Evidence map›Paper›PMID 39863739›Full record

ArticlePituitary2025

Selective resection of the medial wall of the cavernous sinus in pituitary surgery: results of a prospective single center analysis.

Dan Zimelewicz Oberman, Emiliano Sanchez-Garavito, Carlos Perez-Vega, Angela Donaldson, Osarenoma Olomu, Stephen Graepel, Mark A Edgar, Alfredo Quinones-Hinojosa, Kaisorn L Chaichana, Susan L Samson and 1 more

Abstract read
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In one paragraph

Article in Pituitary, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Current treatment landscape of acromegaly.The Journal of clinical endocrinology and metabolism · 2026
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Dan Zimelewicz ObermanDepartment of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Emiliano Sanchez-GaravitoDepartment of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Carlos Perez-VegaDepartment of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Angela DonaldsonDepartment of Otolaryngology, Mayo Clinic, Jacksonville, FL, USA.
Osarenoma OlomuDepartment of Otolaryngology, Mayo Clinic, Jacksonville, FL, USA.
Stephen GraepelDepartment of Neurosurgery, Mayo Clinic, Rochester, MN, USA.
Mark A EdgarDepartment of Pathology, Mayo Clinic, Rochester, MN, USA.
Alfredo Quinones-HinojosaDepartment of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Kaisorn L ChaichanaDepartment of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Susan L SamsonDepartment of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Joao Paulo AlmeidaDepartment of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA. joalmeid@iu.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePituitary adenomas, despite their histologically benign nature, can severely impact patients' quality of life due to hormone hypersecretion. Invasion of the medial wall of the cavernous sinus (MWCS) by these tumors complicates surgical outcomes, lowering biochemical remission rates and increasing recurrence. This study aims to share our institutional experience with the selective resection of the MWCS in endoscopic pituitary surgery.

methodsThis prospective study included patients diagnosed with pituitary adenomas who underwent endoscopic endonasal surgery at Mayo Clinic, Jacksonville. Inclusion criteria encompassed confirmed pituitary adenomas, selective MWCS resection, and availability of histopathological data. Patient demographics, tumor characteristics, surgical outcomes, and postoperative complications were analyzed using descriptive statistics.

resultsTwenty-six cases met the inclusion criteria. Functional adenomas and macroadenomas constituted 80.8% of cases. Recurrent adenomas represented 19.2% of cases. Tumor invasion of the MWCS was confirmed in 76.9% of cases and patients with acromegaly had the highest rate of confirmed invasion of the MW (88.8%). Initial disease control was achieved in 88.5% of the patients, and disease remission at last follow up was observed in those with acromegaly, Cushing's disease and prolactinomas in 87.5%, 83.3% and 66.6% of cases, respectively. Complete resection was achieved in 5/5 nonfunctioning adenomas. There were no carotid injuries, cranial deficits or fatalities observed.

conclusionResection of the MWCS is an effective strategy for improving surgical outcomes in pituitary adenomas with potential invasion into this area, especially in patients with functional and/or recurrent adenomas. The procedure demonstrates a positive balance of efficacy and safety, when performed by teams with high level of experience in endoscopic skull base surgery and in selected patients.

Indexed as

AdenomaCavernous SinusPituitary NeoplasmsAdultAgedFemaleHumansMaleMiddle AgedProspective StudiesTreatment OutcomeCavernous sinusInternal carotid arteryMedial wall of the cavernous sinusPituitary gland

Identifiers

PMID39863739

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.