{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T07:57:28Z","timestamp":1792828648462,"version":"4.5.0"},"reference-count":106,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Perioperative management of patients with sellar lesions is complex, requiring input from a multidisciplinary team of specialists for ongoing management of both endocrinological and neurosurgical issues. Here, the authors reviewed the experience of a single multidisciplinary center over 10 years to identify key postoperative practices that ensure positive outcomes for patients with sellar lesions who undergo transsphenoidal surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors performed a retrospective review of all transsphenoidal operations carried out by the senior author at a single center from April 2008 through November 2018. They included only adult patients and recorded perioperative management. They also reviewed the evolution of clinical practices for perioperative care at their institution to identify strategies for ensuring positive patient outcomes, and they reviewed the literature on select related topics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In total, 1023 operations in 928 patients were reviewed. Of these, 712 operations were for pituitary adenomas (69.6%), and 122 were for Rathke cleft cysts (11.9%). The remainder included operations for craniopharyngiomas (3.6%), arachnoid cysts (1.7%), pituitary tumor apoplexy (1.0%), and other sellar pathologies (12.2%). Among the reviewed operations, the median hospital stay was 3 days (IQR 2\u20133). Patient management details during the pre-, intra-, and postoperative periods were identified, including both shared characteristics of all patients undergoing transsphenoidal surgery and unique characteristics that are specific to certain lesion types or patient populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Patients with sellar lesions who undergo transsphenoidal surgery require complex, multidisciplinary perioperative care to monitor for common adverse events and to improve outcomes, but there is a dearth of high-quality evidence guiding most perioperative practices. Here, the authors reviewed practices at their institution across more than 1000 transsphenoidal operations that may help ensure successful patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2020.3.focus2043","type":"journal-article","created":{"date-parts":[[2020,6,3]],"date-time":"2020-06-03T08:21:59Z","timestamp":1591172519000},"page":"E2","source":"Crossref","is-referenced-by-count":19,"title":["Optimizing pre-, intra-, and postoperative management of patients with sellar pathology undergoing transsphenoidal surgery"],"prefix":"10.3171","volume":"48","author":[{"given":"David J.","family":"Cote","sequence":"first","affiliation":[{"name":"Pituitary\/Neuroendocrine Center, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry L.","family":"Iuliano","sequence":"additional","affiliation":[{"name":"Pituitary\/Neuroendocrine Center, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Catalino","sequence":"additional","affiliation":[{"name":"Pituitary\/Neuroendocrine Center, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts; and"},{"name":"Department of Neurosurgery, University of North Carolina, Chapel Hill, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R.","family":"Laws","sequence":"additional","affiliation":[{"name":"Pituitary\/Neuroendocrine Center, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"813.e1","DOI":"10.1016\/j.wneu.2016.12.009","article-title":"Bolstering the nasoseptal flap using sphenoid sinus fat packing: a technical case report","volume":"99","author":"Abou-Al-Shaar H","year":"2017","unstructured":"Abou-Al-Shaar H, Zaidi HA, Cote DJ, Laws ER Jr: Bolstering the nasoseptal flap using sphenoid sinus fat packing: a technical case report. World Neurosurg 99:813.e1\u2013813.e5, 201710.1016\/j.wneu.2016.12.009"},{"key":"b2","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1007\/s00701-017-3438-z","article-title":"Gross total resection of pituitary adenomas after endoscopic vs. microscopic transsphenoidal surgery: a meta-analysis","volume":"160","author":"Almutairi RD","year":"2018","unstructured":"Almutairi RD, Muskens IS, Cote DJ, Dijkman MD, Kavouridis VK, Crocker E, : Gross total resection of pituitary adenomas after endoscopic vs. microscopic transsphenoidal surgery: a meta-analysis. Acta Neurochir (Wien) 160:1005\u20131021, 201810.1007\/s00701-017-3438-z"},{"key":"b3","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.wneu.2017.09.192","article-title":"Delayed complications after transsphenoidal surgery for pituitary adenomas","volume":"109","author":"Alzhrani G","year":"2018","unstructured":"Alzhrani G, Sivakumar W, Park MS, Taussky P, Couldwell WT: Delayed complications after transsphenoidal surgery for pituitary adenomas. World Neurosurg 109:233\u2013241, 20182898904710.1016\/j.wneu.2017.09.192"},{"key":"b4","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1007\/s11102-014-0600-y","article-title":"Perioperative thromboprophylaxis in Cushing\u2019s disease: What we did and what we are doing?","volume":"18","author":"Barbot M","year":"2015","unstructured":"Barbot M, Daidone V, Zilio M, Albiger N, Mazzai L, Sartori MT, : Perioperative thromboprophylaxis in Cushing\u2019s disease: What we did and what we are doing? Pituitary 18:487\u2013493, 20152523955710.1007\/s11102-014-0600-y"},{"key":"b5","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1001\/jama.1985.03350290088032","article-title":"Multidisciplinary management of acromegaly and its deformities","volume":"253","author":"Brennan MD","year":"1985","unstructured":"Brennan MD, Jackson IT, Keller EE, Laws ER Jr, Sather AH: Multidisciplinary management of acromegaly and its deformities. JAMA 253:682\u2013683, 198510.1001\/jama.1985.033502900880323881612"},{"key":"b6","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s11102-017-0843-5","article-title":"A practical method for prevention of readmission for symptomatic hyponatremia following transsphenoidal surgery","volume":"21","author":"Burke WT","year":"2018","unstructured":"Burke WT, Cote DJ, Iuliano SI, Zaidi HA, Laws ER: A practical method for prevention of readmission for symptomatic hyponatremia following transsphenoidal surgery. Pituitary 21:25\u201331, 201810.1007\/s11102-017-0843-529075986"},{"key":"b7","series-title":"Neurosurgery","article-title":"Diabetes insipidus after endoscopic transsphenoidal surgery","author":"Burke WT","unstructured":"Burke WT, Cote DJ, Penn DL, Iuliano SL, McMillen K, Laws ER: Diabetes insipidus after endoscopic transsphenoidal surgery. Neurosurgery [in press], 202032503055"},{"key":"b8","series-title":"J Neurosurg","article-title":"Prolactinomas and nonfunctioning adenomas: preoperative diagnosis of tumor type using serum prolactin and tumor size","author":"Burke WT","unstructured":"Burke WT, Penn DL, Castlen JP, Donoho DA, Repetti CS, Iuliano S, : Prolactinomas and nonfunctioning adenomas: