Usefulness of bone window CT images parallel to the transnasal surgical route for pituitary disorders

Abe, Takumi; Asahina, Norihiko; Kunii, Norihiko; Ikeda, Hisato; Izumiyama, Hitoshi

doi:10.1007/s00701-002-1043-1

Cited by 9 publications

(3 citation statements)

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“…Besides, the high sensitivity and specialty of CTA for initial detection of aneurysm has been confirmed [ 7 , 24 ]. Moreover, CT is very useful in identifying mural calcification and thrombus which can have a significant impact on treatment decisions for IA, and the sphenoid septal anatomy is better visualized on high-resolution CT for preoperative assessment of PA [ 25 , 26 ]. Thus, CTA added to high-resolution CT was used as a regular examination for skull base tumors in our institute.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and treatment strategies for pituitary adenoma associated with intracranial aneurysm

Huang,

Yang,

et al. 2024

Chin Neurosurg Jl

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Background This study aimed to investigate clinical features and treatment strategies for intracranial aneurysm (IA) associated with pituitary adenoma (PA). Methods We enrolled patients with lesions in the sellar region and age-matched general population who were confirmed with IA from two hospitals. Four types of treatment strategies were performed, which included Type I (both IA and PA were treated with surgery), Type II (IA was treated with surgery and PA was performed by non-surgical treatment), Type III (PA was performed with surgery and observation was available for IA) and Type IV (both IA and PA were performed with non-surgical treatment). Results The incidence of IA was 2.2% in the general population, 6.1% in patients with PA, 4.3% in patients with Rathke cleft cyst, 2.8% in patients with meningioma and none were found with IA in patients with craniopharyngioma. Age over 50 years (OR, 2.69; 95% CI, 1.20–6.04; P = 0.016), female (OR, 3.83, P = 0.003), and invasive tumor (OR, 3.26, P = 0.003) were associated with a higher incidence of IA in patients with PA. During the mean follow-up of 49.2 months, no patients experienced stroke, and recurrence of aneurysms and aneurysms treated with observation were stable. Of four patients with recurrence of PA, three patients were treated for type I and one patient for type III. Conclusions Preoperative evaluation for aneurysm screening is necessary due to the high incidence of IA in PA patients. Our current treatment strategies may provide a benefit for these patients.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and treatment strategies for pituitary adenoma associated with intracranial aneurysm

Huang,

Yang,

et al. 2024

Chin Neurosurg Jl

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“…Patients were diagnosed as hypopituitarism for hypofunction of anyone axis, such as pituitary gland-thyroid axis, growth hormone axis, adrenal cortex axis or gonad axis [17]: (1) hypofunction of adenohypophysis-gonad axis were identified as testosterone level lower than normal range for male patients; serum FSH/LH lower than normal range for female patients at menopause; decreased level of estradiol accompanied by normal or decreased levels of FSH and LH for the female at non-menopause, amenorrhoea or infrequent menstruation [5]; (2) hypofunction of adenohypophysis-thyroid axis were identified as serum level of FT4 lower than normal range accompanied by low or normal TSH level; (3) hypofunction of adenohypophysis-adrenal cortex axis were identified as cortisol level lower than normal reference value and normal ACTH or lower than normal reference value [18]. …”

Section: Methodsmentioning

confidence: 99%

“…Conventionally, the scope of the sellar floor opening in the endonasal transsphenoidal microsurgery would not exceed the tuberculum sellae and the sellar- clivus point frontally and posteriorly respectively, and close to the medial wall of the cavernous sinus. Abe et al [5] applied the bone window CT scanning parallel to the transsphenoidal approach to help determine the lateral boundaries of sellar opening, which showed good operative performance. However, these are generalized boundaries and scopes across patients, it still remains unclear about individualized sellar floor opening procedure, as well as the potential factors affecting the sellar floor opening.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of sellar opening in the pituitary adenoma resection of transsphenoidal surgery influences the degree of tumor resection

et al. 2017

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BackgroundEndonasal transsphenoidal microsurgery is often adopted in the resection of pituitary adenoma, and has showed satisfactory treatment and minor injuries. It is important to accurately localize sellar floor and properly incise the bone and dura matter.MethodsFifty-one patients with pituitary adenoma undergoing endonasal transsphenoidal microsurgery were included in the present study. To identify the scope of sellar floor opening, CT scan of the paranasal sinus and MRI scan of the pituitary gland were performed for each subject. Intraoperatively, internal carotid artery injury, leakage of cerebrospinal fluid, and tumor texture were recorded, and postoperative complications and residual tumors were identified.ResultThe relative size of sellar floor opening significantly differed among the pituitary micro-, macro- and giant adenoma groups, and between the total and partial tumor resection groups. The ratio of sellar floor opening area to maximal tumor area was significantly different between the total and partial resection groups. Logistic regression analysis revealed that the ratio of sellar floor opening area to the largest tumor area, tumor texture, tumor invasion and age were independent prognostic factors. The vertical distance between the top point of sellar floor opening and planum sphenoidale significantly differed between the patients with and without leakage of cerebrospinal fluid.ConclusionThese results together indicated that relatively insufficient sellar floor opening is a cause of leading to residual tumor, and the higher position of the opening and closer to the planum sphenoidale are likely to induce the occurrence of leakage of cerebrospinal fluid.

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Evaluation of pituitary macroadenomas with multidetector-row CT (MDCT): comparison with MR imaging

et al. 2007

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Usefulness of bone window CT images parallel to the transnasal surgical route for pituitary disorders

Abstract: Bone window CT images sliced parallel to the transnasal surgical route provide direct visualization of the nasal anatomy for the transnasal approach. This method is helpful in determining how far to remove the sellar floor laterally, especially in cases requiring repeat surgery.

Cited by 9 publications

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Clinical characteristics and treatment strategies for pituitary adenoma associated with intracranial aneurysm

Clinical characteristics and treatment strategies for pituitary adenoma associated with intracranial aneurysm

Efficacy of sellar opening in the pituitary adenoma resection of transsphenoidal surgery influences the degree of tumor resection

Evaluation of pituitary macroadenomas with multidetector-row CT (MDCT): comparison with MR imaging

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