Transphenoidal surgery in acromegalic patients: Anatomical considerations and potential pitfalls

Giorgio Carrabba, Marco Locatelli, Luca Mattei, Claudio Guastella, Giovanna Mantovani, Paolo Rampini, Sergio Maria Gaini

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Transphenoidal surgery is an effective treatment for acromegalic patients with growth hormone (GH) producing pituitary adenomas. Since acromegaly is a systemic disease which causes multiple bony alterations, we hypothesized that it could affect the sphenoid sinus anatomy. The aim of the study was to determine whether acromegalic patients have sphenoid sinus alterations with potential surgical impact. Methods: Fourty-six consecutive patients (23 acromegalics-GH group, 23 non-acromegalics-nGH group) undergoing transphenoidal surgery were included in this study. Pre-operative volumetric CT scan of the head was used to assess the following anatomic characteristics: type of sphenoid sinus (sellar, pre-sellar, conchal); number of intrasphenoid septa; number of carotid-directed septa; intercarotid distance; depth of the sphenoid sinus; depth and size of the sella. Results: The sphenoid sinus was of the pre-sellar/conchal type in 26 % of the patients with acromegaly (n = 23) versus 9 % of the patients of the nGH group (n = 23). The number of intrasphenoid septations was significantly higher in the GH group than in the nGH group (P =.03). Interestingly, the intercarotid distance was smaller in GH patients than in nGH displaying a trend toward significance (P =.05). The sphenoid bone was deeper in the GH group as compared to the nGH group (P =.01) but the distance sphenoid sinus-sella was reduced (P

Original languageEnglish
Pages (from-to)125-130
Number of pages6
JournalActa Neurochirurgica
Volume155
Issue number1
DOIs
Publication statusPublished - Jan 2013

Keywords

  • Acromegaly
  • Pituitary Adenoma
  • Sphenoid Sinus
  • Transsphenoidal

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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