Objective: Describe the outcome of visual disorders after endonasal transsphenoidal (EET) surgery of pituitary macroadenomas with preoperative chiasmal compression. Patients and Methods: From 2009 to 2013, 225 patient...Objective: Describe the outcome of visual disorders after endonasal transsphenoidal (EET) surgery of pituitary macroadenomas with preoperative chiasmal compression. Patients and Methods: From 2009 to 2013, 225 patients underwent EET surgery for sellar tumor. Among them, 168 suffered from visual disorders induced by chiasmatic compression, of which 88 met the inclusion criteria for this study. Average duration of follow up was 1.8 yrs ± 0.4 yrs. All patients had sellar MRI before surgery and yearly postoperatively, visual acuity (VA) and/or visual field (VF) measurements before, 3 months after surgery and yearly postoperatively. Results: All tumors were macroadenomas with a mean preoperative MRI-estimated volume of 10.0 {plus minus} 9.07 cm<sup>3</sup>. Preoperative VA was impaired with an average of 0.43 ± 0.13 LogMAR (left eye) and 0.36 ± 0.14 LogMAR (right eye) and VF was disturbed in 99% ± 2% of the cases with the most frequent disorder being bitemporal hemianopsia (38 patients). Post-operatively, the mean residual MRI-estimated tumor volume was 3.15 ± 3.71 cm<sup>3</sup>. Mean tumor volume reduction was 62% ± 9% (p < 0.001). Optic chiasmal compression resolved in 72% ± 10% of the cases. Visual function improved in 86% ± 7% of cases (p < 0.001). Conclusion: Endoscopic endonasal management of pituitary gland neoplasms is effective to reduce tumor volume. This technique achieved significant visual improvement in the majority of cases presenting with chiasmal compression syndrome.展开更多
Objective: Our study aimed at analyzing the morphometry of the lumbar spine at the CT scan and to specify its interest in spinal surgery. Methodology: This was a prospective study conducted from May 1, 2011 to July 31...Objective: Our study aimed at analyzing the morphometry of the lumbar spine at the CT scan and to specify its interest in spinal surgery. Methodology: This was a prospective study conducted from May 1, 2011 to July 31, 2011 in Ouagadougou. During this study, 170 patients aged 45.3 ± 12.5 years old with a sex ratio of 1.15 received a CT scan. The symptomatology was dominated by low back pain (60.6%) and lumbar osteoarthritis was the most common etiology (51.8%). The measurements were performed directly on axial and sagittal sections of the lumbar spine with measurement of the vertebral body, and pedicles. Results: The vertebral body increased forward from 24.9 mm in L1 to 26.7 mm in L5 and decreasing backwards from 26.6 mm in L1 to 23.4 mm in L5. The transverse diameter of the vertebral body ranged from 37 mm in L1 to 47.4 mm in L5 and the anteroposterior diameter of 27.6 mm in L1 to 33.5 mm in L5. The lumbar canal had an anteroposterior diameter that ranged from 15.9 mm in L1 to 15.5 mm in L5 and an interpedicular distance increasing from 21.54 mm in L1 to 28.42 mm in L5. The pedicle decreased in length from L1 (9.5 mm) to L5 (6.5 mm) while its width increased from 6.9 mm in L1 to 15.1 mm in L5. Its axis formed, with respect to the sagittal plane, an increasingly obtuse angle varying from 16.3 degrees in L1 to 29.1 degrees in L5 and with respect to the upper plate of the vertebral body, an increasingly acute angle (14, 2 degrees in L1 at 8.8 degrees in L5). Conclusion: The dimensions of the lumbar vertebrae in our series differ from those noted in Western populations in that they have a smaller vertebral body, a shorter, wider pedicle with an angle of inclination of the pedicle compared to the sagittal and horizontal planes more obtuse.展开更多
文摘Objective: Describe the outcome of visual disorders after endonasal transsphenoidal (EET) surgery of pituitary macroadenomas with preoperative chiasmal compression. Patients and Methods: From 2009 to 2013, 225 patients underwent EET surgery for sellar tumor. Among them, 168 suffered from visual disorders induced by chiasmatic compression, of which 88 met the inclusion criteria for this study. Average duration of follow up was 1.8 yrs ± 0.4 yrs. All patients had sellar MRI before surgery and yearly postoperatively, visual acuity (VA) and/or visual field (VF) measurements before, 3 months after surgery and yearly postoperatively. Results: All tumors were macroadenomas with a mean preoperative MRI-estimated volume of 10.0 {plus minus} 9.07 cm<sup>3</sup>. Preoperative VA was impaired with an average of 0.43 ± 0.13 LogMAR (left eye) and 0.36 ± 0.14 LogMAR (right eye) and VF was disturbed in 99% ± 2% of the cases with the most frequent disorder being bitemporal hemianopsia (38 patients). Post-operatively, the mean residual MRI-estimated tumor volume was 3.15 ± 3.71 cm<sup>3</sup>. Mean tumor volume reduction was 62% ± 9% (p < 0.001). Optic chiasmal compression resolved in 72% ± 10% of the cases. Visual function improved in 86% ± 7% of cases (p < 0.001). Conclusion: Endoscopic endonasal management of pituitary gland neoplasms is effective to reduce tumor volume. This technique achieved significant visual improvement in the majority of cases presenting with chiasmal compression syndrome.
文摘Objective: Our study aimed at analyzing the morphometry of the lumbar spine at the CT scan and to specify its interest in spinal surgery. Methodology: This was a prospective study conducted from May 1, 2011 to July 31, 2011 in Ouagadougou. During this study, 170 patients aged 45.3 ± 12.5 years old with a sex ratio of 1.15 received a CT scan. The symptomatology was dominated by low back pain (60.6%) and lumbar osteoarthritis was the most common etiology (51.8%). The measurements were performed directly on axial and sagittal sections of the lumbar spine with measurement of the vertebral body, and pedicles. Results: The vertebral body increased forward from 24.9 mm in L1 to 26.7 mm in L5 and decreasing backwards from 26.6 mm in L1 to 23.4 mm in L5. The transverse diameter of the vertebral body ranged from 37 mm in L1 to 47.4 mm in L5 and the anteroposterior diameter of 27.6 mm in L1 to 33.5 mm in L5. The lumbar canal had an anteroposterior diameter that ranged from 15.9 mm in L1 to 15.5 mm in L5 and an interpedicular distance increasing from 21.54 mm in L1 to 28.42 mm in L5. The pedicle decreased in length from L1 (9.5 mm) to L5 (6.5 mm) while its width increased from 6.9 mm in L1 to 15.1 mm in L5. Its axis formed, with respect to the sagittal plane, an increasingly obtuse angle varying from 16.3 degrees in L1 to 29.1 degrees in L5 and with respect to the upper plate of the vertebral body, an increasingly acute angle (14, 2 degrees in L1 at 8.8 degrees in L5). Conclusion: The dimensions of the lumbar vertebrae in our series differ from those noted in Western populations in that they have a smaller vertebral body, a shorter, wider pedicle with an angle of inclination of the pedicle compared to the sagittal and horizontal planes more obtuse.
