دورية أكاديمية
Pituitary adenoma with oculomotor cistern extension: membranous anatomy and clinical application.
| العنوان: | Pituitary adenoma with oculomotor cistern extension: membranous anatomy and clinical application. |
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| المؤلفون: | Wu X; Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, Nanchang, China., Liang L; Department of Anatomy, Anhui Medical University, NO. 81, Meishan Road, Shushan District, Hefei, Anhui, China., Wu BW; Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, Nanchang, China., Xie SH; Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, Nanchang, China., Wu J; Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, Nanchang, China., Wan XC; Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, Nanchang, China., Din H; Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, Nanchang, China., Zhan J; Department of Radiology, the First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, Nanchang, China., Xiao LM; Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, Nanchang, China., Tang B; Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, Nanchang, China. tonytang19850815@sina.com., Hong T; Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, Nanchang, China. ht2000@vip.sina.com. |
| المصدر: | Acta neurochirurgica [Acta Neurochir (Wien)] 2023 Oct; Vol. 165 (10), pp. 2985-2993. Date of Electronic Publication: 2023 Sep 06. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Austria NLM ID: 0151000 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0942-0940 (Electronic) Linking ISSN: 00016268 NLM ISO Abbreviation: Acta Neurochir (Wien) Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Wien, Springer. |
| مواضيع طبية MeSH: | Pituitary Neoplasms*/surgery , Oculomotor Nerve Diseases* , Adenoma*/surgery, Humans ; Retrospective Studies ; Sella Turcica ; Oculomotor Nerve/surgery |
| مستخلص: | Background: The anatomical basis of pituitary adenomas (PAs) with oculomotor cistern (OC) extension as a growth corridor is overlooked in the literature. In this paper, the authors use the technique of epoxy sheet plastination to study the membranous structure of the OC and validate the results by retrospective analysis of patients with OC extension. Methods: Eighteen specimens were used to study the membranous anatomy surrounding the OC using the epoxy sheet plastination technique. Thirty-four patients with OC extension were retrospectively reviewed. Results: The OC consisted of two thin membranous layers. The inner layer was extended by the arachnoid layer from the posterior fossa, and the lateral layer consisted of the dura mater sinking from the roof of the cavernous sinus. The oculomotor nerve is more likely to displace with a superolateral trajectory due to the weakness of the posterior dura and the relatively large space in the medial and posterior trajectories, which is consistent with the intraoperative observations. Among the anatomical factors that affect the PA by OC extension, we found that the relative position of the internal carotid artery (ICA) and posterior clinoid process may lead to the narrowing of the OC. Of 34 cases, 28 patients achieved total resection. Among 24 preoperative patients with oculomotor nerve palsy, 16 cases were relieved to varying degrees postoperatively. There was no ICA injury or severe intracranial infection found in any of the patients. Conclusions: Extension into the OC is influenced by two anatomical factors: a weak point in the dura in the posterior OC and a potential space beyond this region of the dura. Meticulous knowledge of the membranous anatomy in endoscopic endonasal surgery is required to safely and effectively resect PA with OC extension. (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.) |
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| فهرسة مساهمة: | Keywords: Cavernous sinus; Epoxy sheet; Membranous anatomy; Oculomotor cistern; Pituitary adenoma; Plastination |
| تواريخ الأحداث: | Date Created: 20230906 Date Completed: 20231026 Latest Revision: 20231027 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1007/s00701-023-05784-3 |
| PMID: | 37672094 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 0942-0940 |
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| DOI: | 10.1007/s00701-023-05784-3 |