Vascular Complications of Intercavernous Sinuses during Transsphenoidal Surgery: An Anatomical Analysis Based on Autopsy and Magnetic Resonance Venography |
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Authors: | Xuefei Deng Shijun Chen Ya Bai Wen Song Yongchao Chen Dongxue Li Hui Han Bin Liu |
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Affiliation: | 1. Department of Anatomy, Anhui Medical University, Hefei, Anhui, China.; 2. Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.; 3. Ultrasonic Center, The 105th Hospital of PLA, Hefei, Anhui, China.; 4. Department of Neurosurgery, Anhui Provincial Hospital, Hefei, Anhui, China.; Shenzhen institutes of advanced technology, CHINA, |
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Abstract: | PurposeVascular complications induced by intercavernous sinus injury during dural opening in the transsphenoidal surgery may contribute to incomplete tumour resections. Preoperative neuro-imaging is of crucial importance in planning surgical approach. The aim of this study is to correlate the microanatomy of intercavernous sinuses with its contrast-enhanced magnetic resonance venography (CE-MRV).MethodsEighteen human adult cadavers and 24 patients were examined based on autopsy and CE-MRV. Through dissection of the cadavers and CE-MRV, the location, shape, number, diameter and type of intercavernous sinuses were measured and compared.ResultsDifferent intercavernous sinuses were identified by their location and shape in all the cadavers and CE-MRV. Compared to the cadavers, CE-MRV revealed 37% of the anterior intercavernous sinus, 48% of the inferior intercavernous sinus, 30% of the posterior intercavernous sinus, 30% of the dorsum sellae sinus and 100% of the basilar sinus. The smaller intercavernous sinuses were not seen in the neuro-images. According to the presence of the anterior and inferior intercavernous sinus, four types of the intercavernous sinuses were identified in cadavers and CE-MRV, and the corresponding operative space in the transsphenoidal surgical approach was implemented.ConclusionThe morphology and classification of the cavernous sinus can be identified by CE-MRV, especially for the larger vessels, which cause bleeding more easily. Therefore, CE-MRV provides a reliable measure for individualized preoperative planning during transsphenoidal surgery. |
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