preoperative diagnosis of tumor type using serum prolactin and tumor size. J Neurosurg [epub ahead of print June 14, 2019. DOI: 10.3171\/2019.3.JNS19121]31200381"},{"key":"b9","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1007\/s11102-017-0838-2","article-title":"Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): a Pituitary Society statement","volume":"20","author":"Casanueva FF","year":"2017","unstructured":"Casanueva FF, Barkan AL, Buchfelder M, Klibanski A, Laws ER, Loeffler JS, : Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): a Pituitary Society statement. Pituitary 20:489\u2013498, 20172888441510.1007\/s11102-017-0838-2"},{"key":"b10","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.wneu.2016.01.022","article-title":"Predictors and rates of delayed symptomatic hyponatremia after transsphenoidal surgery: a systematic review [corrected]","volume":"88","author":"Cote DJ","year":"2016","unstructured":"Cote DJ, Alzarea A, Acosta MA, Hulou MM, Huang KT, Almutairi H, : Predictors and rates of delayed symptomatic hyponatremia after transsphenoidal surgery: a systematic review [corrected]. World Neurosurg 88:1\u20136, 20162680568510.1016\/j.wneu.2016.01.022"},{"key":"b11","series-title":"J Am Coll Surg","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1016\/j.jamcollsurg.2017.02.015","article-title":"Readmission and other adverse events after transsphenoidal surgery: prevalence, timing, and predictive factors","volume":"224","author":"Cote DJ","year":"2017","unstructured":"Cote DJ, Dasenbrock HH, Muskens IS, Broekman MLD, Zaidi HA, Dunn IF, : Readmission and other adverse events after transsphenoidal surgery: prevalence, timing, and predictive factors. J Am Coll Surg 224:971\u2013979, 20172827977810.1016\/j.jamcollsurg.2017.02.015"},{"key":"b12","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1016\/j.wneu.2015.05.019","article-title":"The expanding spectrum of disease treated by the transnasal, transsphenoidal microscopic and endoscopic anterior skull base approach: a single-center experience 2008-2015","volume":"84","author":"Cote DJ","year":"2015","unstructured":"Cote DJ, Wiemann R, Smith TR, Dunn IF, Al-Mefty O, Laws ER: The expanding spectrum of disease treated by the transnasal, transsphenoidal microscopic and endoscopic anterior skull base approach: a single-center experience 2008-2015. World Neurosurg 84:899\u2013905, 201510.1016\/j.wneu.2015.05.01926008142"},{"key":"b13","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1002\/cncr.20412","article-title":"The prevalence of pituitary adenomas: a systematic review","volume":"101","author":"Ezzat S","year":"2004","unstructured":"Ezzat S, Asa SL, Couldwell WT, Barr CE, Dodge WE, Vance ML, : The prevalence of pituitary adenomas: a systematic review. Cancer 101:613\u2013619, 20041527407510.1002\/cncr.20412"},{"key":"b14","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1210\/jc.2010-1048","article-title":"Pituitary incidentaloma: an endocrine society clinical practice guideline","volume":"96","author":"Freda PU","year":"2011","unstructured":"Freda PU, Beckers AM, Katznelson L, Molitch ME, Montori VM, Post KD, : Pituitary incidentaloma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 96:894\u2013904, 201110.1210\/jc.2010-104821474686"},{"key":"b15","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.3171\/2018.5.JNS181054","article-title":"Endocrine function and gland volume after endoscopic transsphenoidal surgery for nonfunctional pituitary macroadenomas","volume":"131","author":"Harary M","year":"2019","unstructured":"Harary M, DiRisio AC, Dawood HY, Kim J, Lamba N, Cho CH, : Endocrine function and gland volume after endoscopic transsphenoidal surgery for nonfunctional pituitary macroadenomas. J Neurosurg 131:1142\u20131151, 201910.3171\/2018.5.JNS181054"},{"key":"b16","series-title":"Laryngoscope","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1002\/lary.22475","article-title":"Endoscopic skull base reconstruction of large dural defects: a systematic review of published evidence","volume":"122","author":"Harvey RJ","year":"2012","unstructured":"Harvey RJ, Parmar P, Sacks R, Zanation AM: Endoscopic skull base reconstruction of large dural defects: a systematic review of published evidence. Laryngoscope 122:452\u2013459, 201210.1002\/lary.2247522253060"},{"key":"b17","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.jocn.2014.08.009","article-title":"Risk factors for postoperative cerebrospinal fluid leak and meningitis after expanded endoscopic endonasal surgery","volume":"22","author":"Ivan ME","year":"2015","unstructured":"Ivan ME, Iorgulescu JB, El-Sayed I, McDermott MW, Parsa AT, Pletcher SD, : Risk factors for postoperative cerebrospinal fluid leak and meningitis after expanded endoscopic endonasal surgery. J Clin Neurosci 22:48\u201354, 20152543975410.1016\/j.jocn.2014.08.009"},{"key":"b18","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"67","DOI":"10.3171\/2014.3.JNS131532","article-title":"Morbidity of repeat transsphenoidal surgery assessed in more than 1000 operations","volume":"121","author":"Jahangiri A","year":"2014","unstructured":"Jahangiri A, Wagner J, Han SW, Zygourakis CC, Han SJ, Tran MT, : Morbidity of repeat transsphenoidal surgery assessed in more than 1000 operations. J Neurosurg 121:67\u201374, 201410.3171\/2014.3.JNS13153224834943"},{"key":"b19","series-title":"Neurooncol Pract","first-page":"64","article-title":"Temozolomide therapy for aggressive functioning pituitary adenomas refractory to surgery and radiation: a case series","volume":"5","author":"Jordan JT","year":"2018","unstructured":"Jordan JT, Miller JJ, Cushing T, Seijo M, Batchelor TT, Arrillaga-Romany IC, : Temozolomide therapy for aggressive functioning pituitary adenomas refractory to surgery and radiation: a case series. Neurooncol Pract 5:64\u201368, 201831385986"},{"key":"b20","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"3933","DOI":"10.1210\/jc.2014-2700","article-title":"Acromegaly: an endocrine society clinical practice guideline","volume":"99","author":"Katznelson L","year":"2014","unstructured":"Katznelson L, Laws ER Jr, Melmed S, Molitch ME, Murad MH, Utz A, : Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99:3933\u20133951, 20142535680810.1210\/jc.2014-2700"},{"key":"b21","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1056\/NEJMcp0912025","article-title":"Clinical practice. Prolactinomas","volume":"362","author":"Klibanski A","year":"2010","unstructured":"Klibanski A: Clinical practice. Prolactinomas. N Engl J Med 362:1219\u20131226, 20102035728410.1056\/NEJMcp0912025"},{"key":"b22","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"621","DOI":"10.3171\/2012.11.JNS121190","article-title":"Endoscopic endonasal surgery for giant pituitary adenomas: advantages and limitations","volume":"118","author":"Koutourousiou M","year":"2013","unstructured":"Koutourousiou M, Gardner PA, Fernandez-Miranda JC, Paluzzi A, Wang EW, Snyderman CH: Endoscopic endonasal surgery for giant pituitary