Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31.
Department of Otorhinolaryngology-Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico.
J Craniofac Surg. 2023 Jun 1;34(4):1357-1360. doi: 10.1097/SCS.0000000000009241. Epub 2023 Mar 13.
Transsphenoidal surgeries imply the risk of intraoperative lesions to the neurovascular structures surrounding the sphenoid sinus (SS). Aim of the present study is to assess the metrical and morphologic relationships existing between SS and sella turcica (ST).
Two hundred computed tomography-scans of patients were selected. For each patient volumes of SS were calculated from their 3-dimensional models segmented through ITK-SNAP program. Variants of SS in pneumatisation and sellar diameters [antero-posterior (AP) diameter, depth, and length] were evaluated on each computed tomography-scan. Correlations among different measurements were assessed through Spearman test ( P <0.01), whereas associations between sellar parameters and presence of pneumatisation variants were assessed through Mann-Whitney test ( P <0.01).
In males, pneumatization of the greater wings was related to smaller AP diameter ( P <0.01) and depth of ST ( P <0.01), whereas in females lower values of depth were found in patients with pneumatization of the pterygoid processes ( P <0.01). In both sexes, a positive correlation was found between AP diameter and, respectively, length and depth of ST ( P <0.01), together with a negative correlation between volume of SS and depth of ST ( P <0.01). Lastly, in females a positive correlation was found between age and, respectively, length and depth of ST ( P <0.01).
The present study highlighted new metrical and morphologic relationships between volume and pneumatisation of SS and diameters of ST. Knowledge of these correlations allows to understand more clearly, in the preoperative setting, the surgical working space. Further studies are needed, especially for what concerns the relationship between sellar measurements and age in females.
经蝶窦手术涉及蝶窦（SS）周围神经血管结构的术中损伤风险。本研究旨在评估 SS 和蝶鞍（ST）之间存在的测量和形态关系。
选择了 200 名患者的 CT 扫描。通过 ITK-SNAP 程序对每个患者的 3D 模型进行分割，以计算 SS 的体积。在每一次 CT 扫描中评估 SS 气化的变体和蝶鞍直径[前后（AP）直径、深度和长度]。通过 Spearman 检验（P<0.01）评估不同测量值之间的相关性，通过 Mann-Whitney 检验（P<0.01）评估蝶鞍参数与气化变体之间的关系。
在男性中，翼突气化与 AP 直径（P<0.01）和 ST 深度（P<0.01）较小相关，而在女性中，翼状突气化患者的深度值较低（P<0.01）。在两性中，AP 直径与 ST 的长度和深度呈正相关（P<0.01），同时 SS 体积与 ST 深度呈负相关（P<0.01）。最后，在女性中，年龄与 ST 的长度和深度呈正相关（P<0.01）。
本研究强调了 SS 体积和气化与 ST 直径之间新的测量和形态关系。了解这些相关性可以在术前更清楚地了解手术工作空间。需要进一步的研究，特别是关于女性中蝶鞍测量值与年龄之间的关系。
