ArticleSurgical neurology international2026
Feasibility study of the concepts of 360° access to the cavernous sinus in endoscopic biportal (transorbital and endonasal) surgery for invasive pituitary adenomas: Cadaveric anatomy, surgical nuances, and case illustrations.
Article in Surgical neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The cavernous sinus (CS) is still one of the last frontiers of skull base surgery. Knosp 3B-4 subtypes of invasive pituitary adenomas pose significant difficulties since the endoscopic endonasal approach (EEA) is restricted to the medial compartment of the CS. The current study aims to validate the principle of 360° anatomic access around the CS and to demonstrate the clinical utility of the synergistic endoscopic biportal approach- combining EEA and the endoscopic transorbital approach (ETOA). Methods: Two silicon-injected cadaveric specimens were used to define the corridors EEA and ETOA and their respective access to the CS. A case series with two patients suffering from invasive pituitary adenomas is presented; both cases received a biportal approach, one staged and the other two staged. Results: The cadaveric study confirmed that EEA provides optimal access to the medial and inferior CS, whereas the ETOA corridor provided direct access to the superior and lateral compartments through the Mullan's and Parkinson's triangles. Clinically, a biportal approach in one case allowed for simultaneous dissection from medial and lateral trajectories, facilitating gross-total resection of a radiation-resistant recurrence. A second case demonstrated a staged uniportal ETOA for effective resection of a lateral CS recurrence, avoiding new cranial nerve deficits. Conclusion: The endoscopic biportal (transnasal and transorbital) approach is a feasible technique for invasive pituitary adenomas. This technique applies the concept of a 360° approach to the CS, allowing a panoramic dissection of tumors from complementary angles and overcoming the inherent limitations of a single surgical corridor.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.