adenomas: advantages and limitations. J Neurosurg 118:621\u2013631, 201310.3171\/2012.11.JNS12119023289816"},{"key":"b23","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.3171\/2015.4.JNS142184","article-title":"A checklist for endonasal transsphenoidal anterior skull base surgery","volume":"124","author":"Laws ER","year":"2016","unstructured":"Laws ER, Wong JM, Smith TR, de Los Reyes K, Aglio LS, Thorne AJ, : A checklist for endonasal transsphenoidal anterior skull base surgery. J Neurosurg 124:1634\u20131639, 201610.3171\/2015.4.JNS14218426517770"},{"key":"b24","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/j.wneu.2016.04.059","article-title":"A benchmark for preservation of normal pituitary function after endoscopic transsphenoidal surgery for pituitary macroadenomas","volume":"91","author":"Laws ER Jr","year":"2016","unstructured":"Laws ER Jr, Iuliano SL, Cote DJ, Woodmansee W, Hsu L, Cho CH: A benchmark for preservation of normal pituitary function after endoscopic transsphenoidal surgery for pituitary macroadenomas. World Neurosurg 91:371\u2013375, 201610.1016\/j.wneu.2016.04.05927113402"},{"key":"b25","series-title":"J Clin Endocrinol Metab","article-title":"Radiation therapy in the management of pituitary adenomas","volume":"96","author":"Loeffler JS","year":"1992\u20132003","unstructured":"Loeffler JS, Shih HA: Radiation therapy in the management of pituitary adenomas. J Clin Endocrinol Metab 96:1992\u20132003, 2011"},{"key":"b26","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"404","DOI":"10.3171\/2016.1.JNS152119","article-title":"Cushing\u2019s disease: pathobiology, diagnosis, and management","volume":"126","author":"Lonser RR","year":"2017","unstructured":"Lonser RR, Nieman L, Oldfield EH: Cushing\u2019s disease: pathobiology, diagnosis, and management. J Neurosurg 126:404\u2013417, 201710.3171\/2016.1.JNS15211927104844"},{"key":"b27","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1056\/NEJMra1505550","article-title":"Diagnosis and differential diagnosis of Cushing\u2019s syndrome","volume":"376","author":"Loriaux DL","year":"2017","unstructured":"Loriaux DL: Diagnosis and differential diagnosis of Cushing\u2019s syndrome. N Engl J Med 376:1451\u20131459, 201710.1056\/NEJMra150555028402781"},{"key":"b28","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1227\/NEU.0b013e31826d5d06","article-title":"Pituitary centers of excellence","volume":"71","author":"McLaughlin N","year":"2012","unstructured":"McLaughlin N, Laws ER, Oyesiku NM, Katznelson L, Kelly DF: Pituitary centers of excellence. Neurosurgery 71:916\u2013926, 20122290233410.1227\/NEU.0b013e31826d5d06"},{"key":"b29","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.3171\/2012.3.JNS112160","article-title":"Prevention of intraoperative cerebrospinal fluid leaks by lumbar cerebrospinal fluid drainage during surgery for pituitary macroadenomas","volume":"116","author":"Mehta GU","year":"2012","unstructured":"Mehta GU, Oldfield EH: Prevention of intraoperative cerebrospinal fluid leaks by lumbar cerebrospinal fluid drainage during surgery for pituitary macroadenomas. J Neurosurg 116:1299\u20131303, 201210.3171\/2012.3.JNS11216022482793"},{"key":"b30","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"2558","DOI":"10.1056\/NEJMra062453","article-title":"Medical progress: acromegaly","volume":"355","author":"Melmed S","year":"2006","unstructured":"Melmed S: Medical progress: acromegaly. N Engl J Med 355:2558\u20132573, 20061716713910.1056\/NEJMra062453"},{"key":"b31","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1001\/jama.2016.19699","article-title":"Diagnosis and treatment of pituitary adenomas: a review","volume":"317","author":"Molitch ME","year":"2017","unstructured":"Molitch ME: Diagnosis and treatment of pituitary adenomas: a review. JAMA 317:516\u2013524, 201710.1001\/jama.2016.1969928170483"},{"key":"b32","series-title":"Anesth Analg","doi-asserted-by":"publisher","first-page":"1170","DOI":"10.1213\/01.ane.0000166976.61650.ae","article-title":"Perioperative management of patients undergoing transsphenoidal pituitary surgery","volume":"101","author":"Nemergut EC","year":"2005","unstructured":"Nemergut EC, Dumont AS, Barry UT, Laws ER: Perioperative management of patients undergoing transsphenoidal pituitary surgery. Anesth Analg 101:1170\u20131181, 200510.1213\/01.ane.0000166976.61650.ae16192540"},{"key":"b33","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1177\/0194599819832528","article-title":"A randomized single-blinded trial of ibuprofen- versus opioid-based primary analgesic therapy in outpatient otolaryngology surgery","volume":"160","author":"Nguyen KK","year":"2019","unstructured":"Nguyen KK, Liu YF, Chang C, Park JJ, Kim CH, Hondorp B, : A randomized single-blinded trial of ibuprofen- versus opioid-based primary analgesic therapy in outpatient otolaryngology surgery. Otolaryngol Head Neck Surg 160:839\u2013846, 201910.1177\/019459981983252830832548"},{"key":"b34","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1210\/jc.2008-0125","article-title":"The diagnosis of Cushing\u2019s syndrome: an Endocrine Society Clinical Practice Guideline","volume":"93","author":"Nieman LK","year":"2008","unstructured":"Nieman LK, Biller BMK, Findling JW, Newell-Price J, Savage MO, Stewart PM, : The diagnosis of Cushing\u2019s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 93:1526\u20131540, 200810.1210\/jc.2008-0125"},{"key":"b35","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1056\/NEJM198908243210802","article-title":"Hyponatremia and inappropriate secretion of vasopressin (antidiuretic hormone) in patients with hypopituitarism","volume":"321","author":"Oelkers W","year":"1989","unstructured":"Oelkers W: Hyponatremia and inappropriate secretion of vasopressin (antidiuretic hormone) in patients with hypopituitarism. N Engl J Med 321:492\u2013496, 1989254809710.1056\/NEJM198908243210802"},{"key":"b36","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1056\/NEJM199109263251301","article-title":"Petrosal sinus sampling with and without corticotropin-releasing hormone for the differential diagnosis of Cushing\u2019s syndrome","volume":"325","author":"Oldfield EH","year":"1991","unstructured":"Oldfield EH, Doppman JL, Nieman LK, Chrousos GP, Miller DL, Katz DA, : Petrosal sinus sampling with and without corticotropin-releasing hormone for the differential diagnosis of Cushing\u2019s syndrome. N Engl J Med 325:897\u2013905, 1991165268610.1056\/NEJM199109263251301"},{"key":"b37","series-title":"Handb Clin Neurol","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/B978-0-444-59602-4.00021-6","article-title":"Radiation therapy in the management of pituitary adenomas","volume":"124","author":"Pashtan I","year":"2014","unstructured":"Pashtan I, Oh KS, Loeffler JS: Radiation therapy in the management of pituitary adenomas. Handb Clin Neurol 124:317\u2013324, 20142524859610.1016\/B978-0-444-59602-4.00021-6"},{"key":"b38","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1177\/0194599818756272","article-title":"Risk