CPC width does not affect the efficacy of endoscopic EEA excision to remove cranial pharynx tumor

Ref: Omay SB,et al.
 J Neurosurg2018 Sep;129 (3):642-647doi: 10.3171/2017.6.JNS163188Epub 2017 Nov 24cranial pharynx tumor originated in the pituitary handle, and the lesions of adult patients are usually located above the cross-view and grow to the third ventricleExpanding the bypass through the nose (the extended endonasal approach, EEA) can remove the tumor by looking at the gap between the lower part of the eye and above the pituitary, i.ethe visual cross-pituit corridor (CHIasm-pituitcorridor, CPC) (Figure 1)The current view is that CPC stenosis can lead to visual impairment and difficulty in removing tumors completelyRecently, Sacit Bulent Omay of New York Presbyterian Hospital, Weill Cornell Medical School in New York, USA, and other studies on the effects of cross-pitor dyslecity stenosis on the overall rate of vision and tumor in patients with transnasal tube removal in endoscopy patients, published in J Neurosurg in September 20181 case of intra-surgery photographs of the expansion of the nasal lynx to remove the cranial pharynx tumor, showing the pituitary, visual crossand and visual cross-pituitary channel (CPC)the retrospective study included patients who had EEA surgery to remove craniopharyum tube tumors from July 2004 to August 2016Using preoperative MRI bricemer T1 enhancement imaging, the vertical distance (CTOT) of the CPC width and the highest tumor point is measured with the visual cross to the lowest point of the body pressure (Figures 2, 3)The ratio of CPC to CTOT is defined as channel index (corridor index, CI) as the difficulty parameter for evaluating tumor removal by EEAThe researchers analyzed the relationship between CI and tumor excision, endocrine function and vision prognosisFigure 2Preoperative MRI phase T1 enhanced imagingThe arrow shows the CPC width below the cross to the top of the pituitary bodyFigure 3Preoperative MRI-phase T1 enhanced imaging;results showed that of the 34 patients included in the study, CPC was 5.2-19.1mm, with an average of 10.1mm, CTOT was 0-28.3mm with an average of 12.8mm, and CI was 0.4 to infinity with a median of 0.832 cases (94.1%) were completely excisioned and 2 cases were fully excisiondCPC value and CI value have no obvious relationship with tumor total cutAfter surgery, 44% of patients developed endocrine dysfunction and 6% of vision deterioratedThere was no correlation between the new incidence and vision deterioration of endocrine disorders and ci valuesfinally the author points out that the visual cross position, the visual cross-pitoma channel width, the vertical distance between the tumor and the visual cross-body pressure line can not be regarded as an endoscope can be expanded by nasal access to remove craniopharypharythal tube tumor judgment criteria;