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| Autori principali: | , , , , , , , , , , , , , , |
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| Natura: | Artículo Open Access |
| Pubblicazione: |
Wiley
2025
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| Soggetti: | |
| Accesso online: | https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1002/ohn.1263 |
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Sommario:
- Endoscopic Pituitary Surgery in High‐Resource Settings Versus a Public Hospital in Ghana Katherine Y. Tai Daniel B. Spielman Lauren H. Tucker Kafui Searyoh Loius Armooh Confidence K. Nai Amanda Quarshie Divine A. Kwami Jerome K. Boatey Patrick Bankah George K. Wepeba Rodney J. Schlosser Michael G. Stewart Jonathan B. Overdevest David A. Gudis Otolaryngology–Head and Neck Surgery AbstractObjectiveThe evidence supporting endoscopic transsphenoidal pituitary adenoma resection (TSPR) is predominantly from skull base centers in high‐resource settings (HRSs). This study is the first comparative analysis of TSPR performed at a low‐resource setting (LRS), Korle Bu Teaching Hospital (KBTH), a public hospital in Accra, Ghana, versus HRS.Study DesignCohort study.SettingTertiary skull base surgery centers in Ghana, the United States, Canada, and Australia.MethodsPatients who underwent TSPR at KBTH from 2021 to 2023 were compared to a multi‐institutional cohort of TSPR patients from skull base centers in the United States, Canada, and Australia. Univariate and multivariate analyses were performed controlling for available demographic characteristics and medical history.ResultsThe KBTH cohort included 93 patients, and the HRS cohort included 1112 patients of similar age. The HRS cohort had higher incidences of diabetes (P = .013) and cancer history (P = .012). There were two deaths in the KBTH cohort (one intracranial bleed, one meningitis) versus five in the HRS cohort (odds ratio [OR] = 8.07, 95% CI 1.28, 50.98). There were no differences in rates of other postoperative complications.ConclusionThese findings demonstrate the capacity of LRSs to perform endoscopic pituitary surgery and highlight the need for building rhinologic and skull base surgery capacity around the world. This study was unable to control for important factors including tumor size, postoperative access to health care resources, availability of adjuvant treatments such as neuro‐interventional radiology and stereotactic radiation therapy, and others. 10.1002/ohn.1263 http://onlinelibrary.wiley.com/termsAndConditions#vor