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Endoscopic anatomy of sellar region

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Abstract

The transsphenoidal approach is the preferred access used in surgical treatment of most sellar region pathologies. The use of endoscopy is advantageous, and it is considered a good alternative to the traditional microsurgical technique. The purpose of this study is to recognize and describe anatomical variations of the sphenoid sinus and the sellar region, mainly describing the anatomy of the posterior wall of the sphenoid sinus and analyzing intercarotid distances in 3 regions. Thirty sphenoid blocks treated with formaldehyde were injected and dissected. Using endoscopy, anatomical variations were studied and the intercarotid distances were measured at the tuberculum sellae, sellar floor and clivus. The types of sphenoid sinus found were: conchal in 1 (4.76 %), pré-sellar in 2 (9.52 %) and sellar in 19 (85.7 %) specimens. The mean distance found from the sphenoid sinus ostium to the sella turcica was 19 mm (±6.5) mm. The mean intercarotid distances found at the tuberculum sellae, sellar floor and clivus were respectively 13.32, 18.00 and 18.90 mm. Endoscopy, with its magnification and lighting provide a panoramic view of deep fields. The anatomical variations described in this study support the need for a careful evaluation of preoperative images in each case.

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Authors and Affiliations

  1. Microsurgical Anatomy, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Gerson Evandro Perondi, Gustavo Rassier Isolan, Paulo Henrique Pires de Aguiar, Marco Antônio Stefani & E. Frederico Falcetta

  2. Porto Alegre Skull Base Foundation, Porto Alegre, Brazil

    Gerson Evandro Perondi, Gustavo Rassier Isolan, Paulo Henrique Pires de Aguiar, Marco Antônio Stefani & E. Frederico Falcetta

  3. Department of Neurology, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, Porto Alegre, RS, 2350, Brazil

    Gustavo Rassier Isolan

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  1. Gerson Evandro Perondi
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  2. Gustavo Rassier Isolan
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Correspondence to Gustavo Rassier Isolan.

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Perondi, G.E., Isolan, G.R., de Aguiar, P.H.P. et al. Endoscopic anatomy of sellar region. Pituitary 16, 251–259 (2013). https://doi.org/10.1007/s11102-012-0413-9

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