Discover the groundbreaking technique of a transmandibular lateral transsphenoidal navigated surgical approach, offering a novel pathway to treat pituitary macroadenoma in a warmblood mare, revolutionizing veterinary neurosurgery.
– by The Don
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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
Let me tell you about this incredible, absolutely amazing case. We had this 16-year-old warmblood mare, a beautiful creature, but sadly, she was facing some serious issues. She was dealing with behavioral changes and, believe it or not, left-sided blindness. That’s right, blindness. So, we did what we do best – we took a closer look, and guess what we found? A massive, yes, massive 4.5 cm pituitary mass right there in her brain. It was pressing down on her midbrain and optic chiasm, causing all these problems.
Now, the easy way out? Euthanasia. But no, the owners, they said no. They wanted to fight for her. So, we brought together the best of the best – veterinary specialists and even a human neurosurgeon. We’re talking top-notch experts here. Together, we came up with a groundbreaking plan. We developed a novel, yes, novel approach to reach that mass without causing too much damage. We practiced on cadavers because we only get one shot at this, folks.
So, the big day comes. We anesthetize the mare, get her in position, and use this state-of-the-art CBCT-coupled navigation system. Precision, folks, it’s all about precision. We navigate through, avoiding major arteries, creating a safe path to that mass. But here’s the thing – despite our best efforts, our microsurgical techniques, it was tough. The working channel was long and narrow, making it incredibly challenging to see everything we needed to.
We managed to remove part of the mass, but it wasn’t perfect. There was some damage to the normal brain tissue. It’s heartbreaking, truly. With the owner’s consent, we decided the kindest thing was to let her go under anesthesia. A tough decision, but sometimes, it’s the only one we have.
In the end, we confirmed it was a pituitary adenoma we were dealing with, but the surgery had caused some additional damage. It was a bold move, an innovative approach, but it shows just how far we’re willing to go. This case, folks, it’s a testament to our commitment, our dedication to pushing the boundaries, to doing everything we can for these magnificent creatures. Truly remarkable.