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Objective To investigate the related anatomical parameters of single-nostril transsphenoidal approach in adults.Methods Two hundred and ninty-four adults,performed head-neck CTA in our hospital from October 2011 to January 2012,were prospectively collected; and their CT data were collected,and the following anatomical parameters were measured through the multi-planar reconstruction of the CTA images:the angle of sella lowest point-anterior nasal spine root-the bottom of nasal cavity (∠ 1),the angle of the connection of Maxillary central incisors bottom to auditory canal crossing with the bottom of nasal cavity(∠ 2),the angle of tuberculum sellae-anterior nasal spine root-the bottom of nasal cavity(∠3),the angle ofdorsum sellae-anterior nasal spine root-the bottom of nasal cavity (∠4),and the angles of right / left sphenoid sinus mouth-maxillary ridge-the bottom of nasal cavity(∠5 / ∠6).Results ∠1(29.7±3.1°),∠2(29.5±3.1°),∠3(33.6±3.8°),∠4(28.8±3.6°),∠5(33.9±4.2°) and ∠6(33.6±4.5°) were calculated; significant differences were noted between each two angles (P＜0.05); ∠ 1 and ∠2 had a positive linear correlation (r=0.78,P＜0.05).Conclusion Preoperative multi-planar reconstruction images of CT facilitates safe opening of the anterior wall of spheniodal sinus and the sellar floor,and the operative position refers to the orientation that the virtual plane of Maxillary central incisors bottom to bilateral auditory canal erects the ground.
RESUMO
Objective To investigate the role of preoperative image information in tumor resection degrees,surgical complications and mortality of patients with meningiomas.Methods One hundred and seventy-two patients with meningiomas,admitted to our hospital from January 2008 to June 2011,were chosen in our study; the complete image informations,including tumor location,tumor size,nerves and vessels wraping around tumor or tumor wraping around nerves and vessels,tumor invasiveness,tumor margin,tumor shape,degrees of tumor enhancement and peritumoral brain edema,were retrospectively analyzed; univariate factor Chi-square test was performed to analyze the factors influencing the extent of tumor resection,surgical complications and death.Binary logistic stepwise regression analysis was performed to analyze statistical significance of the factors.Results Tumor location,tumor size,tumor invasiveness,tumor shape and tumor margin were the five independent risk factors of tumor residual,and tumor invasiveness was the primary risk factor.Tumor location,tumor size,nerves and vessels wraping around tumor or tumor wraping around nerves and vessels,and degrees of tumor enhancement were the four independent risk factors of surgical complications,and tumor location was the primary risk factor.Tumor location and tumor size were two independent risk factors of morbidity,and tumor location was the primary risk factor of mortality.Conclusion Preoperative image information of meningioma,especially the four primary factors (tumor location,tumor size,tumor invasiveness,and nerves and vessels wraping around tumor or tumor wraping around nerves and vessels),may objectively and accurately to estimate and evaluate meningioma resection degree,surgicalcomplications and mortality.