title: Carotid artery protrusion and dehiscence in patients with acromegaly.
abstract: OBJECTIVE
  Acromegaly is a systemic disease which causes multiple bony alterations. Some authors reported that acromegalic patients have risk factors for an intraoperative vascular injury due to the specific anatomical features of their sphenoid sinus. The objective of our study was to analyze the anatomic characteristics of sphenoid sinus in acromegalic patients compared with controls, by evaluation of computed tomography (CT) findings.
  
  
  METHODS
  We examined 45 acromegalic (acromegaly group) and 45 non-acromegalic patients (control group) with pituitary adenomas who were matched for sex, age, height, tumor size, and cavernous sinus invasion (Knosp grade). Preoperative CT of the pituitary region including the sphenoid sinus was used to evaluate the following anatomic characteristics: type of sphenoid sinus (sellar or pre-sellar/conchal); intrasphenoid septa (non/single or multiple); carotid artery protrusion; carotid artery dehiscence; intercarotid distance.
  
  
  RESULTS
  Sixteen acromegalic patients (35.5 %) and 6 controls (13.3 %) had carotid artery protrusion. Additionally, 10 acromegalic patients (22.2 %) and 3 controls (6.6 %) had carotid artery dehiscence. Carotid artery protrusion and dehiscence were more frequent in the acromegaly group than in control group (p = 0.013 and 0.035, respectively). Other anatomic characteristics (type of sphenoid sinus, intrasphenoid septa, and intracarotid distance) showed no significant differences between acromegaly and control groups.
  
  
  CONCLUSIONS
  Our study suggests that carotid artery protrusion and dehiscence occur more frequently among acromegalic patients, compared with non-acromegalic patients. It is important for surgeons to be aware of these anatomic variations to avoid vital complications, such as carotid injuries, during surgery.
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan. yacchan1218@yahoo.co.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sasagawa
authors.affiliation: Department of Neurosurgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Tachibana
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Doai
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Department of Diagnostic and Therapeutic Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Tonami
authors.affiliation: Department of Neurosurgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Iizuka
authors.affiliation: Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Nakada
mesh_terms: D000172:Acromegaly / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013101:Sphenoid Sinus / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
keywords: Acromegaly; Carotid artery dehiscence; Carotid artery protrusion; Sphenoid sinus