Anatomical aspects in the transsphenoidal–transethmoidal approach to the optic canal: An anatomic–cadaveric study

Yılmazlar, Selçuk; Saraydaroğlu, Özlem; Korfalı, Ender

doi:10.1016/j.jcms.2011.10.008

Cited by 33 publications

(34 citation statements)

References 51 publications

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“…They could be identified comprehensively by their morphologies and adjacent anatomical landmarks. Our results were consistent with the anatomic study by Selcuk et al, [14] suggesting that protection of the prominence of optic canal, prominence of internal carotid artery and tuberculum sellae are of great significance.…”

Section: Discussionsupporting

confidence: 93%

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Anatomic study and clinical significance of extended endonasal anterior skull base surgery

Wang

et al. 2014

Neurol India

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During the endonasal approach for anterior skull base surgery, full advantage of the surgical corridor made by the middle turbinate resection should be taken. To control intraoperative bleeding, it is critical to identify anterior and posterior ethmoidal artery. Identification and protection of medial orbital wall and the optic nerve, and controlling the ranges of anterior basicranial craniotomy are of great importance for surgical safety.

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Section: Discussionsupporting

confidence: 93%

“…As a result, a series of basic scientific observations have been focused on the applied anatomy. [12][13][14] However, prevention of bleeding during surgery and delayed postoperative bleeding is rarely studied. [6] Identification of anatomical landmarks and their relations during endonasal approach is important for bleeding control.…”

Section: Introductionmentioning

confidence: 99%

Anatomic study and clinical significance of extended endonasal anterior skull base surgery

Wang

et al. 2014

Neurol India

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“…Several authors have recommended being cautious while opening the dura at the vicinity of the optic nerve during EEA without providing practical landmarks to safely expose the OphA. 1,15,45 According to our results, the opticotubercular line (passing through the medial vertex of the LOCR and midtubercular recess point) was a useful guide in localizing the OphA origin. The origin of the OphA was usually found on this line within 4 mm of the medial opticocarotid point (Fig.…”

Section: Dural Opening and Exposure Of The Ophamentioning

confidence: 63%

Anatomical assessment of the endoscopic endonasal approach for the treatment of paraclinoid aneurysms

Meybodi¹,

Moreira²,

Little³

et al. 2019

Journal of Neurosurgery

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OBJECTIVEEndoscopic endonasal approaches (EEAs) are increasingly being incorporated into the neurosurgeon’s armamentarium for treatment of various pathologies, including paraclinoid aneurysms. However, few anatomical assessments have been performed on the use of EEA for this purpose. The aim of the present study was to provide a comprehensive anatomical assessment of the EEA for the treatment of paraclinoid aneurysms.METHODSFive cadaveric heads underwent an endonasal transplanum-transtuberculum approach to expose the paraclinoid area. The feasibility of obtaining proximal and distal internal carotid artery (ICA) control as well as the topographic location of the origin of the ophthalmic artery (OphA) relative to dural landmarks were assessed. Limitations of the EEA in exposing the supraclinoid ICA were also recorded to identify favorable paraclinoid ICA aneurysm projections for EEA.RESULTSThe extracavernous paraclival and clinoidal ICAs were favorable segments for establishing proximal control. Clipping the extracavernous ICA risked injury to the trigeminal and abducens nerves, whereas clipping the clinoidal segment put the oculomotor nerve at risk. The OphA origin was found within 4 mm of the medial opticocarotid point on a line connecting the midtubercular recess point to the medial vertex of the lateral opticocarotid recess. An average 7.2-mm length of the supraclinoid ICA could be safely clipped for distal control. Assessments showed that small superiorly or medially projecting aneurysms were favorable candidates for clipping via EEA.CONCLUSIONSWhen used for paraclinoid aneurysms, the EEA carries certain risks to adjacent neurovascular structures during proximal control, dural opening, and distal control. While some authors have promoted this approach as feasible, this work demonstrates that it has significant limitations and may only be appropriate in highly selected cases that are not amenable to coiling or clipping. Further clinical experience with this approach helps to delineate its risks and benefits.

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“…9 After the opening of the aperture of the sphenoidal sinus and the resection of the mucosa in the sphenoidal sinus, the TR and the middle lowest point of the SF can be located easily and are regarded as ideal bony landmarks during endoscopic transphenoid surgery. 10,11 Because there is no protuberance of PCP formed into the sphenoid sinus, the location of the basement of PCP can be found through TR and the mid-lowest point of the SF. This study indicated that it is 7.04 ± 0.43 mm posterior from the TR or 12.11 ± 0.44 mm from the middle lowest point of SF.…”

Section: Location Of Pcp In Transphenoid Approachmentioning

confidence: 99%

Anatomical Study of Posterior Clinoid Process (PCP) and Its Clinical Meanings

Cheng¹,

Chen²,

Zhou³

et al. 2015

Journal of Craniofacial Surgery

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The shape of PCP is various, and the analysis of its relationship to the important structures around it is of great value. In addition, the preoperative radiological evaluation plays a major role in patients considered for endoscopic sinus surgery. Detailed preoperative analysis of the anatomy of the sphenoid sinus and its boundaries is crucial in facilitating entry to the pituitary fossa and reducing intraoperative complications.

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Anatomical aspects in the transsphenoidal–transethmoidal approach to the optic canal: An anatomic–cadaveric study

Cited by 33 publications

References 51 publications

Anatomic study and clinical significance of extended endonasal anterior skull base surgery

Anatomic study and clinical significance of extended endonasal anterior skull base surgery

Anatomical assessment of the endoscopic endonasal approach for the treatment of paraclinoid aneurysms

Anatomical Study of Posterior Clinoid Process (PCP) and Its Clinical Meanings

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