Assessment of sellar parameters using computed tomography for a safe endonasal transsphenoidal approach in pituitary surgery.

IF 1.2 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2025-10-13 DOI:10.1007/s00276-025-03744-3

İbrahim Akbudak, Muhammed Tekinhatun, Mehmet Turmak, Muhammed Akif Deniz

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引用次数: 0

Abstract

Purpose: Endoscopic endonasal transsphenoidal surgery (EETS) is a key treatment for pituitary tumours unresponsive to medication, but it carries risks such as internal carotid artery injury and cavernous sinus haemorrhage. This study aims to establish safe surgical boundaries by measuring sellar region parameters on computed tomography angiography (CTA) images to enhance EETS efficacy and minimize complications.

Methods: This study involved 460 adult patients who underwent head and neck CTA scanning at our clinic from August 2023 to April 2024. Measurements taken from CTA images included skull base angle (SBA), Anterior Surgical Angle (ASA), Posterior Surgical Angle (PSA), Anterior Distance 1 (AD1), Anterior Distance 2 (AD2), Posterior Distance 1 (PD1), Posterior Distance 2 (PD2), Safe Window Area (SWA), Depth of the Sella Turcica (DST), Intercarotid Distance (ID), Apex Nasi-Sella Turcica Angle (ANSTA), Sella Anterior Wall Thickness (TSAW) and Sella Floor Wall Thickness (TSFW). Sphenoid sinus types were also assessed, with comparisons made between genders and age groups.

Results: When comparing genders, median values of SBA, ASA, DST and ANSTA were significantly higher in females, whereas AD1, AD2, PD1, PD2, SWA, ID and TSAW were significantly higher in males (p < 0.05). Moreover, correlation analysis revealed a significant positive correlation between age and PSA, PD1-2, ID, TSAW and TSFW.

Conclusion: Pre-operative measurement of sella turcica parameters and sphenoid sinus type by radiologists is crucial for neurosurgeons planning EETS for pituitary lesions, potentially reducing complications through a better understanding of surgical anatomy.

查看原文本刊更多论文

应用计算机断层扫描评估经鼻蝶窦入路安全的垂体手术鞍参数。

目的：内镜下经鼻蝶窦手术（EETS）是治疗对药物无反应的垂体肿瘤的关键治疗方法，但其存在颈内动脉损伤和海绵窦出血等风险。本研究旨在通过测量ct血管造影（CTA）图像的鞍区参数来建立安全的手术边界，以提高EETS的疗效并减少并发症。方法：本研究纳入460例成人患者，于2023年8月至2024年4月在我诊所进行了头颈部CTA扫描。CTA图像测量包括颅底角（SBA）、前手术角（ASA）、后手术角（PSA）、前距离1 （AD1）、前距离2 （AD2）、后距离1 （PD1）、后距离2 （PD2）、安全窗口面积（SWA）、蝶鞍深度（DST）、颈动脉间距（ID）、鼻尖-蝶鞍角（ANSTA）、蝶鞍前壁厚度（TSAW）和蝶鞍底壁厚度（TSFW）。蝶窦类型也进行了评估，并在性别和年龄组之间进行了比较。结果：在性别比较中，女性的SBA、ASA、DST和ANSTA的中位数显著高于男性，而男性的AD1、AD2、PD1、PD2、SWA、ID和TSAW的中位数显著高于女性。(p)结论：术前由放射医师测量蝶鞍参数和蝶窦类型对于神经外科医生规划垂体病变的EETS至关重要，通过更好地了解手术解剖，可能减少并发症。

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

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.