Virtual endoscopy in endoscopic pituitary tumor resection through the endonasal transsphenoidal approach / 中华神经医学杂志

Objective To observe the anatomical structure via endonasal transsphenoidal approach with virtual endoscopy (VE) and explore the clinical applications of VE in endoscopic pituitary tumor resection through the endonasal transsphenoidal approach. Methods The VE was applied to the reconstruction of the pre-surgical 64-slice CT scanning of the 21 patients with pituitary adenoma received the endoscopic endonasal transsphenoidal surgery. A comparative study and a correlation analysis of cumulative scores of the anatomical structure were performed between the reconstructed VE images and the intraoperative endoscopic ones. Results Preoperative VE images and intraoperative endoscope images are very similar. The correlation of cumulative scores of the anatomical structure between the VE images of anatomical findings and the intraoperative images was positively noted (r=0.923, P=0.001),indicating that VE can be applied to simulately observe the anatomical structure before the endoscopic endonasal transsphenoidal pituitary surgery, and observe the anatomical structure through the endonasal transsphenoidal approach. Conclusion Being able to display the important anatomical structure and its varieties before the endoscopic endonasal transsphenoidal pituitary surgery, VE proves to be a valuable approach to the preoperative planning, increases the surgical efficiency and improves the safety of the surgery.

Three-dimensional reconstruction of CT imaging in endoscopic surgery of patients with hypertensive intracerebral hemorrhage / 中华神经医学杂志

Objective To develop a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with hypertensive intracerebral hemorrhage (HICH).Methods Eighteen patients with HICH, admitted to our hospital from June 2008 to August 2010, were performed endoscopic minimally invasive surgery; CT three-dimensional reconstruction was employed to locate the intracerebral hematoma and select the appropriate endoscopic approach before the endoscopic surgery.The clinical data and treatmem efficacy were analyzed.Results According to the results of CT three-dimensional reconstruction, our neurosurgeons could design the best endoscopic approach; the three-dimensional relationship between intracerebral hematoma and scalp markers was shown directly and accurate positioning of the location of drilling was achieved; therefore, the time for preoperative preparation, anesthesia and operation was shortened. The mean operating time of these 18 patients was about 1.5 h; the volume of blood loss was only 30-40 mL; and the evacuation ratio was about 89.2%.After the elimination of hematoma, the brain tissues were flabby, so decompressive craniectomy was not needed. Conclusion CT three-dimensional reconstruction is a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with HICH.