Effectiveness of Aquatic Therapy in Autism Spectrum Disorders

Area of Science:

• Neurosurgery
• Endocrinology
• Radiology

Background:

• Pituitary adenomas are common sellar tumors.
• Transsphenoidal surgery is a primary treatment.
• Extrasellar extension, particularly cavernous sinus invasion, impacts surgical outcomes.

Purpose of the Study:

• To review and compare the Hardy-Wilson and Knosp classifications for predicting surgical resection extent in pituitary adenomas.
• To evaluate the reliability of these classifications in modern endoscopic surgical practice.

Main Methods:

• Systematic review of evidence on Hardy-Wilson and Knosp classifications.
• Analysis of correlation between classification grades and extent of resection.
• Assessment of revised Knosp subdivision (3A/3B) predictive value.

Main Results:

• Hardy-Wilson classification has limited value for parasellar invasion on modern MRI.
• Knosp classification, based on internal carotid artery relationship, better estimates cavernous sinus invasion.
• Higher Knosp grades correlate with reduced resection and remission rates.
• Revised Knosp subdivision improves predictive accuracy for surgical outcomes.

Conclusions:

• Revised Knosp classification is more reliable for predicting surgical outcomes in pituitary adenoma resection.
• Accurate radiological classification is vital for operative planning and patient counseling in pituitary adenoma surgery.