Universidad Autónoma de Nuevo León, School of Medicine, Human Anatomy Department, Monterrey, Nuevo León, México.
Universidad Autónoma de Nuevo León, University Hospital "Dr. José Eleuterio González", Radiology and Imaging Department, Monterrey, Nuevo León, México.
Folia Morphol (Warsz). 2023;82(1):17-23. doi: 10.5603/FM.a2021.0125. Epub 2021 Nov 26.
The aims are to evaluate the morphometry of the sellar region and propose a safety window on the floor of the sella turcica for the transsphenoidal approach in a Hispanic population.
We retrospectively analysed 150 computed tomographic angiography sellar region images from asymptomatic patients. The images were evaluated intraobservatory by an expert radiologist. We measured: intercarotid distance of cavernous segment; depth of sella turcica; skull base angle; anterior distance, the distance between anterior spinal nasal and floor of the sella turcica; posterior distance, the distance between anterior spinal nasal and posterior wall of the sella turcica; anterior surgical angle, formed between the floor of the nostril and superior limit of the anterior wall of the sella turcica; and posterior angle, formed between the floor of the nostril and the inferior limit of the posterior wall of the sella turcica.
Safety window was based on two measures: the intercarotid distance and depth. The mean of the safety window is 151.13 mm² and 147.60 mm² for men and women, respectively. The intercarotid distance was 17.83 mm. The depth of the sella turcica was 8.46 mm. The skull base angle was 112.13 grades. The anterior distance was 76.34 mm. The posterior distance was 87.59 mm. The anterior surgical angle was 32.76 grades. The posterior surgical angle was 87.59 grades.
The surgical approach space is smaller in females. It could significate a more complicated surgery in this population. Anatomical understanding could reduce complications in hospitals without a neuronavigation system.
本研究旨在评估西班牙裔人群蝶鞍区的形态计量学，并提出经蝶窦入路至鞍底的安全窗口。
我们回顾性分析了 150 例无症状患者的计算机断层血管造影鞍区图像。这些图像由一位专家放射科医生进行了内部观测评估。我们测量了：海绵窦段颈内动脉间距；鞍底深度；颅底角度；前距，即前鼻脊髓与鞍底的距离；后距，即前鼻脊髓与鞍底后壁的距离；前手术角，由鼻孔底与鞍底前壁的上缘形成；后手术角，由鼻孔底与鞍底后壁的下缘形成。
安全窗口基于两个指标：颈内动脉间距和深度。男性和女性的安全窗口平均值分别为 151.13mm²和 147.60mm²。颈内动脉间距为 17.83mm。鞍底深度为 8.46mm。颅底角度为 112.13 度。前距为 76.34mm。后距为 87.59mm。前手术角为 32.76 度。后手术角为 87.59 度。
女性的手术入路空间较小。在该人群中，手术可能更为复杂。解剖学理解可以减少没有神经导航系统的医院的并发症。
