Abstract：
OBJECTIVE: Adrenocorticotrophic hormone excessive secretion in pituitary-dependent Cushing disease (CD) patients may lead to anatomic variations of the nasal-sphenoidal corridor as a result of hormone-induced abnormal soft tissue change. However, there is still a lack of data on anatomic dimensions in CD patients. In this study, magnetic resonance images were analyzed to determine the anatomic variations of the nasal cavity and sphenoid sinus in CD patients.
METHODS: A retrospective radiographic analysis was conducted on CD patients undergoing endonasal transsphenoidal surgery as primary treatment between January 2013 and December 2017. A total of 97 CD patients and 100 controls were included. The nasal and sphenoidal anatomic dimensions of CD patients were compared with the control group.
RESULTS: Both sides of nasal cavity height, middle nasal meatus width, and inferior nasal meatus width in CD patients were narrower than that of controls. When compared with controls, the ratio of the middle turbinate to middle nasal meatus and the ratio of inferior turbinate to inferior nasal meatus was found to increase on both sides in CD patients. Intercarotid distance of CD patients was shorter than that of controls. The most prevalent pneumatization pattern of CD patients was postsellar, followed by sellar, presellar, and conchal.
CONCLUSIONS: Cushing disease patients have nasal and sphenoidal anatomic variations affecting the endonasal transsphenoidal surgical corridor, especially the shorter intercarotid distance. The neurosurgeon should be aware of these anatomic variations, and adapt surgical techniques and optimal approaches to reach the sella safely.
METHODS: A retrospective radiographic analysis was conducted on CD patients undergoing endonasal transsphenoidal surgery as primary treatment between January 2013 and December 2017. A total of 97 CD patients and 100 controls were included. The nasal and sphenoidal anatomic dimensions of CD patients were compared with the control group.
RESULTS: Both sides of nasal cavity height, middle nasal meatus width, and inferior nasal meatus width in CD patients were narrower than that of controls. When compared with controls, the ratio of the middle turbinate to middle nasal meatus and the ratio of inferior turbinate to inferior nasal meatus was found to increase on both sides in CD patients. Intercarotid distance of CD patients was shorter than that of controls. The most prevalent pneumatization pattern of CD patients was postsellar, followed by sellar, presellar, and conchal.
CONCLUSIONS: Cushing disease patients have nasal and sphenoidal anatomic variations affecting the endonasal transsphenoidal surgical corridor, especially the shorter intercarotid distance. The neurosurgeon should be aware of these anatomic variations, and adapt surgical techniques and optimal approaches to reach the sella safely.
摘要：
目的：垂体依赖性库欣病（CD）患者促肾上腺皮质激素过度分泌可能导致激素引起的异常软组织改变导致鼻蝶窦通道的解剖变异。然而,目前仍缺乏CD患者的解剖尺寸数据.在这项研究中,分析磁共振图像以确定CD患者鼻腔和蝶窦的解剖变异。
方法：对2013年1月至2017年12月期间接受经鼻蝶入路手术作为主要治疗的CD患者进行回顾性影像学分析。共包括97名CD患者和100名对照。将CD患者的鼻和蝶窦解剖尺寸与对照组进行比较。
结果：两侧鼻腔高度，中鼻道宽度，CD患者的下鼻道宽度比对照组窄。与对照组相比，发现CD患者两侧中鼻甲与中鼻道的比率和下鼻甲与下鼻道的比率均增加。CD患者的颈动脉距离短于对照组。CD患者最普遍的肺炎模式是鞍后，紧随其后的是赛勒，前，还有Conchal.
结论：库欣病患者的鼻和蝶窦解剖变异影响经鼻蝶手术走廊，尤其是颈动脉间距离较短。神经外科医生应该意识到这些解剖变异，并调整手术技术和最佳方法以安全到达蝶鞍。
方法：对2013年1月至2017年12月期间接受经鼻蝶入路手术作为主要治疗的CD患者进行回顾性影像学分析。共包括97名CD患者和100名对照。将CD患者的鼻和蝶窦解剖尺寸与对照组进行比较。
结果：两侧鼻腔高度，中鼻道宽度，CD患者的下鼻道宽度比对照组窄。与对照组相比，发现CD患者两侧中鼻甲与中鼻道的比率和下鼻甲与下鼻道的比率均增加。CD患者的颈动脉距离短于对照组。CD患者最普遍的肺炎模式是鞍后，紧随其后的是赛勒，前，还有Conchal.
结论：库欣病患者的鼻和蝶窦解剖变异影响经鼻蝶手术走廊，尤其是颈动脉间距离较短。神经外科医生应该意识到这些解剖变异，并调整手术技术和最佳方法以安全到达蝶鞍。
