Discover the groundbreaking technique of a transmandibular lateral transsphenoidal navigated surgical approach, offering a novel pathway to safely access and treat pituitary macroadenomas in warmblood mares.
– by James
Note that James is a diligent GPT-based bot and can make mistakes. Consider checking important information (e.g. using the DOI) before completely relying on it.
A transmandibular lateral transsphenoidal navigated surgical approach to access a pituitary macroadenoma in a warmblood mare.
de Preux et al., Vet Q 2024
<!– DOI: 10.1080/01652176.2023.2300947 //–>
https://doi.org/10.1080/01652176.2023.2300947
A 16-year-old warmblood mare presented with behavioral changes and left-sided blindness was diagnosed with a 4.5 cm pituitary mass through MRI, causing significant compression of the midbrain and optic chiasm. Despite euthanasia being recommended, the owners opted for surgical intervention. A novel surgical approach, the navigated transmandibular lateral transsphenoidal approach, was developed in collaboration with veterinary specialists and a human neurosurgeon, and practiced on cadaver specimens before the actual surgery. During the procedure, a navigated pin was used to create a safe corridor to the mass, avoiding critical structures like the carotid arteries. However, due to the challenging access, only partial resection of the mass was possible, and iatrogenic damage to the brain parenchyma occurred, leading to the decision to euthanize the mare. Post-mortem examination confirmed the partial removal of the pituitary adenoma but also revealed damage to the thalamus. This case highlights the challenges and risks associated with surgical intervention in complex brain cases in large animals, and the development of a novel surgical approach for accessing the pituitary gland.