Relationship between pneumatization of lateral recess in the sphenoid sinus and removal of cavernous sinus invasion in pituitary adenomas by endoscopic endonasal surgery

Kenzo Kosugi, Ryota Tamura, Taro Mase, Haruka Tamura, Masahiro Jinzaki, Kazunari Yoshida, Masahiro Toda

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background: Endoscopic endonasal transsphenoidal surgery (EES) is the gold standard for pituitary adenoma (PA) resection. The sphenoid sinus (SS), a highly variable anatomic structure, is located in the center of the cranial base. It has previously been reported that poor pneumatization of the lateral recess of the SS (LRSS) increases the difficulty level of the surgery and the risk of neural and vascular injury. However, to date no studies have evaluated the association between LRSS volume and PAs removal rate by EES. Methods: The present study analyzed 23 consecutive patients with new-onset PAs categorized as Knosp Grades 3 and 4 who underwent EES. A retrospective radiographic analysis was conducted on patients undergoing magnetic resonance imaging and high-resolution computed tomography scans. Results: Among PA cases categorized as Knosp 3 and 4, no significant association was found between the whole tumor's resection rate and LRSS volume (R = 0.08, P = 0.70). However, a significant association was found between cavernous sinus (CS) tumors' removal rate and LRSS volume (R = 0.52, P = 0.011). The same results were achieved in PAs with a Knosp Grade 4, with a stronger correlation (R = 0.60, P = 0.014). Conclusion: The development of LRSS pneumatization affects the removal rate of CS tumors in PAs. Preoperative analysis of LRSS development should be considered when planning EES against PA with CS invasion.

Original languageEnglish
Article numberA4
JournalSurgical Neurology International
Volume10
DOIs
Publication statusPublished - 2019

Keywords

  • Cavernous sinus
  • Endoscopic endonasal transsphenoidal surgery
  • Lateral recess of the sphenoid sinus
  • Pituitary adenoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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