Transnasal Endoscopic Pituitary Surgery-The Role of a CT Scan in Individual Tailoring of Posterior Septum Size Resection.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Tomography Pub Date : 2023-12-12 DOI:10.3390/tomography9060172

Jakub Lubojacký, Lenka Čábalová, Michaela Mladoňová, Viktória Hránková, Tomáš Krejčí, Jakub Mičaník, Maria Miklošová, Lačezar Ličev, Pavel Komínek, Petr Matoušek

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Abstract

Objective: This study was designed to evaluate the possibility of predicting the minimum size of septal resection for safe tumor extraction in transnasal paraseptal pituitary adenoma resection from preoperative computed tomography scans.

Methods: A retrospective CT scan analysis was performed on 20 patients who underwent endoscopic pituitary surgery at the University Hospital in Ostrava. Virtual insertion of the straight instrument into the sphenoid cavity was simulated using a CT scan. The minimum septal resection size was predicted and compared to various diameters in the nasal cavity. The results were then compared with cadaveric dissections, in which septal resections were performed at 1 cm and 2 cm distances from the anterior sphenoid wall. The association between cadaver dissections and CT scan results was studied.

Results: A total of 20 patients who underwent endoscopic transnasal surgery for pituitary adenoma between the years 2020 and 2021 were enrolled in the study. The mean virtual posterior septal size resection needed to reach the medial edge of the ICA with the straight instrument, without infracturing the nasal septum, was 13.2 mm. In cadavers with a 1 cm posterior septal resection, the medial edge of the ICA was reached with the straight instrument. In 2 cm resections, it was possible to reach beyond the lateral edge of the ICA.

Conclusion: There is no significant correlation between the minimum septal size resection and measured diameters in the nasal cavity. According to our study, a 1 cm resection is sufficient for a non-extended pituitary tumor extraction. More extensive septal resections allow for better maneuverability and overview in the surgical field.

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经鼻内窥镜垂体手术--CT 扫描在个性化定制后隔膜大小切除术中的作用。

研究目的本研究旨在评估通过术前计算机断层扫描预测经鼻旁垂体腺瘤切除术中为安全摘除肿瘤而进行隔膜切除的最小尺寸的可能性：对在俄斯特拉发大学医院接受内窥镜垂体手术的 20 名患者进行了回顾性 CT 扫描分析。利用 CT 扫描模拟将直形器械虚拟插入蝶窦腔。预测了鼻中隔最小切除尺寸，并与鼻腔内的各种直径进行了比较。然后将结果与尸体解剖进行比较，尸体解剖是在距鼻中隔前壁 1 厘米和 2 厘米处进行鼻中隔切除的。研究了尸体解剖与 CT 扫描结果之间的关联：研究共纳入了 2020 年至 2021 年期间接受内窥镜经鼻垂体腺瘤手术的 20 名患者。在不伤及鼻中隔的情况下，使用直形器械到达 ICA 内侧边缘所需的虚拟鼻中隔后部大小切除平均为 13.2 毫米。在切除 1 厘米鼻中隔后部的尸体中，使用直的器械可以到达 ICA 的内侧边缘。结论：鼻中隔后部切除术与鼻窦切除术之间没有明显的相关性：结论：鼻中隔最小切除尺寸与鼻腔内的测量直径之间没有明显的相关性。根据我们的研究，1 厘米的切除足以进行非扩展垂体瘤摘除术。鼻中隔切除范围越大，手术区域的可操作性和视野就越好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.