Intracavernous Branches of the Internal Carotid Artery Through an Endoscopic Endonasal Approach: Anatomical Study and Review of the Literature

Aibar-Durán, Juan Ángel; Muñoz-Hernández, Fernando; Asencio-Cortés, Carlos; Montserrat-Gili, Joan R.; Gras-Cabrerizo, Juan R.; Mirapeix, Rosa M.

doi:10.1016/j.wneu.2021.04.046

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…[4][5][6]10 Although preserved in 2 of their cases, Miranda et al recommended routine coagulation of IHA to perform the transcavernous posterior clinoidectomy. 4 Furthermore, Aibar-Durán et al 7 believed that IHA must be cut to accomplish transcavernous posterior clinoidectomy. IHA division, no doubt, widens the surgical corridor between the pituitary tunica and the carotid artery within the cavernous sinus, allowing effective pituitary hemitransposition to reach the superior aspect of the posterior clinoid, facilitating its removal.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 The IHA is typically a branch of the meningohypophyseal trunk or may arise directly from the cavernous carotid artery to supply the posterior lobe of the pituitary gland. 6,7 Although unilateral IHA sacrifice is well tolerated in most patients, some may experience transient posterior pituitary dysfunction leading to protracted recovery. 4 However, as our knowledge of anatomy and endoscopic surgery evolves, we have found it safe and favorable to preserve the IHA during posterior clinoidectomy to avoid the risk of transient postoperative diabetes insipidus (DI).…”

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confidence: 99%

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Endoscopic Endonasal Transcavernous Posterior Clinoidectomy With Inferior Hypophyseal Artery Preservation for a Cavernous Sinus Hemangioma: Technical Case Report

Gosal

Bhuskute

Alsavaf

et al. 2023

Operative Neurosurgery

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BACKGROUND AND IMPORTANCEUnilateral inferior hypophyseal artery (IHA) sacrifice is routinely performed during endoscopic endonasal transcavernous interdural posterior clinoidectomy. However, unilateral IHA sacrifice presents the risk of temporary postoperative diabetes insipidus. We present a case demonstrating the feasibility of endoscopic endonasal transcavernous posterior clinoidectomy without IHA sacrifice.CLINICAL PRESENTATION:A 62-year-old man presented with progressive weakness of his left oculomotor and abducens nerves. MRI of the brain revealed a small lesion suspicious for hemangioma in the posterior compartment of the left cavernous sinus. Following an endoscopic endonasal transcavernous approach using the interdural peeling technique, an IHA-sparing posterior clinoidectomy was performed to provide access to the tumor in the posterior cavernous sinus. After complete resection, the patient's symptoms improved and a diagnosis of cavernous sinus hemangioma was confirmed by histopathology.CONCLUSIONUnilateral IHA preservation may be performed safely when performing a transcavernous interdural posterior clinoidectomy. IHA preservation can be readily achieved if the artery is redundant, the lesion is small and located in the posterior cavernous sinus, and there is a short posterior clinoid, ultimately avoiding the risk of transient postoperative diabetes insipidus.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Endoscopic Endonasal Transcavernous Posterior Clinoidectomy With Inferior Hypophyseal Artery Preservation for a Cavernous Sinus Hemangioma: Technical Case Report

Gosal

Bhuskute

Alsavaf

et al. 2023

Operative Neurosurgery

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“…This retrospective study provided an overview of the main anatomical variants of ICAs in relationship with the sphenoidal sinus. By definition, the internal carotid arteries, in their intracavernous course, exhibit a protrusion within the sphenoid sinus, similar to the optic nerve [ 15 ]. This results in a certain degree of indentation within the sinus.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Variants of Internal Carotid Artery—Results from a Retrospective Study

et al. 2023

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Background and Objectives: The internal carotid artery (ICA) is a vascular structure that can be easily injured during sinus endoscopic procedures, and surgeons should be familiar with its anatomic variants. The aim of this study was to describe the anatomical variations in the internal carotid artery in relationship to sphenoidal sinuses, using computed tomography (CT). Materials and Methods: In this retrospective study, we evaluated the variations of the ICA in relationship to sphenoidal sinuses in a cohort of 600 patients who were assessed between January 2020 and December 2022 in ‘Saint Spiridon’ Emergency Hospital, Iasi, Romania. Descriptive statistics were used to characterize our data. Results: The most prevalent anatomical variant was represented by intrasinusal septa with posterior insertion on the ICA (58.6%), followed by procident ICA (58%) and dehiscent ICA (52%). We could not find any statistical significance regarding demographic characteristics among groups. Conclusions: A thorough CT examination should be performed before functional endoscopic sinus surgery, with the identification of anatomical variants of the ICA, in order to prevent its injury with potentially fatal consequences.

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Anatomy of the Dorsal Meningeal Artery Including Its Variations: Application to Skull Base Surgery and Diagnostic and Interventional Imaging

McCormack

Nerva

et al. 2021

World Neurosurgery

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Intracavernous Branches of the Internal Carotid Artery Through an Endoscopic Endonasal Approach: Anatomical Study and Review of the Literature

Cited by 4 publications

References 16 publications

Endoscopic Endonasal Transcavernous Posterior Clinoidectomy With Inferior Hypophyseal Artery Preservation for a Cavernous Sinus Hemangioma: Technical Case Report

Endoscopic Endonasal Transcavernous Posterior Clinoidectomy With Inferior Hypophyseal Artery Preservation for a Cavernous Sinus Hemangioma: Technical Case Report

Anatomical Variants of Internal Carotid Artery—Results from a Retrospective Study

Anatomy of the Dorsal Meningeal Artery Including Its Variations: Application to Skull Base Surgery and Diagnostic and Interventional Imaging

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