title: Bone CT evaluation of nasal cavity of acromegalics--its morphological and surgical implication in comparison to non-acromegalics.
abstract: OBJECTIVE
  In order to numerically compare the morphological differences of the nasal cavity and nasal sinus between acromegalics and non-acromegalics, bone window CT scans sliced parallel to the transsphenoidal surgical route were performed. MATERIAL AND CASES: Acromegalic patients had small or large macroadenomas and were 13 (7 men and 6 women) in number, aged 53.2 +/- 16.1 years. Non-acromegalic patients had pituitary tumors and were 44 (21 men and 23 women) in number, aged 52.1 +/- 12.5 years.
  
  
  RESULTS
  The results of acromegalics are described in comparison to non-acromegalics in parentheses. a) The width of the surgical corridor: piriform aperture, 27.6 +/- 2.7 (25.9 +/- 2.6) mm; origin of inferior nasal concha, 29.4 +/- 9.4 (26.6 +/- 4.0) mm; and origin of middle nasal concha, 29.8 +/- 3.2 (26.2 +/- 4.2) mm. b) The depth of the surgical corridor: the upper lip thickness, 18.1 +/- 2.7 (13.3 +/- 1.4) mm; the distances between piriform aperture and sphenoid wall, 52.9 +/- 4.6 (49 +/- 4.2) mm; sphenoid wall and sellar floor, 17.3 +/- 4.1 (18.7 +/- 4.1) mm; and sellar floor to dorsum sellae, 17.6 +/- 3.4 (15.6 +/- 4.0) mm. c) Marked carotid prominence: 7/13=53.4% (8/44=18.25%). d) Sinusitis: 8/13=61.5% (12/44=27.3%).
  
  
  CONCLUSIONS
  The data presented above show that morphological differences in bony nasal cavity and soft tissue may be responsible for a deeper and narrower surgical field for acromegalics. Acromegalics had a marked carotid prominence more frequently, which needs special attention to avoid carotid injury, when enlarging the surgical field. Knowing these morphological differences will provide useful information for peri- and intra-operative care.
authors.affiliation: Department of Neurological Surgery, Chiba University School of Medicine, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Saeki
authors.forename: T
authors.initials: T
authors.lastname: Iuchi
authors.forename: Y
authors.initials: Y
authors.lastname: Higuchi
authors.forename: Y
authors.initials: Y
authors.lastname: Uchino
authors.forename: H
authors.initials: H
authors.lastname: Murai
authors.forename: S
authors.initials: S
authors.lastname: Isono
authors.forename: T
authors.initials: T
authors.lastname: Yasuda
authors.forename: M
authors.initials: M
authors.lastname: Minagawa
authors.forename: A
authors.initials: A
authors.lastname: Yamaura
authors.forename: K
authors.initials: K
authors.lastname: Sunami
mesh_terms: D000172:Acromegaly / Q000000981:diagnostic imaging* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009295:Nasal Bone / Q000000981:diagnostic imaging*; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed