Reaching the sellar region endonasally — One or both nostrils? A pilot study in body donors

Linsler S, Breuskin D, Tschernig T, Oertel J (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Annals of Anatomy-Anatomischer Anzeiger Elsevier

Book Volume: 217

Pages Range: 40-46

DOI: 10.1016/j.aanat.2018.01.005

Abstract

Introduction: The purpose of this study was to evaluate the effect of posterior septectomy size on surgical exposure and surgical freedom during the endoscopic transsphenoidal approach to the sellar and parasellar region. Methods: A mononostril and binostril approach to the sellar region was performed on 4 formalin-fixed cadaveric heads. Predefined anatomical structures were identified. Additionally, a millimeter gauge was introduced into the surgical site and the extent of dorsal septectomy was analyzed for both approaches. Surgical freedom was defined as the distance between the ipsilateral and contralateral limit of opening of the sphenoid sinus. Results: The mean extent of dorsal septectomy was 15.7 ± 5.7 mm using a binostril approach to achieve adequate visualization of all relevant anatomical structures. Superior results were obtained via binostril technique with respect to the ability to identify the contralateral internal carotid artery or opticocarotid recessus. No such advantage was found for all other landmarks. Surgical freedom between the ipsilateral and contralateral limit of exposure of the sphenoid sinus was measured with 15 ± 0.8 mm in the mononostril and 19.2 ± 0.9 mm in the binostril group. Conclusions: The surgical exposure increased significantly with progressively larger posterior septectomy in binostril approaches until a 20-mm posterior septectomy. Bilateral lateral opticocarotid recesses were accessible with a mean of 15 mm for posterior septectomy. In the mononostril group no dorsal septectomy was necessary. Thus, the nasal mucosa is more preserved by this technique. However, the lateral exposure is partially limited and the use of angled endoscopes is recommended when adopting a mononostril approach to the sellar region.

Authors with CRIS profile

Stefan Nikolaus Linsler

Involved external institutions

Universitätsklinikum des Saarlandes (UKS) DE Germany (DE) Universität des Saarlandes (UdS) DE Germany (DE)

How to cite

APA:

Linsler, S., Breuskin, D., Tschernig, T., & Oertel, J. (2018). Reaching the sellar region endonasally — One or both nostrils? A pilot study in body donors. Annals of Anatomy-Anatomischer Anzeiger, 217, 40-46. https://doi.org/10.1016/j.aanat.2018.01.005

MLA:

Linsler, Stefan, et al. "Reaching the sellar region endonasally — One or both nostrils? A pilot study in body donors." Annals of Anatomy-Anatomischer Anzeiger 217 (2018): 40-46.

BibTeX: Download