The Study On Significance Of Three Dimensional Reconstruction Of CT Scan Of Sphenoidal Sinus In Transsphenoidal Microsurgery For Pituitary Adenoma

Objective To study the significance of three dimensional reconstruction of CT scan of sphenoidal sinus in transsphenoidal microsurgery for pituitary adenoma. Methods In our study multi-slice spiral CT scan and three dimensional reconstruction and AQI image workstation were used in 54 patients with pituitary adenoma.The pneumatization classification and septum of sphenoid sinus, and the relation between sphenoid sinus and sella floor were observed. The following datas were preoperatively measured:the distance between anterior crista nasalis and the lowest point, of pituitary fosse (OD), the anterior wall of sphenoidal sinus(OE), and the angle between the plane of the nasal bottom and the line of OD (∠AOD), and the anterior clinoid process(∠AOB), the line of the anterior crista nasalis and the recess of sphenoidal sinus(∠AOC), and the distance between the internal carotid artery notch and the midline. The image dates were further proved and compared with the real anatomy of sphenoidal sinuses during the microneurosurgical procedure. Results The sphenoid sinuses were found to be identical type of pneumatization in 24 cases and non-identical in 30 cases..The perfect pneumatization in both sides were demonstrated in 37 cases, and the perfect pneumatization only in one side were found in 12 cases. The inadequatial pneumatization in both sides were found in 5 cases. The septums of sphenoidal sinus were located in midline in 14 cases, in left side in 15 cases, in right side in 9 cases. Transverse- or oblique-oriented septums were found in 6 cases. Classification of sphenoidal sinus were established according to the vertical line drawed from the central point of the sella floor to Nassion line, and the sphenoid sinuses were located in front of the vertical line in 12 cases, under the vertical line in 32 cases, and behind of the vertical line in 10 cases.The OD is 68.79±4.4861 mm,OE is 54.69±4.0780 mm,∠AOD is 31.29±3.9984°,∠AOB is 35.66±4.3879°,∠AOC is 26.21±4.6434°, and the distance between the internal carotid artery notch is 18.15±2.3714mm, and the distance between the midline and the left and right internal carotid notch are 8.97±1.6557 mm,9.18±1.4291 mm respectively.There were statistically variation in individual. Conclusion The three dimensional reconstruction of CT scan can accurately show the shape and adjacent structures of sphenoidal sinus and aid in transsphenoidal microsurgery for pituitary adenoma.