Turkish Neurosurgery
The role of OsiriX based virtual endoscopy in planning endoscopic transsphenoidal surgery for pituitary adenoma
Daniel Rotariu1, Alexandru Budu1, Ziyad Faiyad1, Ion Poeata2
1N Oblu Hospital, Neurosurgery, Iasi,
2Gr T Popa University, Neurosurgery, Iasi,
DOI: 10.5137/1019-5149.JTN.16311-15.2

Aim:Evaluate the role and accuracy of the virtual endoscopy realized using commercially available software, OsiriX, as a method of planning of surgical interventions.Material and Methods:The CTs of 22 patients with pituitary adenomas proposed for endoscopic approach were reconstructed using OsiriX. VE was performed prior surgery to assess the surgical corridor and particular anatomy. We have evaluated the following landmarks: inferior and middle turbinate, sphenoid ostia (SO), choanal arch (Ch), sphenoethmoidal recess (SER), sphenoid septa, sella turcica, carotid prominences and opticocarotid recesses (OCR). The intraoperative endoscopic images were reviewed and compared with the virtual images.Results:The virtual images had a good resemblance with the actual surgical images, all the structures from the nasal cavity were identified and had a perfect matching except the SO which was identified in 8 cases in VE vs. 12 intraoperative. All the structures from the sphenoid sinus were identified with perfect matching except the ipsilateral carotid prominence (14 in VE vs. 10 intraoperative) and the contralateral carotid prominence (16 in VE vs. 18 intraoperative). The VE could not appreciate the state of the sellar floor and did not offer any information about the sellar content.Conclusion:VE realized in OsiriX represents an affordable alternative to the specially designed systems, offering reliable data and good quality images that are useful for the preoperative planning.

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