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

Xiao, Shengxiang; Ma, Yue-Hui; Zhan, Renya; Wen, Liang

doi:10.1055/s-0031-1284385

Cited by 2 publications

(2 citation statements)

References 5 publications

(6 reference statements)

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“…It was suggested the nose tip-ear apex line could represent a practical tool for orienting the sphenoid sinus, sellar floor and surgical trajectory of the endonasal transsphenoidal approach and it was discussed that preoperative 3D-CT increases the surgeon's confidence in such surgical approaches 21 .…”

Section: Resultsmentioning

confidence: 99%

Variations of sphenoid pneumatization: a CBCT study

Craiu

Săndulescu

Rusu

2015

Romanian Journal of Rhinology

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The transsphenoidal approach of the skull base has become a usual surgical procedure which targets the sellar, parasellar and suprasellar regions of the middle cranial fossa, as well as Meckel's cave and the clivus 1 . Anatomical studies are essential in increasing the anatomical knowledge and improving surgical performance 2 . Although pituitary surgery is traditionally within the realm of neurosurgeons, otolaryngologists became active partners in the surgical management of hypophysis to decrease rates of complications and morbidity 3 , being known that the posterior ethmoid air cells and the sphenoid sinus are surrounded by more vital structures than any other sinus 4 .The sphenoid sinus is probably the most variably pneumatized structure of the skull; its recesses are able to facilitate minimally invasive access to different surgical targets, thus it play roles in the selection of surgical procedures 1 . From a developmental point of view, the sphenoid sinus will not reach its full extension until adolescence and it may occasionally extend into the vomer, ethmoid, palatine and occipital bones, as well as in different parts of the sphenoid bone, such as the anterior clinoid process, the lesser wing and the great wing, and the pterygoid process 5 . The pneumatizations of the anterior clinoid process and pterygoid process are surprisingly common 6 .According to its sagittal extension, as related to the sella turcica, the sphenoid sinus was classified either in three, or in four types. There are authors describing sellar, presellar and conchal types of sinus, which occur in 55%, 17% and, respectively, 28% of cases 7 . This classification in three types was suggested by Congdon in 1920 8 . Other authors also considered the postsellar pneumatization 9 which can occur in more than 50% of cases 10 . There were not found differences in regard to age, gender and ethnicity 9 .The lateral recess of the sphenoid sinus was evaluated in relation to the pterygopalatine fossa, and was classified in six types: type I, in which such recess is absent in the posterior fossa wall, type II, when the recess reaches above the vidian canal, type III with the recess engaged between the vidian and maxillary nerve canals, type IV, of alar pneumatization, type V, in which the root of the pterygoid process lodges the pneumatic expansion and type VI, of combined alar and pterygoid pneumatizations 11 . aBSTRaCT BaCKgROund. The pneumatization pattern of the sphenoid sinus seems rather unpredictable, as resulted from previous

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Section: Resultsmentioning

confidence: 99%

Variations of sphenoid pneumatization: a CBCT study

Craiu

Săndulescu

Rusu

2015

Romanian Journal of Rhinology

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“…Our results support the hypothesis, showing normal distribution of all measured parameters, except for the sphenoid sinus volume, which shows variability consistent with previous reports. [7][8][9][10] It should be noted, though, that patterns of sphenoid sinus aeration did not correlate to sphenoid bone morphometric parameters, thus having no impact on the identified anatomic correlations identified in this study.…”

Section: Discussionmentioning

confidence: 92%

Predictors of the Size and Surgical Freedom of the Trans-Cribriform and Trans-Clival Corridors, a Radiographic Analysis

Aljuboori

Nuru

Sharma

et al. 2021

J Neurol Surg B Skull Base

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Introduction The transcribriform and transclival corridors are endoscopic endonasal approaches used to treat pathologies of the skull base. We present a predictive model that uses the clival length and ethmoidal width to predict the size and surgical freedom (SF) of these corridors. Methods Adult facial computed tomography scans were reviewed. Exclusion criteria included patients <18 years of age or radiographic evidence of trauma, neoplasm, or congenital deformities of the skull base. The images were analyzed using OsiriX MD (Bernex, Switzerland). Patients' demographics, clival length, ethmoidal width, surface area, and others were collected. Linear regression was used to create prediction models for the size and SF of the transclival and transcribriform corridors. Results A total of 103 patients were included with an average age of 44.9 years and 47% males. Females had a smaller clival surface area (8 vs. 9.2 cm2, p = 0.001). For transclival corridor, clival length correlated positively with SF in the sagittal plane (rho = 0.44, p < 0.05) and negatively with SF in the coronal plane (rho = − 0.2, p < 0.05). For transcribriform corridor, ethmoidal width correlated positively with SF in the coronal plane (rho = 0.74, p < 0.05), and negatively with SF in the sagittal plane (rho = − 0.2, p < 0.05). Conclusion A significant variability of the bony anatomy of the anterior and central skull base was found. The use of clival length and ethmoidal width as part of preoperative surgical planning might help to overcome the anatomical variability which could affect the adequacy of surgical corridors.

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

Cited by 2 publications

References 5 publications

Variations of sphenoid pneumatization: a CBCT study

Variations of sphenoid pneumatization: a CBCT study

Predictors of the Size and Surgical Freedom of the Trans-Cribriform and Trans-Clival Corridors, a Radiographic Analysis

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