factors for intraoperative and postoperative cerebrospinal fluid leaks in endoscopic transsphenoidal sellar surgery","volume":"158","author":"Patel PN","year":"2018","unstructured":"Patel PN, Stafford AM, Patrinely JR, Smith DK, Turner JH, Russell PT, : Risk factors for intraoperative and postoperative cerebrospinal fluid leaks in endoscopic transsphenoidal sellar surgery. Otolaryngol Head Neck Surg 158:952\u2013960, 20182940588510.1177\/0194599818756272"},{"key":"b39","series-title":"Oper Neurosurg (Hagerstown)","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1093\/ons\/opy219","article-title":"Abdominal fat graft for sellar reconstruction: retrospective outcomes review and technical note","volume":"16","author":"Roca E","year":"2019","unstructured":"Roca E, Penn DL, Safain MG, Burke WT, Castlen JP, Laws ER: Abdominal fat graft for sellar reconstruction: retrospective outcomes review and technical note. Oper Neurosurg (Hagerstown) 16:667\u2013674, 201910.1093\/ons\/opy219"},{"key":"b40","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1007\/s11102-013-0517-x","article-title":"Pituitary incidentalomas","volume":"17","author":"Scangas GA","year":"2014","unstructured":"Scangas GA, Laws ER Jr: Pituitary incidentalomas. Pituitary 17:486\u2013491, 20142405224210.1007\/s11102-013-0517-x"},{"key":"b41","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1093\/oxfordjournals.bja.a013400","article-title":"Anaesthetic complications of acromegaly","volume":"84","author":"Seidman PA","year":"2000","unstructured":"Seidman PA, Kofke WA, Policare R, Young M: Anaesthetic complications of acromegaly. Br J Anaesth 84:179\u2013182, 200010.1093\/oxfordjournals.bja.a01340010743450"},{"key":"b42","series-title":"J Neurooncol","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1007\/s11060-016-2124-y","article-title":"Resection of pituitary tumors: endoscopic versus microscopic","volume":"130","author":"Singh H","year":"2016","unstructured":"Singh H, Essayed WI, Cohen-Gadol A, Zada G, Schwartz TH: Resection of pituitary tumors: endoscopic versus microscopic. J Neurooncol 130:309\u2013317, 201610.1007\/s11060-016-2124-y27161249"},{"key":"b43","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1016\/j.jocn.2015.06.001","article-title":"Current indications for the surgical treatment of prolactinomas","volume":"22","author":"Smith TR","year":"2015","unstructured":"Smith TR, Hulou MM, Huang KT, Gokoglu A, Cote DJ, Woodmansee WW, : Current indications for the surgical treatment of prolactinomas. J Clin Neurosci 22:1785\u20131791, 201510.1016\/j.jocn.2015.06.00126277642"},{"issue":"2","key":"b44","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E12","DOI":"10.3171\/2014.10.FOCUS14705","article-title":"Complications after transsphenoidal surgery for patients with Cushing\u2019s disease and silent corticotroph adenomas","volume":"38","author":"Smith TR","year":"2015","unstructured":"Smith TR, Hulou MM, Huang KT, Nery B, de Moura SM, Cote DJ, : Complications after transsphenoidal surgery for patients with Cushing\u2019s disease and silent corticotroph adenomas. Neurosurg Focus 38(2):E12, 20152563931410.3171\/2014.10.FOCUS14705"},{"key":"b45","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"2743","DOI":"10.1210\/jc.2009-0290","article-title":"Hypercoagulable state in Cushing\u2019s syndrome: a systematic review","volume":"94","author":"Van Zaane B","year":"2009","unstructured":"Van Zaane B, Nur E, Squizzato A, Dekkers OM, Twickler MTB, Fliers E, : Hypercoagulable state in Cushing\u2019s syndrome: a systematic review. J Clin Endocrinol Metab 94:2743\u20132750, 200910.1210\/jc.2009-029019454584"},{"issue":"4","key":"b46","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E8","DOI":"10.3171\/2010.8.FOCUS10156","article-title":"Transsphenoidal surgery in patients with acromegaly: operative strategies for overcoming technically challenging anatomical variations","volume":"29","author":"Zada G","year":"2010","unstructured":"Zada G, Cavallo LM, Esposito F, Fernandez-Jimenez JC, Tasiou A, De Angelis M, : Transsphenoidal surgery in patients with acromegaly: operative strategies for overcoming technically challenging anatomical variations. Neurosurg Focus 29(4):E8, 201010.3171\/2010.8.FOCUS1015620887133"},{"key":"b47","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1007\/s11102-012-0423-7","article-title":"The postoperative cortisol stress response following transsphenoidal pituitary surgery: a potential screening method for assessing preserved pituitary function","volume":"16","author":"Zada G","year":"2013","unstructured":"Zada G, Tirosh A, Huang AP, Laws ER, Woodmansee WW: The postoperative cortisol stress response following transsphenoidal pituitary surgery: a potential screening method for assessing preserved pituitary function. Pituitary 16:319\u2013325, 20132291528910.1007\/s11102-012-0423-7"},{"key":"b48","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"596","DOI":"10.3171\/2015.4.JNS15102","article-title":"Comparison of outcomes between a less experienced surgeon using a fully endoscopic technique and a very experienced surgeon using a microscopic transsphenoidal technique for pituitary adenoma","volume":"124","author":"Zaidi HA","year":"2016","unstructured":"Zaidi HA, Awad AW, Bohl MA, Chapple K, Knecht L, Jahnke H, : Comparison of outcomes between a less experienced surgeon using a fully endoscopic technique and a very experienced surgeon using a microscopic transsphenoidal technique for pituitary adenoma. J Neurosurg 124:596\u2013604, 201610.3171\/2015.4.JNS15102"},{"key":"b49","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1016\/j.wneu.2016.09.052","article-title":"Time course of symptomatic recovery after endoscopic transsphenoidal surgery for pituitary adenoma apoplexy in the modern era","volume":"96","author":"Zaidi HA","year":"2016","unstructured":"Zaidi HA, Cote DJ, Burke WT, Castlen JP, Bi WL, Laws ER Jr, : Time course of symptomatic recovery after endoscopic transsphenoidal surgery for pituitary adenoma apoplexy in the modern era. World Neurosurg 96:434\u2013439, 20162766326310.1016\/j.wneu.2016.09.052"},{"key":"b50","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.jocn.2018.04.055","article-title":"Root cause analysis of diagnostic and surgical failures in the treatment of suspected Cushing\u2019s disease","volume":"53","author":"Zaidi HA","year":"2018","unstructured":"Zaidi HA, Penn DL, Cote DJ, Laws ER Jr: Root cause analysis of diagnostic and surgical failures in the treatment of suspected Cushing\u2019s disease. J Clin Neurosci 53:153\u2013159, 20182971680410.1016\/j.jocn.2018.04.055"},{"key":"b51","series-title":"Endocrine","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1007\/s12020-017-1338-x","article-title":"High levels of IGF-1 predict difficult intubation of patients with acromegaly","volume":"57","author":"Zhang Y","year":"2017","unstructured":"Zhang Y, Guo X, Pei L, Zhang Z, Tan G, Xing B: High levels of IGF-1 predict difficult intubation