Prevalencia de variantes anatómicas en imágenes tomográficas preoperatorias para planificación quirúrgica en pacientes intervenidos con técnica de corredor quirúrgico endonasal transesfenoidal para abordar la silla turca durante el periodo 2021-2023 en base de datos INVIMEDIC.

Abstract

Introduction: The endonasal-transsphenoidal-sellar approach is essential to remove pituitary tumors. At the Luis Vernaza Hospital in Guayaquil, 149 surgeries were performed with this technique in the last 8 years. Understanding anatomy is crucial to minimizing risks and optimizing patient outcomes. Objective: This study aims to identify the most common anatomical variants in preoperative tomographic images for surgical planning of the transsphenoidal endonasal approach. Materials and Method: A retrospective observational prevalence study was carried out using data from 102 patients from the INVIMEDIC database. Images in DICOM format were analyzed with RadiAnt software. Diacom Viewer® . Data were collected in Microsoft Excel and statistical analyzes were performed with SPSS28 for Windows, including cross tables, Perason 's Chi-square test , and logistic regression analysis. Results: Significant differences were found between men and women, with men tending to have deeper and wider sphenoid sinuses on average (24.55 mm) compared to women. It stands out that the average intercarotid distance in the studied population was 19.85 mm. Discussion: Two important findings stand out. First, the mean anteroposterior length of the sphenoid sinus in the studied population was 24.55 mm, significantly contrasting with previous theories. Furthermore, the average intercarotid distance was 19.85 mm, 3.3 mm beyond the upper limit of the theoretical range established by CastleKirszbaum M. Conclusions: Significant differences were observed in the morphology of the sphenoid sinus between sexes, highlighting dimensions that contrast with previous theories. Keywords: Endonasal, transsphenoid