Application of computed tomography virtual endoscopy in endoscopic transsphenoidal pituitary surgery

Abstract

Objective To valuate the application of computed tomography virtual endoscopy (CTVE) for endoscopic transsphenoidal pituitary surgery.Method The CTVE was applied to a series of 38 patients with pituitary adenomas operated endoscopically via the transsphenoidal approach at the Wuxi Second Hospital Affiliated Nanjing Medical University between September 2010 and June 2011.Results CTVE can be applied to simulate the endoscopic endonasal transsphenoidal pituitary surgery,and indicate the anantomic structure through the endonasal transsphenoidal approach.CTVE can preoperatively assess the morphological images of the nasal,sphenoid sinus,sellar floor and around structure,which correlated well with the intraoperative endoscopic view.The degree of pneumatization of the sphenoid sinus,the size of the sella and the sept conditions may influence the application of CTVE.Conclusions CTVE can not only act as a training simulator for the endoscopic transsphenoidal pituitary surgery,but for the experienced surgeon,it can depict the individual patient's anatomical landmarks and variations,what may help make preoperative planning and increase the safety of the endoscopic endonasal transsphenoidal pituitary surgery. Key words: Neuroendoscopy; Pituitary adenoma; Virtual endoscopy; Endonasal transsphenoidal surgery