of patients with acromegaly. Endocrine 57:326\u2013334, 20172862086610.1007\/s12020-017-1338-x"},{"key":"b52","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"E541","DOI":"10.1227\/NEU.0000000000001392","article-title":"Congress of Neurological Surgeons systematic review and evidence-based guideline on posttreatment follow-up evaluation of patients with nonfunctioning pituitary adenomas","volume":"79","author":"Ziu M","year":"2016","unstructured":"Ziu M, Dunn IF, Hess C, Fleseriu M, Bodach ME, Tumialan LM, : Congress of Neurological Surgeons systematic review and evidence-based guideline on posttreatment follow-up evaluation of patients with nonfunctioning pituitary adenomas. Neurosurgery 79:E541\u2013E543, 201610.1227\/NEU.000000000000139227635964"},{"key":"b53","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.3171\/2018.4.JNS172447","article-title":"Does lumbar drainage reduce postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery? A prospective, randomized controlled trial","volume":"131","author":"Zwagerman NT","year":"2019","unstructured":"Zwagerman NT, Wang EW, Shin SS, Chang YF, Fernandez-Miranda JC, Snyderman CH, : Does lumbar drainage reduce postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery? A prospective, randomized controlled trial. J Neurosurg 131:1172\u20131178, 201910.3171\/2018.4.JNS172447"},{"key":"b1","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"813.e1","DOI":"10.1016\/j.wneu.2016.12.009","article-title":"Bolstering the nasoseptal flap using sphenoid sinus fat packing: a technical case report","volume":"99","author":"Abou-Al-Shaar H","year":"2017","unstructured":"Abou-Al-Shaar H, Zaidi HA, Cote DJ, Laws ER Jr: Bolstering the nasoseptal flap using sphenoid sinus fat packing: a technical case report. World Neurosurg 99:813.e1\u2013813.e5, 201710.1016\/j.wneu.2016.12.009"},{"key":"b2","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1007\/s00701-017-3438-z","article-title":"Gross total resection of pituitary adenomas after endoscopic vs. microscopic transsphenoidal surgery: a meta-analysis","volume":"160","author":"Almutairi RD","year":"2018","unstructured":"Almutairi RD, Muskens IS, Cote DJ, Dijkman MD, Kavouridis VK, Crocker E, : Gross total resection of pituitary adenomas after endoscopic vs. microscopic transsphenoidal surgery: a meta-analysis. Acta Neurochir (Wien) 160:1005\u20131021, 201810.1007\/s00701-017-3438-z"},{"key":"b3","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.wneu.2017.09.192","article-title":"Delayed complications after transsphenoidal surgery for pituitary adenomas","volume":"109","author":"Alzhrani G","year":"2018","unstructured":"Alzhrani G, Sivakumar W, Park MS, Taussky P, Couldwell WT: Delayed complications after transsphenoidal surgery for pituitary adenomas. World Neurosurg 109:233\u2013241, 20182898904710.1016\/j.wneu.2017.09.192"},{"key":"b4","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1007\/s11102-014-0600-y","article-title":"Perioperative thromboprophylaxis in Cushing\u2019s disease: What we did and what we are doing?","volume":"18","author":"Barbot M","year":"2015","unstructured":"Barbot M, Daidone V, Zilio M, Albiger N, Mazzai L, Sartori MT, : Perioperative thromboprophylaxis in Cushing\u2019s disease: What we did and what we are doing? Pituitary 18:487\u2013493, 20152523955710.1007\/s11102-014-0600-y"},{"key":"b5","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1001\/jama.1985.03350290088032","article-title":"Multidisciplinary management of acromegaly and its deformities","volume":"253","author":"Brennan MD","year":"1985","unstructured":"Brennan MD, Jackson IT, Keller EE, Laws ER Jr, Sather AH: Multidisciplinary management of acromegaly and its deformities. JAMA 253:682\u2013683, 198510.1001\/jama.1985.033502900880323881612"},{"key":"b6","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s11102-017-0843-5","article-title":"A practical method for prevention of readmission for symptomatic hyponatremia following transsphenoidal surgery","volume":"21","author":"Burke WT","year":"2018","unstructured":"Burke WT, Cote DJ, Iuliano SI, Zaidi HA, Laws ER: A practical method for prevention of readmission for symptomatic hyponatremia following transsphenoidal surgery. Pituitary 21:25\u201331, 201810.1007\/s11102-017-0843-529075986"},{"key":"b7","series-title":"Neurosurgery","article-title":"Diabetes insipidus after endoscopic transsphenoidal surgery","author":"Burke WT","unstructured":"Burke WT, Cote DJ, Penn DL, Iuliano SL, McMillen K, Laws ER: Diabetes insipidus after endoscopic transsphenoidal surgery. Neurosurgery [in press], 202032503055"},{"key":"b8","series-title":"J Neurosurg","article-title":"Prolactinomas and nonfunctioning adenomas: preoperative diagnosis of tumor type using serum prolactin and tumor size","author":"Burke WT","unstructured":"Burke WT, Penn DL, Castlen JP, Donoho DA, Repetti CS, Iuliano S, : Prolactinomas and nonfunctioning adenomas: preoperative diagnosis of tumor type using serum prolactin and tumor size. J Neurosurg [epub ahead of print June 14, 2019. DOI: 10.3171\/2019.3.JNS19121]31200381"},{"key":"b9","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1007\/s11102-017-0838-2","article-title":"Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): a Pituitary Society statement","volume":"20","author":"Casanueva FF","year":"2017","unstructured":"Casanueva FF, Barkan AL, Buchfelder M, Klibanski A, Laws ER, Loeffler JS, : Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): a Pituitary Society statement. Pituitary 20:489\u2013498, 20172888441510.1007\/s11102-017-0838-2"},{"key":"b10","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.wneu.2016.01.022","article-title":"Predictors and rates of delayed symptomatic hyponatremia after transsphenoidal surgery: a systematic review [corrected]","volume":"88","author":"Cote DJ","year":"2016","unstructured":"Cote DJ, Alzarea A, Acosta MA, Hulou MM, Huang KT, Almutairi H, : Predictors and rates of delayed symptomatic hyponatremia after transsphenoidal surgery: a systematic review [corrected]. World Neurosurg 88:1\u20136, 20162680568510.1016\/j.wneu.2016.01.022"},{"key":"b11","series-title":"J Am Coll Surg","doi-asserted-by":"publisher","first-page":"971","DOI":"10.1016\/j.jamcollsurg.2017.02.015","article-title":"Readmission and other adverse events after transsphenoidal surgery: prevalence, timing, and predictive factors","volume":"224","author":"Cote DJ","year":"2017","unstructured":"Cote DJ, Dasenbrock HH, Muskens IS, Broekman MLD, Zaidi HA, Dunn IF, : Readmission and other adverse events after transsphenoidal surgery: prevalence, timing, and predictive factors. J Am Coll Surg 224:971\u2013979, 20172827977810.1016\/j.jamcollsurg.2017.02.015"},{"key":"b12","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1016\/j.wneu.2015.05.019","article-title":"The expanding spectrum of disease treated by the transnasal, transsphenoidal microscopic and endoscopic anterior skull base approach: a single-center experience 2008-2015","volume":"84","author":"Cote