Intraoperative CT in endoscopic endonasal surgery for pituitary adenomas

Abstract

Objective To explore the value ofintraoperative CT (iCT) in endoscopic endonasal surgery for pituitary adenomas.Methods A retrospective analysis was conducted in the clinical data of 37 patients with pituitary adenomas performed endoscopic endonasal surgery with assistance of iCT in our hospital from November 2012 to June 2013.The influences of iCT on surgical process and results were analyzed.Results Intraoperative scanning was performed 1 to 3 times in each patient,averaging 1.43 times.The scanning time was only 50-60 s.Among the 37 patients,iCT revealed residual tumor in 11,9 of which underwent further resection with total removal in 6 and subtotal in 3,and the tumors in the other two patients were unable to be resected because the adenomas were tenacious and adhered closely to the internal carotid artery.Finally,the rate of gross total removal increased from 70.3％ to 86.5％,rising by 16.2％.No iCT related complications and severe surgical complication occurred.Conclusion The application of iCT in endoscopic endonasal surgery for pituitary adenomas provides objective evidence for the guidance of surgical procedure and real-time judgment of surgical results,which not only leads to higher percentage of tumor removal but also eliminates the unnecessary blind surgical manipulation to increase the safety of the operation. Key words: Intraoperative computed tomography; Pituitary adenoma; Neuroendoscopy