Three-Dimensional Reconstruction of the Sphenoid Sinus Anatomy for Presurgical Planning with Free OSIRIX Software

Javier Abarca-Olivas; Patrick Bärtschi; Irene Monjas-Cánovas; Pablo González-López; Elena García-Garrigós; Jose Sánchez-Payá; Pedro Moreno-López

doi:10.1055/s-0041-1725169

Journal of Neurological Surgery Part B: Skull Base, Inhaltsverzeichnis

J Neurol Surg B Skull Base 2022; 83(S 02): e244-e252
DOI: 10.1055/s-0041-1725169

Original Article

Three-Dimensional Reconstruction of the Sphenoid Sinus Anatomy for Presurgical Planning with Free OSIRIX Software

Authors

Javier Abarca-Olivas

¹Department of Neurosurgery, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante University General Hospital, Alicante, Spain
Patrick Bärtschi

²Department of Neurosurgery, Hospital de Jaen, Jaen, Spain
Irene Monjas-Cánovas

³Department of ENT, Alicante University General Hospital, Alicante, Spain
Pablo González-López

¹Department of Neurosurgery, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante University General Hospital, Alicante, Spain
Elena García-Garrigós

⁴Department of Radiology, General University Hospital Alicante, Isabial, Spain
Jose Sánchez-Payá

⁵Department of Epidemiology, General University Hospital Alicante, Isabial, Spain
Pedro Moreno-López

¹Department of Neurosurgery, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante University General Hospital, Alicante, Spain

Abstract

Background A preoperative three-dimensional (3D) surgical field understanding remains a key factor to achieve safer endonasal transsphenoidal endoscopic approaches (ETSE). The aim of this article is to describe how we can get a reliable 3D sphenoidal anatomical reconstruction for surgical planning by using a user-friendly, accurate, and free image software.

Methods Free computer software (OSIRIX Medical Imaging Software) was used to create in a personal computer a three-dimensional (3D) reconstruction of the sphenoid sinus (SS) based on head computed tomography angiographies (CTAs) from a series of 67 patients who were operated for sellar tumors during a 4-year period (March 2016 to March 2020). The aim of the 3D reconstruction with OSIRIX was to reveal preoperatively the most important intrasphenoidal structures seen from the endonasal point of view.

Results The intraoperative visible sphenoidal structures were previously recognized in the virtual 3D reconstructed image with 100% of specificity (SP) and positive predictive value. The OSIRIX view by using region of interest points allowed us to see preoperatively the internal carotid artery parasellar course even in those cases in which it was hidden by bone or tumor. Moreover, the 3D reconstruction was able to provide a clear differentiation between the tumor and the pituitary gland when both structures were in contact with the sellar floor.

Conclusion Our experience with the OSIRIX software from CTA as preoperative planning for endonasal pituitary surgery was valuable, because it gave us access in simple way to a free and reliable 3D image of the SS.

Keywords

sphenoid sinus - pituitary surgery - endoscopic transsphenoidal approach - 3D reconstruction

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