DJ","year":"2015","unstructured":"Cote DJ, Wiemann R, Smith TR, Dunn IF, Al-Mefty O, Laws ER: The expanding spectrum of disease treated by the transnasal, transsphenoidal microscopic and endoscopic anterior skull base approach: a single-center experience 2008-2015. World Neurosurg 84:899\u2013905, 201510.1016\/j.wneu.2015.05.01926008142"},{"key":"b13","series-title":"Cancer","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1002\/cncr.20412","article-title":"The prevalence of pituitary adenomas: a systematic review","volume":"101","author":"Ezzat S","year":"2004","unstructured":"Ezzat S, Asa SL, Couldwell WT, Barr CE, Dodge WE, Vance ML, : The prevalence of pituitary adenomas: a systematic review. Cancer 101:613\u2013619, 20041527407510.1002\/cncr.20412"},{"key":"b14","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1210\/jc.2010-1048","article-title":"Pituitary incidentaloma: an endocrine society clinical practice guideline","volume":"96","author":"Freda PU","year":"2011","unstructured":"Freda PU, Beckers AM, Katznelson L, Molitch ME, Montori VM, Post KD, : Pituitary incidentaloma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 96:894\u2013904, 201110.1210\/jc.2010-104821474686"},{"key":"b15","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.3171\/2018.5.JNS181054","article-title":"Endocrine function and gland volume after endoscopic transsphenoidal surgery for nonfunctional pituitary macroadenomas","volume":"131","author":"Harary M","year":"2019","unstructured":"Harary M, DiRisio AC, Dawood HY, Kim J, Lamba N, Cho CH, : Endocrine function and gland volume after endoscopic transsphenoidal surgery for nonfunctional pituitary macroadenomas. J Neurosurg 131:1142\u20131151, 201910.3171\/2018.5.JNS181054"},{"key":"b16","series-title":"Laryngoscope","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1002\/lary.22475","article-title":"Endoscopic skull base reconstruction of large dural defects: a systematic review of published evidence","volume":"122","author":"Harvey RJ","year":"2012","unstructured":"Harvey RJ, Parmar P, Sacks R, Zanation AM: Endoscopic skull base reconstruction of large dural defects: a systematic review of published evidence. Laryngoscope 122:452\u2013459, 201210.1002\/lary.2247522253060"},{"key":"b17","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.jocn.2014.08.009","article-title":"Risk factors for postoperative cerebrospinal fluid leak and meningitis after expanded endoscopic endonasal surgery","volume":"22","author":"Ivan ME","year":"2015","unstructured":"Ivan ME, Iorgulescu JB, El-Sayed I, McDermott MW, Parsa AT, Pletcher SD, : Risk factors for postoperative cerebrospinal fluid leak and meningitis after expanded endoscopic endonasal surgery. J Clin Neurosci 22:48\u201354, 20152543975410.1016\/j.jocn.2014.08.009"},{"key":"b18","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"67","DOI":"10.3171\/2014.3.JNS131532","article-title":"Morbidity of repeat transsphenoidal surgery assessed in more than 1000 operations","volume":"121","author":"Jahangiri A","year":"2014","unstructured":"Jahangiri A, Wagner J, Han SW, Zygourakis CC, Han SJ, Tran MT, : Morbidity of repeat transsphenoidal surgery assessed in more than 1000 operations. J Neurosurg 121:67\u201374, 201410.3171\/2014.3.JNS13153224834943"},{"key":"b19","series-title":"Neurooncol Pract","first-page":"64","article-title":"Temozolomide therapy for aggressive functioning pituitary adenomas refractory to surgery and radiation: a case series","volume":"5","author":"Jordan JT","year":"2018","unstructured":"Jordan JT, Miller JJ, Cushing T, Seijo M, Batchelor TT, Arrillaga-Romany IC, : Temozolomide therapy for aggressive functioning pituitary adenomas refractory to surgery and radiation: a case series. Neurooncol Pract 5:64\u201368, 201831385986"},{"key":"b20","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"3933","DOI":"10.1210\/jc.2014-2700","article-title":"Acromegaly: an endocrine society clinical practice guideline","volume":"99","author":"Katznelson L","year":"2014","unstructured":"Katznelson L, Laws ER Jr, Melmed S, Molitch ME, Murad MH, Utz A, : Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 99:3933\u20133951, 20142535680810.1210\/jc.2014-2700"},{"key":"b21","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1056\/NEJMcp0912025","article-title":"Clinical practice. Prolactinomas","volume":"362","author":"Klibanski A","year":"2010","unstructured":"Klibanski A: Clinical practice. Prolactinomas. N Engl J Med 362:1219\u20131226, 20102035728410.1056\/NEJMcp0912025"},{"key":"b22","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"621","DOI":"10.3171\/2012.11.JNS121190","article-title":"Endoscopic endonasal surgery for giant pituitary adenomas: advantages and limitations","volume":"118","author":"Koutourousiou M","year":"2013","unstructured":"Koutourousiou M, Gardner PA, Fernandez-Miranda JC, Paluzzi A, Wang EW, Snyderman CH: Endoscopic endonasal surgery for giant pituitary adenomas: advantages and limitations. J Neurosurg 118:621\u2013631, 201310.3171\/2012.11.JNS12119023289816"},{"key":"b23","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.3171\/2015.4.JNS142184","article-title":"A checklist for endonasal transsphenoidal anterior skull base surgery","volume":"124","author":"Laws ER","year":"2016","unstructured":"Laws ER, Wong JM, Smith TR, de Los Reyes K, Aglio LS, Thorne AJ, : A checklist for endonasal transsphenoidal anterior skull base surgery. J Neurosurg 124:1634\u20131639, 201610.3171\/2015.4.JNS14218426517770"},{"key":"b24","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/j.wneu.2016.04.059","article-title":"A benchmark for preservation of normal pituitary function after endoscopic transsphenoidal surgery for pituitary macroadenomas","volume":"91","author":"Laws ER Jr","year":"2016","unstructured":"Laws ER Jr, Iuliano SL, Cote DJ, Woodmansee W, Hsu L, Cho CH: A benchmark for preservation of normal pituitary function after endoscopic transsphenoidal surgery for pituitary macroadenomas. World Neurosurg 91:371\u2013375, 201610.1016\/j.wneu.2016.04.05927113402"},{"key":"b25","series-title":"J Clin Endocrinol Metab","article-title":"Radiation therapy in the management of pituitary adenomas","volume":"96","author":"Loeffler JS","year":"1992\u20132003","unstructured":"Loeffler JS, Shih HA: Radiation therapy in the management of pituitary adenomas. J Clin Endocrinol Metab 96:1992\u20132003, 2011"},{"key":"b26","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"404","DOI":"10.3171\/2016.1.JNS152119","article-title":"Cushing\u2019s disease: pathobiology, diagnosis, and management","volume":"126","author":"Lonser RR","year":"2017","unstructured":"Lonser RR, Nieman L, Oldfield EH: Cushing\u2019s disease: pathobiology, diagnosis, and management. J Neurosurg 126:404\u2013417, 201710.3171\/2016.1.JNS15211927104844"},{"key":"b27","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1056\/NEJMra1505550","article-title":"Diagnosis and differential diagnosis of Cushing\u2019s