Safety window for the transsphenoidal approach for pituitary tumours: a computed tomographic angiography study.

BACKGROUND: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Cochlear morphometry in healthy ears of a mexican population: A comparison of measurement techniques.

OBJECTIVE: This study describes the cochlear morphometry of a mexican population analysed by laterality and sex. The objective is to compare Cochlear Length (CL) evaluation between Alexiades et al. formula and manual method described by Würfel et al. PATIENTS: Hispanic patients from Mexico, with an age of 18 years or older, were included. Morphometric examination was performed retrospectively on 200 subjects who underwent previously temporal bone imaging for clinical purposes. MATERIALS AND METHODS: Horos for Mac program was used to measure CL, cochlear height, distance A, and distance B. WorkStation AW Volume Share 2 was used to obtain volume. CL was measured in 400 temporal bones (228 females, 172 males). RESULTS: The mean CL was 34.02mm±2.15mm. A significant difference was found in all variables between sex (P=≤0.05) and laterality (P=≤0.05). The Alexiades equation was used for determining CL and compared with the manual formula, with no significant differences (κ=0.71). However, the time consumption was 5 times faster with the calculated method. The Alexiades formula was demonstrated to be a reliable method measurement. CONCLUSION: Preoperative Computed Tomography evaluation of the internal ear helps to plan the Cochlear Implants (CI) surgical approach and allows to choose an appropriate electrode length for each necessity. Our findings may be useful to facilitate and adapt preoperative management of CI surgery by considering the characteristics of cochlear morphology of Latin-American populations.

[Vertebral fixation with a transpedicular approach. Relevance of anatomical and imaging studies]. / Fijación vertebral por vía transpedicular. Importancia de los estudios anatómicos y de imagen.

The number of patients with spine conditions has grown exponentially in recent years leading to an increase in the number of cases requiring surgical treatment. Currently vertebral fusion surgery with a transpedicular approach represents the most commonly used technique to treat any type of vertebral disorder. The morphometric characteristics of vertebrae, particularly the pedicle, determine the size of pedicular implants, including width and length, as well as the shape and direction of the screw and its ideal angulation at the time of introduction. Knowing these characteristics is important to prevent injuring important adjacent structures and to decrease the postoperative complication rate. In recent decades numerous studies on the morphometric characteristics of the vertebral pedicle have been conducted in different populations to determine its real dimensions by means of direct measurement and imaging methods. These studies have concluded that there are significant differences in these measurements among the different ethnic groups, races, genders, ages and the vertebral regions studied. This paper analyzes the different morphometric studies of the pedicle and all the other vertebral elements studied in Mexico and the rest of the world and explain the importance of their knowledge and surgical application for the correct development of vertebral fusion surgery with a transpedicular approach.