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Carotid artery protrusion and dehiscence in patients with acromegaly

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Abstract

Purpose

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.

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Authors and Affiliations

  1. Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan

    Yasuo Sasagawa, Yasuhiko Hayashi & Mitsutoshi Nakada

  2. Department of Neurosurgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan

    Osamu Tachibana & Hideaki Iizuka

  3. Department of Diagnostic and Therapeutic Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan

    Mariko Doai & Hisao Tonami

Authors
  1. Yasuo Sasagawa
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  2. Osamu Tachibana
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  3. Mariko Doai
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  4. Yasuhiko Hayashi
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  5. Hisao Tonami
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  6. Hideaki Iizuka
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  7. Mitsutoshi Nakada
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Corresponding author

Correspondence to Yasuo Sasagawa.

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The authors declare that they have no conflicts of interest.

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Sasagawa, Y., Tachibana, O., Doai, M. et al. Carotid artery protrusion and dehiscence in patients with acromegaly. Pituitary 19, 482–487 (2016). https://doi.org/10.1007/s11102-016-0728-z

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  • DOI: https://doi.org/10.1007/s11102-016-0728-z

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