Intercarotid distance variations in pituitary adenomas: a cone-beam computed tomographic study

Abstract

Introduction Transnasal trans-sphenoidal surgery has become the most popular procedure to approach different sellar lesions. Internal carotid artery injury during this approach could be minimized by accurate preoperative assessment of its course and detection of anatomical variations. Patients and methods This study was conducted on 24 cases with pituitary adenomas. The intercarotid distance (ICD) was measured by cone-beam computed tomography, and defined as the minimal distance between the inner walls of the carotid sulcus of the horizontal parasellar internal carotid artery. Comparison of measurements in the study group with that of healthy individuals of the control group was done. Aim The aim of this study was to detect variations in ICD with pituitary adenomas. Results This study showed that ICD was statistically significantly higher in the study than control groups (P=0.01). A statistically significant correlation between lesion size and ICD was found (P=0.04). A statistically significant difference between the ICD with the type of sellar pathology was found. The widest distance was found with suprasellar lesions (mean = 8.93 ± 2.09, P1 = 0.009) and the least in sellar lesions (mean = 16.58 ± 1.94). Conclusion Preoperative measurement of ICD is applicable and helpful in operative planning for the trans-sphenoid approach to pituitary lesions. The size of the adenomas directly affects the ICD with larger adenomas showing wider distance.