3D modeling-based surgical planning in transsphenoidal pituitary surgery – preliminary results

Raappana, Antti; Koivukangas, John; Pirilä, Tapio

doi:10.1080/00016480701805489

Cited by 18 publications

(8 citation statements)

References 13 publications

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“…Detailed pre-operative study of CT and MRI scans, [4] per-operative endoscopic visualization, [5] and preoperative three-dimensional modeling of the pituitary adenoma [6] can provide information about the anatomy of sphenoid sinus, sellar floor, para-nasal sinuses, tuberculum sellae, clivus, position of carotid artery, optic pathways, and infundibulum. A detailed study of lesion and its surrounding structures is important to improve the safety and accuracy of surgery.…”

Section: Investigationsmentioning

confidence: 99%

Endoscopic endonasal trans-sphenoid surgery of pituitary adenoma

Yadav

Sachdev

Parihar

et al. 2012

Journal of Neurosciences in Rural Practice

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Endoscopic endonasal trans-sphenoid surgery (EETS) is increasingly used for pituitary lesions. Pre-operative CT and MRI scans and peroperative endoscopic visualization can provide useful anatomical information. EETS is indicated in sellar, suprasellar, intraventricular, retro-infundibular, and invasive tumors. Recurrent and residual lesions, pituitary apoplexy and empty sella syndrome can be managed by EETS. Modern neuronavigation techniques, ultrasonic aspirators, ultrasonic bone curette can add to the safety. The binostril approach provides a wider working area. High definition camera is much superior to three-chip camera. Most of the recent reports favor EETS in terms of safety, quality of life and tumor resection, hospital stay, better endocrinological, and visual outcome as compared to the microscopic technique. Nasal symptoms, blood loss, operating time are less in EETS. Various naso-septal flaps and other techniques of CSF leak repair could help reduce complications. Complications can be further reduced after achieving the learning curve, good understanding of limitations with proper patient selection. Use of neuronavigation, proper post-operative care of endocrine function, establishing pituitary center of excellence and more focused residency and endoscopic fellowship training could improve results. The faster and safe transition from microscopic to EETS can be done by the team concept of neurosurgeon/otolaryngologist, attending hands on cadaveric dissection, practice on models, and observation of live surgeries. Conversion to a microscopic or endoscopic-assisted approach may be required in selected patients. Multi-modality treatment could be required in giant and invasive tumors. EETS appears to be a better surgical option in most pituitary adenoma.

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Section: Investigationsmentioning

confidence: 99%

Endoscopic endonasal trans-sphenoid surgery of pituitary adenoma

Yadav

Sachdev

Parihar

et al. 2012

Journal of Neurosciences in Rural Practice

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“…Based on the 3D reconstruction, the tumorspecific preoperative planning allows surgeons to operate in familiar territory at the time of the actual surgery [19]. We found that the preoperative planning simulated by the software was valuable for the tumor resection in all our patients as it provided better anatomical layers and stripping methods for the tumors.…”

Section: Discussionmentioning

confidence: 87%

“…In the study by Moharir et al [11] three such tumors were accurately reconstructed for subject-specific preoperative assessment. Raappana et al [19] reported the 3D reconstruction of a pituitary adenoma and its adjoining structures for preoperative surgical planning. For each patient, they used the 3D model as a ''road map'' during the operation to improve the safety and effectiveness of the surgery.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional reconstruction of extremity tumor regions by CT and MRI image data fusion for subject-specific preoperative assessment and planning

Dong

2011

Computer Aided Surgery

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This study was conducted to demonstrate the feasibility of three-dimensional (3D) reconstruction of extremity tumor regions for patient-specific preoperative assessment and planning by using CT and MRI image data fusion. The CT and MRI image data of five patients with solid tumors were fused to construct 3D models of the respective tumor regions. The reconstruction time and image fusion accuracy were measured, and the tumor features and spatial relationships were analyzed to enable subject-specific preoperative assessment and planning as guidance for tumor resection. The 3D models of the tumor regions, including skin, fat, bones, tumor, muscles, internal organs, nerves and vessels, were created with a mean reconstruction time of 103 minutes and fusion accuracy of 2.02 mm. The 3D reconstruction clearly delineated the tumor features, and provided a vivid view of spatial relationships within the tumor region. Based on this intuitional information, the subject-specific preoperative assessment and planning were easily accomplished, and all tumor resections were performed as planned preoperatively. Three-dimensional reconstruction using CT/MRI image fusion is feasible for accurate reproduction of the complex anatomy of the tumor region with high efficiency, and can help surgeons improve the preoperative assessment and planning for effective removal of tumors.

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“…To date, there have been fewer reports of surface markers with which to identify the location of the sphenoid sinus. In recent years, computerized imaging methods have become capable of building 3D models of structures in the sellar region [ 11 ] . The 3D reconstruction of CT images provides a realistic representation of an individual's surgical pathological anatomy and, combined with the clip technique, can show the contours of the head and interior structures.…”

Section: Discussion ▼mentioning

confidence: 99%

Sella Turcica Anatomy by Three-Dimensional Computed Tomography for an Endonasal Transsphenoidal Approach to Pituitary Adenoma

Xiao

Ma²,

Zhan³

et al. 2011

Minim Invasive Neurosurg

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The nose tip-ear apex line provides a precise, simple, and practical tool for orienting the sphenoid sinus, sellar floor and surgical trajectory of the endonasal transsphenoidal approach. 3D-CT images more clearly and intuitively display the sella turcica anatomy. Preoperative 3D-CT increases the surgeon's confidence in endonasal transsphenoidal operations and should be routinely performed in patients with pituitary adenomas.

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3D modeling-based surgical planning in transsphenoidal pituitary surgery – preliminary results

Cited by 18 publications

References 13 publications

Endoscopic endonasal trans-sphenoid surgery of pituitary adenoma

Endoscopic endonasal trans-sphenoid surgery of pituitary adenoma

Three-dimensional reconstruction of extremity tumor regions by CT and MRI image data fusion for subject-specific preoperative assessment and planning

Sella Turcica Anatomy by Three-Dimensional Computed Tomography for an Endonasal Transsphenoidal Approach to Pituitary Adenoma

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