Al-Azhar Neurosurgery

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Al-Hussein university hospital , Al-Sayyed Galal hospital

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Case 22

Case 22 Pituitary macroadenoma

A close-up of a mri Description automatically generated

Figure 22-1: MRI of the patient axial with contrat.

  • Q1. What is Knosp classification?
A diagram of a diagram of the internal organs Description automatically generated
  • Figure 22-2: sinus invasion classification

  • Q2. What are the Types of sphenoid sinus pneumatization?
A diagram of a bird's body Description automatically generated with medium confidence

Figure 22-3A. Choncal,B. presellar, C.sellar and D.post sellar (types of sphenoid sinus pneumatization )

  • Q3: What is the sequence of tumor removal in this case to achieve maximum tumor resection and avoid CSF leak?
  • The usual sequence for pituitary tumor removal is as follows: remove the inferior portion first, then the sides, and finally the superior portion. This sequence aims to avoid obstructing the view with the diaphragm sellae if the superior part is removed first, and it minimizes the likelihood of a CSF leak.