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Intrasellar ultrasound in transsphenoidal surgery: a novel technique

Abstract

OBJECTIVE: Residual tumor masses are common after transsphenoidal surgery. The risk of a residual mass increases with tumor size and parasellar or suprasellar growth. Transsphenoidal surgery is usually performed without image guidance. We aimed to investigate a new technical solution developed for intraoperative ultrasound imaging during transsphenoidal surgery, with respect to potential clinical use and the ability to identify neuroanatomy and tumor. METHODS: In 9 patients with pituitary macroadenomas, intrasphenoidal and intrasellar ultrasound was assessed during transsphenoidal operations. Ultrasound B-mode, power-Doppler and color-Doppler images were acquired using a small prototype linear array, side-looking probe. The long probe tip measures only 3 x 4 mm. We present images and discuss the potential of intrasphenoidal and intrasellar and ultrasound in transsphenoidal surgery. RESULTS: We present 2-dimensional, high-resolution ultrasound images. A small side-looking, high-frequency ultrasound probe can be used to ensure orientation in the midline for the surgical approach to identify important neurovascular structures to be avoided during surgery and for resection control and identification of normal pituitary tissue. The image resolution is far better than what can be achieved with current clinical magnetic resonance imaging technology. CONCLUSION: We believe that the concept of intrasellar ultrasound can be further developed to become a flexible and useful tool in transsphenoidal surgery.

Category

Academic article

Language

English

Author(s)

  • Ole Solheim
  • Tormod Selbekk
  • Lasse Løvstakken
  • Geir Arne Tangen
  • Ole Vegard Solberg
  • Tonni Franke Johansen
  • Johan Cappelen
  • Geirmund Unsgård

Affiliation

  • Norwegian University of Science and Technology
  • St. Olavs Hospital, Trondheim University Hospital
  • SINTEF

Year

2010

Published in

Neurosurgery

ISSN

0148-396X

Publisher

Oxford University Press

Volume

66

Issue

1

Page(s)

173 - 1985

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