Estimating nasoseptal flap length for sellar reconstruction: a surgical and radiological study.
To assess whether computed tomography (CT) can predict the nasoseptal flap length necessary for reconstruction after endoscopic approaches to the sellar region.
Twenty consecutive patients who underwent endoscopic resection of pituitary adenoma were included, and data were obtained prospectively in 2 stages, one radiological and one surgical. The length of the flap as estimated by CT (CT-Est) was compared with the flap length considered optimal (Ideal Flap), after intraoperative measurements. Correlation between the 2 values was assessed with the Spearman correlation test.
The mean length estimated on CT scans was 63.8 ± 2.3 mm, and the mean Ideal Flap was 59.1 ± 2.3 mm. The mean difference (Δ CT-Est - Ideal Flap) between these 2 values was 4.7 ± 0.7 mm. The Spearman coefficient of correlation between Ideal Flap and CT-Est was 0.938 (95% CI = 0.843 to 0.976), with p = 0.001, denoting a very strong and statistically significant correlation.
CT-based estimates closely approximated the nasoseptal flap length required for reconstruction of a sellar approach defect. CT has the potential to be a useful tool for preoperative planning of tailored flaps.
Twenty consecutive patients who underwent endoscopic resection of pituitary adenoma were included, and data were obtained prospectively in 2 stages, one radiological and one surgical. The length of the flap as estimated by CT (CT-Est) was compared with the flap length considered optimal (Ideal Flap), after intraoperative measurements. Correlation between the 2 values was assessed with the Spearman correlation test.
The mean length estimated on CT scans was 63.8 ± 2.3 mm, and the mean Ideal Flap was 59.1 ± 2.3 mm. The mean difference (Δ CT-Est - Ideal Flap) between these 2 values was 4.7 ± 0.7 mm. The Spearman coefficient of correlation between Ideal Flap and CT-Est was 0.938 (95% CI = 0.843 to 0.976), with p = 0.001, denoting a very strong and statistically significant correlation.
CT-based estimates closely approximated the nasoseptal flap length required for reconstruction of a sellar approach defect. CT has the potential to be a useful tool for preoperative planning of tailored flaps.
Authors
Portella Gazmenga Portella Gazmenga, Sampaio Sampaio, Infanger Serrano Infanger Serrano, Sakuma Sakuma, Dal Fabbro Dal Fabbro, Sakano Sakano
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