gland when compared with historical controls.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.2.jns10566","type":"journal-article","created":{"date-parts":[[2011,3,11]],"date-time":"2011-03-11T17:10:53Z","timestamp":1299863453000},"page":"55-62","source":"Crossref","is-referenced-by-count":31,"title":["Endocrinological outcome after pituitary transposition (hypophysopexy) and adjuvant radiotherapy for tumors involving the cavernous sinus"],"prefix":"10.3171","volume":"115","author":[{"given":"Philipp","family":"Taussky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricky","family":"Kalra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen","family":"Coppens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jahan","family":"Mohebali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randy","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T.","family":"Couldwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns10566","series-title":"J Endocrinol Invest","first-page":"18","article-title":"Experience in management of 51 non-functioning 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disease","volume":"336","author":"Estrada","year":"1997"},{"key":"b10-jns10566","series-title":"Stereotact Funct Neurosurg","first-page":"213","article-title":"Gamma knife radiosurgery for growth hormone-secreting pituitary adenomas invading the cavernous sinus","volume":"76","author":"Fukuoka","year":"2001"},{"issue":"Suppl 9","key":"b11-jns10566","series-title":"Expert Rev Anticancer Ther","first-page":"S55","article-title":"Treatment of infertility in women with pituitary tumors","volume":"6","author":"Hirshfeld-Cytron","year":"2006"},{"key":"b12-jns10566","series-title":"Postgrad Med","first-page":"168","article-title":"Multimodality treatment for invasive pituitary adenomas","volume":"121","author":"Hornyak","year":"2009"},{"key":"b13-jns10566","series-title":"Neurosurgery","first-page":"284","article-title":"Adrenocorticotropic hormone-producing pituitary tumors: 12- to 22-year follow-up after treatment with stereotactic 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