syndrome","volume":"376","author":"Loriaux DL","year":"2017","unstructured":"Loriaux DL: Diagnosis and differential diagnosis of Cushing\u2019s syndrome. N Engl J Med 376:1451\u20131459, 201710.1056\/NEJMra150555028402781"},{"key":"b28","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1227\/NEU.0b013e31826d5d06","article-title":"Pituitary centers of excellence","volume":"71","author":"McLaughlin N","year":"2012","unstructured":"McLaughlin N, Laws ER, Oyesiku NM, Katznelson L, Kelly DF: Pituitary centers of excellence. Neurosurgery 71:916\u2013926, 20122290233410.1227\/NEU.0b013e31826d5d06"},{"key":"b29","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.3171\/2012.3.JNS112160","article-title":"Prevention of intraoperative cerebrospinal fluid leaks by lumbar cerebrospinal fluid drainage during surgery for pituitary macroadenomas","volume":"116","author":"Mehta GU","year":"2012","unstructured":"Mehta GU, Oldfield EH: Prevention of intraoperative cerebrospinal fluid leaks by lumbar cerebrospinal fluid drainage during surgery for pituitary macroadenomas. J Neurosurg 116:1299\u20131303, 201210.3171\/2012.3.JNS11216022482793"},{"key":"b30","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"2558","DOI":"10.1056\/NEJMra062453","article-title":"Medical progress: acromegaly","volume":"355","author":"Melmed S","year":"2006","unstructured":"Melmed S: Medical progress: acromegaly. N Engl J Med 355:2558\u20132573, 20061716713910.1056\/NEJMra062453"},{"key":"b31","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1001\/jama.2016.19699","article-title":"Diagnosis and treatment of pituitary adenomas: a review","volume":"317","author":"Molitch ME","year":"2017","unstructured":"Molitch ME: Diagnosis and treatment of pituitary adenomas: a review. JAMA 317:516\u2013524, 201710.1001\/jama.2016.1969928170483"},{"key":"b32","series-title":"Anesth Analg","doi-asserted-by":"publisher","first-page":"1170","DOI":"10.1213\/01.ane.0000166976.61650.ae","article-title":"Perioperative management of patients undergoing transsphenoidal pituitary surgery","volume":"101","author":"Nemergut EC","year":"2005","unstructured":"Nemergut EC, Dumont AS, Barry UT, Laws ER: Perioperative management of patients undergoing transsphenoidal pituitary surgery. Anesth Analg 101:1170\u20131181, 200510.1213\/01.ane.0000166976.61650.ae16192540"},{"key":"b33","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1177\/0194599819832528","article-title":"A randomized single-blinded trial of ibuprofen- versus opioid-based primary analgesic therapy in outpatient otolaryngology surgery","volume":"160","author":"Nguyen KK","year":"2019","unstructured":"Nguyen KK, Liu YF, Chang C, Park JJ, Kim CH, Hondorp B, : A randomized single-blinded trial of ibuprofen- versus opioid-based primary analgesic therapy in outpatient otolaryngology surgery. Otolaryngol Head Neck Surg 160:839\u2013846, 201910.1177\/019459981983252830832548"},{"key":"b34","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1210\/jc.2008-0125","article-title":"The diagnosis of Cushing\u2019s syndrome: an Endocrine Society Clinical Practice Guideline","volume":"93","author":"Nieman LK","year":"2008","unstructured":"Nieman LK, Biller BMK, Findling JW, Newell-Price J, Savage MO, Stewart PM, : The diagnosis of Cushing\u2019s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 93:1526\u20131540, 200810.1210\/jc.2008-0125"},{"key":"b35","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1056\/NEJM198908243210802","article-title":"Hyponatremia and inappropriate secretion of vasopressin (antidiuretic hormone) in patients with hypopituitarism","volume":"321","author":"Oelkers W","year":"1989","unstructured":"Oelkers W: Hyponatremia and inappropriate secretion of vasopressin (antidiuretic hormone) in patients with hypopituitarism. N Engl J Med 321:492\u2013496, 1989254809710.1056\/NEJM198908243210802"},{"key":"b36","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1056\/NEJM199109263251301","article-title":"Petrosal sinus sampling with and without corticotropin-releasing hormone for the differential diagnosis of Cushing\u2019s syndrome","volume":"325","author":"Oldfield EH","year":"1991","unstructured":"Oldfield EH, Doppman JL, Nieman LK, Chrousos GP, Miller DL, Katz DA, : Petrosal sinus sampling with and without corticotropin-releasing hormone for the differential diagnosis of Cushing\u2019s syndrome. N Engl J Med 325:897\u2013905, 1991165268610.1056\/NEJM199109263251301"},{"key":"b37","series-title":"Handb Clin Neurol","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/B978-0-444-59602-4.00021-6","article-title":"Radiation therapy in the management of pituitary adenomas","volume":"124","author":"Pashtan I","year":"2014","unstructured":"Pashtan I, Oh KS, Loeffler JS: Radiation therapy in the management of pituitary adenomas. Handb Clin Neurol 124:317\u2013324, 20142524859610.1016\/B978-0-444-59602-4.00021-6"},{"key":"b38","series-title":"Otolaryngol Head Neck Surg","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1177\/0194599818756272","article-title":"Risk factors for intraoperative and postoperative cerebrospinal fluid leaks in endoscopic transsphenoidal sellar surgery","volume":"158","author":"Patel PN","year":"2018","unstructured":"Patel PN, Stafford AM, Patrinely JR, Smith DK, Turner JH, Russell PT, : Risk factors for intraoperative and postoperative cerebrospinal fluid leaks in endoscopic transsphenoidal sellar surgery. Otolaryngol Head Neck Surg 158:952\u2013960, 20182940588510.1177\/0194599818756272"},{"key":"b39","series-title":"Oper Neurosurg (Hagerstown)","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1093\/ons\/opy219","article-title":"Abdominal fat graft for sellar reconstruction: retrospective outcomes review and technical note","volume":"16","author":"Roca E","year":"2019","unstructured":"Roca E, Penn DL, Safain MG, Burke WT, Castlen JP, Laws ER: Abdominal fat graft for sellar reconstruction: retrospective outcomes review and technical note. Oper Neurosurg (Hagerstown) 16:667\u2013674, 201910.1093\/ons\/opy219"},{"key":"b40","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1007\/s11102-013-0517-x","article-title":"Pituitary incidentalomas","volume":"17","author":"Scangas GA","year":"2014","unstructured":"Scangas GA, Laws ER Jr: Pituitary incidentalomas. Pituitary 17:486\u2013491, 20142405224210.1007\/s11102-013-0517-x"},{"key":"b41","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1093\/oxfordjournals.bja.a013400","article-title":"Anaesthetic complications of acromegaly","volume":"84","author":"Seidman PA","year":"2000","unstructured":"Seidman PA, Kofke WA, Policare R, Young M: Anaesthetic complications of acromegaly. Br J Anaesth 84:179\u2013182, 200010.1093\/oxfordjournals.bja.a01340010743450"},{"key":"b42","series-title":"J Neurooncol","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1007\/s11060-016-2124-y","article-title":"Resection of pituitary tumors: endoscopic versus microscopic","volume":"130","author":"Singh H","year":"2016","unstructured":"Singh H, Essayed