ArticleAmerican journal of rhinology & allergy
The use of image-guidance during transsphenoidal pituitary surgery in the United States.
Article in American journal of rhinology & allergy. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- [The advances in the application of image-guided system in endoscopic skull base surgery].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2025Review
- Neuronavigation-assisted pituitary neuroendocrine tumor resection: a systematic review and meta-analysis.Quantitative imaging in medicine and surgery · 2024Article
- Development and prospective validation of an artificial intelligence-based smartphone app for rapid intraoperative pituitary adenoma identification.Communications medicine · 2024Article
- Review
- Skull-Base Surgery-A Narrative Review on Current Approaches and Future Developments in Surgical Navigation.Journal of clinical medicine · 2023Review
- Image-guidance in endoscopic pituitary surgery: an in-silico study of errors involved in tracker-based techniques.Frontiers in surgery · 2023Article
- Outcomes in Pediatric Transsphenoidal Pituitary Surgery Stratified by the Use of Image Guidance: An Analysis of the Kids' Inpatient Database from 1997 to 2016.Journal of neurological surgery. Part B, Skull base · 2021Article
- A multi-subject accuracy study on granular jamming for non-invasive attachment of fiducial markers to patients.International journal of computer assisted radiology and surgery · 2020Article
- Advancing the field of rhinology and allergy.American journal of rhinology & allergyArticle
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3 authors.
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Abstract
backgroundIntraoperative image guidance is a useful modality for transsphenoidal pituitary surgery. However, the outcomes associated with this technology have not been systematically evaluated.
objectiveThe purpose of the study was to quantify complication rates with and without the use of image guidance during transsphenoidal pituitary surgery using a nationwide database with broadly applicable results.
methodsA retrospective analysis of the Nationwide Inpatient Sample was performed from 2007 to 2011. Transsphenoidal pituitary resections for adenomas were identified by International Classification of Diseases-9th Revision, Clinical Modification code. The effect of image guidance on cerebrospinal fluid (CSF) leak complications and cost-benefit was analyzed.
resultsA total of 48,848 transsphenoidal pituitary resections were identified, of which 77.5% were partial resections and 22.5% were complete. Pathologic indications included benign (89.3%), malignant primary (0.6%), and malignant secondary (0.4%). Complications included same-stay death (0.4%), CSF leak (8.8%), postoperative CSF rhinorrhea (1.9%), diabetes insipidus (12.4%), and meningitis (0.4%). Image guidance was employed in 7% (n = 3401) of all cases. When analyzed by modality, computed tomography (CT)-assisted procedures had lower CSF rhinorrhea rates (1.1%) compared with cases with no image guidance (1.9%), whereas magnetic resonance (MR)-assisted procedures had the highest rates (2.7%, χ2 p < 0.001). Rates of CSF leak demonstrated a similar pattern (CT 6.4%, no image guidance 8.9%, MR 9.2%, χ2 p < 0.001). CT-assisted surgery had significantly shorter length of stay (2.9 days) versus no image guidance (3.7 days, p < 0.001), lower total charges ($47,589 versus $62,629, p < 0.001), and lower total cost ($16,748 versus $20,530, p < 0.001).
conclusionsCT-assisted surgery is associated with a lower rate of CSF leak, shorter length of stay, and lower cost compared with patients without image guidance. Further studies that control for severity and extent of disease are warranted to confirm this finding.
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