{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T02:34:09Z","timestamp":1779330849954,"version":"3.51.4"},"reference-count":39,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The oculomotor cistern (OMC) is a meningeal cuff filled with CSF that contains the oculomotor nerve (cranial nerve [CN] III) at the level of the lateral wall of the cavernous sinus. Only a few studies have investigated the involvement of the OMC by pituitary adenomas (pituitary neuroendocrine tumors [PitNETs]), mainly with relatively small case series. The aim of this study was to perform a histomorphological description of the OMC and systematically analyze its involvement by PitNETs from radiological, clinical, and surgical perspectives.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Ten hemisellae from formalin-fixed specimens were studied with 3-\u00b5m sections. Digital image analysis software was used for morphological and quantitative assessments. Clinical, radiological, surgical, and histological data of patients undergoing endoscopic transsphenoidal surgery for PitNETs at the University of Brescia, Italy, between 2014 and 2021 were recorded. OMC involvement was graded as not compressed, compressed, and invaded. The same surgical team operated on all patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The OMC had an elliptical shape with an average area of 3.1 mm<jats:sup>2<\/jats:sup> and a length of 5.5 mm. No cisternal points of weakness were recognized in the histomorphological study.<\/jats:p>\n<jats:p>Of 315 patients, 246 had complete data: apoplexy and CN III palsy were documented in 6.9% and 8.5%, respectively. OMC compression and invasion were recorded in 106 (43.1%) and 23 (9.3%) patients. Significant associations between OMC involvement and PitNET dimensions (p &lt; 0.001), Knosp grade (p &lt; 0.001), preoperative oculomotor palsy (p &lt; 0.001), Ki-67 percentage (p = 0.009), and recurrence\/progression of residual tumor (p = 0.008) were found. A new postoperative CN III palsy was evident in 2%: transient in 4 cases, and persistent in 1 patient treated for a recurrent PitNET who experienced a local infection complication. Preoperative CN III palsy improved in 10 cases.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Significant OMC involvement by PitNETs might be underrecognized, but it can be treated using the endoscopic transsphenoidal approach, and it affects patient outcomes.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.5.jns232626","type":"journal-article","created":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T01:25:09Z","timestamp":1727486709000},"page":"1-11","source":"Crossref","is-referenced-by-count":2,"title":["The oculomotor cistern and pituitary adenomas: anatomical and clinical study"],"prefix":"10.3171","author":[{"given":"Simona","family":"Serioli","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Division of Neurosurgery, Spedali Civili of Brescia, University of Brescia, Italy;"},{"name":"Neurosurgery, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Buffoli","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Section of Anatomy and Physiopathology, University of Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marika","family":"Vezzoli","sequence":"additional","affiliation":[{"name":"Department of Molecular and Translational Medicine, Unit of Biostatistics, University of Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Franco","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Section of Anatomy and Physiopathology, University of Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"Agosti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Division of Neurosurgery, Spedali Civili of Brescia, University of Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Costanza Maria","family":"Zattra","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Division of Neurosurgery, Spedali Civili of Brescia, University of Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucio","family":"De Maria","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Division of Neurosurgery, Spedali Civili of Brescia, University of Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Mattavelli","sequence":"additional","affiliation":[{"name":"Department of Surgical Specialties, Radiological Sciences, and Public Health, Unit of Otorhinolaryngology\u2013Head and Neck Surgery, ASST Spedali Civili of Brescia, University of Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Rigante","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology and Head-Neck Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University School of Medicine, Rome, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Section of Otorhinolaryngology\u2013Head and Neck Surgery, University of Padua, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PierPaolo","family":"Mattogno","sequence":"additional","affiliation":[{"name":"Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena","family":"Hirtler","sequence":"additional","affiliation":[{"name":"Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Austria;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Rezzani","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Section of Anatomy and Physiopathology, University of Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Herman","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, AP-HP, H\u00f4pital Lariboisi\u00e8re, Paris Diderot University, Paris, France;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damien","family":"Bresson","sequence":"additional","affiliation":[{"name":"Neurosurgery, H\u00f4pital Foch, Ile-de-France, France;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Department of Surgical Specialties, Radiological Sciences, and Public Health, Unit of Otorhinolaryngology\u2013Head and Neck Surgery, ASST Spedali Civili of Brescia, University of Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Maroldi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Division of Radiology, University of Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Gasparotti","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Unit of Neuroradiology, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Gaudino","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences, Institute of Radiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University School of Medicine, Rome, Italy; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piero","family":"Nicolai","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Section of Otorhinolaryngology\u2013Head and Neck Surgery, University of Padua, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco Maria","family":"Fontanella","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Division of Neurosurgery, Spedali Civili of Brescia, University of Brescia, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro Luigi","family":"Poliani","sequence":"additional","affiliation":[{"name":"Unit of Pathology, Vita-Salute San Raffaele University, IRCCS San Raffaele, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liverana","family":"Lauretti","sequence":"additional","affiliation":[{"name":"Neurosurgery, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy;"},{"name":"Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Olivi","sequence":"additional","affiliation":[{"name":"Neurosurgery, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy;"},{"name":"Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Doglietto","sequence":"additional","affiliation":[{"name":"Neurosurgery, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy;"},{"name":"Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, 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