Rolul echipei multidisciplinare în diagnosticul şi tratamentul tumorilor lojei hipofizare.

The sellar and parasellar region is an anatomically complex area where a number of neoplastic, inflammatory, infectious, malformative and vascular diseases can develop. Although most sellar lesions are due to pituitary adenomas, a number of other pathologies involving the sellar/parasellar region can present in a similar manner. The management of these pathologies involves a multidisciplinary approach. Our multidisciplinary team includes doctors from several specialties: neurosurgery, otolaryngology, anesthesiology, endocrinology, neurology, ophthalmology, radiology, pathology, oncology, clinical laboratory. For a precise staging and planning, the magnetic resonance imaging and computed tomography scans are analyzed with the neuroradiologist. An endocrine and ophthalmological assessment should be performed before and after the surgery. Our surgical team, that includes neurosurgeon and ENT surgeon, performs transnasal endoscopic surgery with the patient under general controlled hypotensive anesthesia; it is important to have a neuroanesthesiologist with experience in intracranial surgery. The neuronavigation system with CT-scan/MRI fusion is used for all our surgeries to help anatomical orientation and reduce complications related to the approach. The endoscopic endonasal approach to the skull base provides a direct anatomical route to the lesion, with very good visibility, without traversing any major neurovascular structures, obviating brain retraction. Postoperatively a MRI is performed and the hidroelectrolytic balance is closely monitored in order to detect diabetes insipidus. We consider that rhinosurgical-neurosurgical cooperation shortens the learning curve and offers interdisciplinary benefit, with less surgical morbidity and better surgical results. Interdisciplinary collaboration facilitates decision making in all phases of the complex treatment. [ABSTRACT FROM AUTHOR]