The Value Of MDCT In Single-Nostril Transsphenoidal Microsurgery For Pituitary Adenoma

Objective: To explore the value of 16 multidector-row CT(MDCT)in resection of the pituitary adenomas by single-nostril transsphenoidal approach.Methods: 76 pituitary adenoma cases underwent single-nostril transsphenoidal microsurgery were reviewed,according to different CT examine for patients,all patients were divided into the SRCT and MDCT group, each group included 30 cases and 46 cases respectively. 30 cases of SRCT group were checked with single row CT in coronal plane scan.46 cases of MDCT group were checked with 16 multidector-row CT in thin slice scan.then,sagittal or Parallel to the surgical approach reconstruction were conducted.observed the structures of sphenoid sinus and sellar-related (sphenoid sinus, sella and Septum sinuum frontalium ) from CT images. And then measure structure in sagittal images .To design the best surgical approach and remove the tumor by the information provided preoperation.Make comparisons between two groups of patients in length of operation, blood loss, postoperative hospital stay and postoperative complications.Results: (1) In SRCT group,there were two cases erroneously gone to suprasphenoid cells, One case strayed into the anterior skull baseand one strayed into the clivus there were 7 cases with cerebrospinal leak during the operation.There are 12 cases transient diabetes insipidus after perative In MDCT group,we rely on information provided by preoperative CT and sphenoid sinus anatomic landmarks,the sphenoid sinus and sellae position was located accurately.No one cases of deviation, no one cases deaths, three cases of cerebrospinal leak during operative.There are 8 cases transient diabetes insipidus after operative. (2) Statistical analysis domonstrated that operative time, amount of bleeding, postoperative hospital stay , the number of transient diabetes insipidus after operative, the number of cerebrospinal leak during operative, were significantly higher in the SRCT group than in the MDCT group (p<0.05 for all). AGE, Gender, Tumor size,did not differ in the two groups (p>0.05 for all).Conclusions: MDCT scan can be a good show at sella and Sphenoid anatomy .we can measured the interested structure in sagittal reconstruction images,It can guide accurate positioning sphenoid sinus and sella in Single-nostril-transsphenoidal resection of pituitary adenoma.MDCT technology applications can shorten operative time,postoperative hospitalization time, less blood loss, less postoperative complications.