Objective: To use non-X-ray comprehensive measurement for accurate localization of sublabio-septo-sphenoidal approach for shortening operating duration, decreasing hemorrhage, and increasing the success rate of operation.
Methods: Operations in 122 patients suffering from tumors in the sella turcica region used non-X-ray localizations including localization by the angle formed by the glalella, anterior nasal spina and anterior nasal spina-sella turcica; localization by the angle formed by the upper incisors, anterior nasal spina and anterior nasal spina-sella turcica; and localization by anatomical markers (determination of the midline by the nasoseptum and vomer; determination of the anterior wall of the sphenoidal sinus by the foramen of the sphenoidal sinus and vomer body; correction of the site by septum of the sphenoidal sinus; location of the center of saddle by the shape of the floor of the sella and determination of the approach direction by the damaged area in the sella turcica region) were comprehensively employed. Additionally, X-ray localization was used to correct its accuracy.
Results: Non-X-ray comprehensive localization was applied to 40 patients for determining the site and depth of the floor of the sella, and the preciseness of the measurement was confirmed with X-ray. Operating duration averages 2.2 hours. Non-X-ray localization was directly applied to 82 patients for comprehensively measuring the floor of the sella, and operations were successful. Operating duration averages 1.5 hours and blood transfusion averages 200 ml. No deaths and severe complications occurred.
Conclusion: Non-X-ray comprehensive measurement can be directly applied for precisely localizing the floor of the sella.