The Use of Neuronavigation with Vasular Microdoppler in Transsphenoidal Pituitary Surgery

Mehmet Hakan Seyithanoglu,Serkan Kitis,Serdar Cevik,Tolga Turan Dundar,Fatih Calis,Meliha Gundag Papaker

doi:10.4236/ojmn.2016.61009

Mehmet Hakan Seyithanoglu, Serkan Kitis + Show 4 more

Open Access

https://doi.org/10.4236/ojmn.2016.61009

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Abstract

Object: To evaluate the use of neuronavigation with vascular micro-doppler in transsphenoidal pituitary surgery. Methods: 141 cases having done transsphenoidal pituitary surgery are evaluated from 2005 to 2014. Fluoroscopy was used in 69 cases and vascular micro-doppler with neuronavigation were used in 72 cases. Results: Transsphenoidal surgery has a lot of risks due to sella’s deep location, and position of the carotid artery and the optic nerve. Clasically the fluoroscopy and microscopic anatomical markers were used in order to minimize the risk of carotid artery and optic nerve damage. Additional devices such as neuronavigation and vascular micro-doppler are needed to decrease the morbidity and mortality arising from these injuries. Conclusion: Neurovascular complications such as carotid artery and optic nerve injuries owing to disorientation in transsphenoidal surgery will reduce the use of neuronavigation with vascular micro-doppler.

Highlights

Pituitary adenoma is a benign neoplasm which is derived from adenohypophysis and grows slowly
Pituitary adenomas are shown over secretion of hormone or mass effect
Classical fluoroscopy was used in 69 patients (48.9%) and neuronavigation with vascular micro-doppler used in 72 patients (51.1%)

Summary

Introduction

Pituitary adenoma is a benign neoplasm which is derived from adenohypophysis and grows slowly. Pituitary adenomas are shown over secretion of hormone or mass effect. Classical surgical treatment of pituitary adenoma is a transsphenoidal approach. (2016) The Use of Neuronavigation with Vasular Microdoppler in Transsphenoidal Pituitary Surgery. The most serious complication of this surgery is cavernous internal carotid artery injury during the dural incision in sellar base. This catastrophic complication is seen in 0.3% - 8% of cases [7]-[16]. Surgeons have disorientation during transsphenoidal surgery due to anatomic variation of the patient and fluoroscopy gives sagittal series of images [8]. Micro-doppler usage before dural incision, carotid localization is determined and potential injuries of Internal carotid artery (ICA) can be avoided [17] [18]

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Conclusion