WI, Cohen-Gadol A, Zada G, Schwartz TH: Resection of pituitary tumors: endoscopic versus microscopic. J Neurooncol 130:309\u2013317, 201610.1007\/s11060-016-2124-y27161249"},{"key":"b43","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1016\/j.jocn.2015.06.001","article-title":"Current indications for the surgical treatment of prolactinomas","volume":"22","author":"Smith TR","year":"2015","unstructured":"Smith TR, Hulou MM, Huang KT, Gokoglu A, Cote DJ, Woodmansee WW, : Current indications for the surgical treatment of prolactinomas. J Clin Neurosci 22:1785\u20131791, 201510.1016\/j.jocn.2015.06.00126277642"},{"issue":"2","key":"b44","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E12","DOI":"10.3171\/2014.10.FOCUS14705","article-title":"Complications after transsphenoidal surgery for patients with Cushing\u2019s disease and silent corticotroph adenomas","volume":"38","author":"Smith TR","year":"2015","unstructured":"Smith TR, Hulou MM, Huang KT, Nery B, de Moura SM, Cote DJ, : Complications after transsphenoidal surgery for patients with Cushing\u2019s disease and silent corticotroph adenomas. Neurosurg Focus 38(2):E12, 20152563931410.3171\/2014.10.FOCUS14705"},{"key":"b45","series-title":"J Clin Endocrinol Metab","doi-asserted-by":"publisher","first-page":"2743","DOI":"10.1210\/jc.2009-0290","article-title":"Hypercoagulable state in Cushing\u2019s syndrome: a systematic review","volume":"94","author":"Van Zaane B","year":"2009","unstructured":"Van Zaane B, Nur E, Squizzato A, Dekkers OM, Twickler MTB, Fliers E, : Hypercoagulable state in Cushing\u2019s syndrome: a systematic review. J Clin Endocrinol Metab 94:2743\u20132750, 200910.1210\/jc.2009-029019454584"},{"issue":"4","key":"b46","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E8","DOI":"10.3171\/2010.8.FOCUS10156","article-title":"Transsphenoidal surgery in patients with acromegaly: operative strategies for overcoming technically challenging anatomical variations","volume":"29","author":"Zada G","year":"2010","unstructured":"Zada G, Cavallo LM, Esposito F, Fernandez-Jimenez JC, Tasiou A, De Angelis M, : Transsphenoidal surgery in patients with acromegaly: operative strategies for overcoming technically challenging anatomical variations. Neurosurg Focus 29(4):E8, 201010.3171\/2010.8.FOCUS1015620887133"},{"key":"b47","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1007\/s11102-012-0423-7","article-title":"The postoperative cortisol stress response following transsphenoidal pituitary surgery: a potential screening method for assessing preserved pituitary function","volume":"16","author":"Zada G","year":"2013","unstructured":"Zada G, Tirosh A, Huang AP, Laws ER, Woodmansee WW: The postoperative cortisol stress response following transsphenoidal pituitary surgery: a potential screening method for assessing preserved pituitary function. Pituitary 16:319\u2013325, 20132291528910.1007\/s11102-012-0423-7"},{"key":"b48","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"596","DOI":"10.3171\/2015.4.JNS15102","article-title":"Comparison of outcomes between a less experienced surgeon using a fully endoscopic technique and a very experienced surgeon using a microscopic transsphenoidal technique for pituitary adenoma","volume":"124","author":"Zaidi HA","year":"2016","unstructured":"Zaidi HA, Awad AW, Bohl MA, Chapple K, Knecht L, Jahnke H, : Comparison of outcomes between a less experienced surgeon using a fully endoscopic technique and a very experienced surgeon using a microscopic transsphenoidal technique for pituitary adenoma. J Neurosurg 124:596\u2013604, 201610.3171\/2015.4.JNS15102"},{"key":"b49","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1016\/j.wneu.2016.09.052","article-title":"Time course of symptomatic recovery after endoscopic transsphenoidal surgery for pituitary adenoma apoplexy in the modern era","volume":"96","author":"Zaidi HA","year":"2016","unstructured":"Zaidi HA, Cote DJ, Burke WT, Castlen JP, Bi WL, Laws ER Jr, : Time course of symptomatic recovery after endoscopic transsphenoidal surgery for pituitary adenoma apoplexy in the modern era. World Neurosurg 96:434\u2013439, 20162766326310.1016\/j.wneu.2016.09.052"},{"key":"b50","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.jocn.2018.04.055","article-title":"Root cause analysis of diagnostic and surgical failures in the treatment of suspected Cushing\u2019s disease","volume":"53","author":"Zaidi HA","year":"2018","unstructured":"Zaidi HA, Penn DL, Cote DJ, Laws ER Jr: Root cause analysis of diagnostic and surgical failures in the treatment of suspected Cushing\u2019s disease. J Clin Neurosci 53:153\u2013159, 20182971680410.1016\/j.jocn.2018.04.055"},{"key":"b51","series-title":"Endocrine","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1007\/s12020-017-1338-x","article-title":"High levels of IGF-1 predict difficult intubation of patients with acromegaly","volume":"57","author":"Zhang Y","year":"2017","unstructured":"Zhang Y, Guo X, Pei L, Zhang Z, Tan G, Xing B: High levels of IGF-1 predict difficult intubation of patients with acromegaly. Endocrine 57:326\u2013334, 20172862086610.1007\/s12020-017-1338-x"},{"key":"b52","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"E541","DOI":"10.1227\/NEU.0000000000001392","article-title":"Congress of Neurological Surgeons systematic review and evidence-based guideline on posttreatment follow-up evaluation of patients with nonfunctioning pituitary adenomas","volume":"79","author":"Ziu M","year":"2016","unstructured":"Ziu M, Dunn IF, Hess C, Fleseriu M, Bodach ME, Tumialan LM, : Congress of Neurological Surgeons systematic review and evidence-based guideline on posttreatment follow-up evaluation of patients with nonfunctioning pituitary adenomas. Neurosurgery 79:E541\u2013E543, 201610.1227\/NEU.000000000000139227635964"},{"key":"b53","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1172","DOI":"10.3171\/2018.4.JNS172447","article-title":"Does lumbar drainage reduce postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery? A prospective, randomized controlled trial","volume":"131","author":"Zwagerman NT","year":"2019","unstructured":"Zwagerman NT, Wang EW, Shin SS, Chang YF, Fernandez-Miranda JC, Snyderman CH, : Does lumbar drainage reduce postoperative cerebrospinal fluid leak after endoscopic endonasal skull base surgery? A prospective, randomized controlled trial. J Neurosurg 131:1172\u20131178, 201910.3171\/2018.4.JNS172447"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/48\/6\/article-pE2.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/48\/6\/article-pE2.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/48\/6\/article-pE2.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T08:39:01Z","timestamp":1778315941000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/48\/6\/article-pE2.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6]]},"references-count":106,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2020.3.focus2043","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6]]}}}