Owen Tina J, Chen Annie V, Frey Stephen, Martin Linda G, Kalebaugh Tobin
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington.
McGill University, Montreal, Quebec, Canada.
Vet Surg. 2018 Jul;47(5):664-671. doi: 10.1111/vsu.12906. Epub 2018 May 23.
To determine the accuracy of locating the pituitary fossa with the Brainsight neuronavigation system by determining the mean target error of the rostral (tuberculum sellae) and caudal (dorsum sellae) margins of the pituitary fossa.
Experimental cadaveric study.
Ten canine cadavers.
Computed tomography (CT) and MRI were performed on each cadaver with fiducials in place. Images were saved to the neuronavigation computer and used to plan the drilling approach. The cadavers were placed in the surgical head clamp of the Brainsight system and positioned for a transsphenoidal approach. On the basis of the planning, 2 localization points were drilled, 1 each at the rostral and caudal margins of the pituitary fossa, and CT was repeated. Error was assessed from the difference in millimeters between the targets identified during Brainsight planning and the actual location of the 2 points drilled on each cadaver skull as identified by postdrilling CT.
The rostral and caudal margins of the pituitary fossa provided 2 target points per cadaver. The median target error (interquartile range) for all target sites (n = 20) was 3.533 mm (range, 2.013-4.745).
This stereotactic system allowed the surgeon to locate the rostral and caudal margins of the pituitary fossa with clinically acceptable accuracy and confidence.
Using the Brainsight neuronavigation system for localization during transsphenoidal hypophysectomy may decrease morbidity and surgical time.
通过确定垂体窝前缘（鞍结节）和后缘（鞍背）的平均目标误差，来判定Brainsight神经导航系统定位垂体窝的准确性。
实验性尸体研究。
十具犬类尸体。
对每具放置了基准物的尸体进行计算机断层扫描（CT）和磁共振成像（MRI）。图像保存到神经导航计算机中，用于规划钻孔入路。将尸体置于Brainsight系统的手术头架上，并定位为经蝶窦入路。根据规划，在垂体窝的前缘和后缘各钻一个定位点，然后重复进行CT扫描。误差通过Brainsight规划中确定的目标与钻孔后CT确定的每具尸体颅骨上钻出的两个点的实际位置之间的毫米差异来评估。
每具尸体的垂体窝前缘和后缘提供了两个目标点。所有目标位点（n = 20）的中位目标误差（四分位间距）为3.533毫米（范围为2.013 - 4.745毫米）。
该立体定向系统使外科医生能够以临床上可接受的准确性和信心定位垂体窝的前缘和后缘。
在经蝶窦垂体切除术中使用Brainsight神经导航系统进行定位可能会降低发病率并缩短手术时间。
