Analysis of the Medial Opticocarotid Recess in Patients with Pituitary Macroadenoma Using Three-Dimensional Images.
OBJECTIVE
The medial opticocarotid recess (MOCR), which contains the lateral tubercular recess (LTR), is an important landmark for the cavernous internal carotid artery (ICA) and for accessing the parasellar and suprasellar regions. These microanatomic landmarks for endoscopic endonasal surgery can be observed using surgical simulation with three-dimensional images. The aim of this study was to analyze the MOCR in patients with pituitary macroadenoma using three-dimensional images.


METHODS
We constructed three-dimensional computed tomography images of 20 patients with pituitary macroadenoma and 20 patients with unruptured aneurysms as a control. Using these images, we measured the distance between the left and right LTR, the midline and the unilateral LTR, and the left and right ICA.


RESULTS
The distance between the left and right LTR was statistically longer in the pituitary adenoma group versus the control group. Tumor volumes were multivariate parameters for the distance between the left and right LTR, which was significantly longer in the group with tumor volumes >5 cm(3) versus the other groups. This distance was also significantly correlated with the distance between the left and right ICA.


CONCLUSIONS
Pituitary macroadenomas expand the distance between the left and right MOCR together with the distance between the left and right ICA.
Department of Neurosurgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan. Electronic address: fi020084@yahoo.co.jp.
Ryogo
R
Kikuchi
Department of Neurosurgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
Masahiro
M
Toda
Keio University School of Medicine, Shinjuku, Tokyo, Japan.
Sota
S
Wakahara
Department of Diagnostic Radiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
Hirokazu
H
Fujiwara
Department of Diagnostic Radiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
Masahiro
M
Jinzaki
Department of Neurosurgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
Kazunari
K
Yoshida
D000368:Aged; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging* / Q000473:pathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery; D044583:Neuroendoscopy; D015588:Observer Variation; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019291:Skull Base / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
Opticocarotid recess; Pituitary adenoma; Three-dimensional image