García-Pastor C, Moreno-Jiménez S, Gómez-Llata AG

Language: Spanish
References: 18
Page: 212-220
PDF size: 109.55 Kb.

ABSTRACT

Objective: to describe main anatomic landmarks of the sellar and paraclinoid region, including their osseous, dural and vascular structures, also the main craneometric measures. Methods: we studied 35 human specimens, 25 of them dry craniums and 10 wet specimen with dural sheets, vascular and neural elements. The description was made under magnification through a surgical microscope. Results: tubercullum sellae configuration was an osseous rod in 54.3%; in 51.4% of the specimens middle clinoid processes were found, and in 25.7% foramen carotid clinoid; in 5.7% of them interclinoid osseous bridge was found. Average supraorbitarium-tubercullar distance was 51.2mm; and for pterion-tubercullar distance was 52.4 mm. Also presented are sellar measures, getting as average volume 743 mm³. In all our specimens the ophthalmic artery emerged from the ophthalmic segment of the internal carotid artery. In all specimens were also observed both carotid rings both proximal and distal, and in 70% of them carotid cavum was observed. Apart from these, anterior, posterior and basilar intracavemous sinuses are described. Conclusions: tubercullum sellar configuration had not been reported before, and inmost of the cases there is no presence of tubercullum as such. Craneometric measures are inresting due to the fact that they are comparable to those reported in other series.

REFERENCES

1. De Jesus O, Sekhar LN, Riedel CJ. Clinoid and paraclinoid aneurysms: surgical anatomy, operative techniques and outcome. Surg Neurol 1999; 51:477-87.

2. Day AL. Aneurysms of the ophtalmic segment. A clinical and anatomical study. J Neurosurg 1990; 72: 677-91.

3. Bouthillier A, van Loveren H, Keller J. Segments of the internal carotid artery: A New Classification. Neurosurgery 1996; 38 (3): 425-33.

4. Kaplan H, Bowder J, Krieger A. Intercavernous connections of the cavernous sinuses. The superior and inferior circular sinuses. J Neurosurg 1976; 45: 166-8.

5. Rosenberg M. Neuro-ophtalmology. En Wilkins R, Renganchary S. Neurosurgery. 2a. edición USA. Editorial Mc Graw-Hill,1999; vol II: 87-116.

6. Masdeu J. The localization of lesions affecting the visual pathways en Brazis P, Masdeu J, Biller J. Localization in clinical neurology. 2a edicion USA Editorial Little, Brown and Company 1990.

7. Renn W, Rhoton A. Microsurgical anatomy of the sellar region. J Neurosurg 1975 Sep 43:288-98.

8. Min J, Romano A, Sanan A, van Loveren H, Keller J. Microsurgical anatomic features and nomenclatura of the paraclinoid region. Neurosurgery 2000; 46(3):670-82.

9. Plaut M. Anatomic variations of the sella turcica. Surg Neurol 1978; 10: 259-61.

10. Cabeza ósea en Testut L, Latarjet A. Tratado de anatomía humana. Barcelona Editorial Salvat, 1990.

11. Van Loveren H, Guthikonda M, El-Kalliny M, Keller J. Surgical anatomy of the cavernous sinus. En Wilkins R, Renganchary S, editores. Neurosurgery Volume II USA Mc Graw Hill 1996.

12. Nutik SL. Renoval of the anterior clinoid process for exposure of the proximal intracranial carotid artery. J Neurosurg 1988; 69:529-34.

13. Nutik S. Carotid paraclinoid aneurysms with intradural origin and intracavernous location. J Neurosurg 1978; 48: 526-33.

14. Perneczky A, Knosp E, Volkapic P, Czech T. Direct surgical approach to intraclinoidal aneurysms. Acta Neurochir (Wie) 1985; 76:36-44.

15. Knosp E, Muller G, Perneczky A. The paraclinoid carotid artery: anatomical aspects of a microneurosurgical approach. Neurosurgery 1988; 22:896-901.

16. Kobayashi S, Kyoshima K, Gibo H, Ende S, Takemae T, Sugita K. Carotid cave aneurysms of the internal carotid artery. J Neurosurg 1989; 70:216-21.

17. Hitotsumatsu T, Natori Y, Matsushima T, Fukui M, Tateishi J. Micro-anatomical study of the carotid cave. Acta Neurchir (Wien) 1997; 139:869-74.

18. Seoane E, Rhoton A, Oliveira E. Microsurgical anatomy of the dural collar (carotid collar) and rings around the clinoid segment of the internal carotid artery. Neurosurgery 1998;42(4) 869-86.