Letter: Visual Field Defects in the Setting of Suprasellar Lesions: Could Vascularization Patterns of the Optic Chiasm Play a Role?

Agosti, Edoardo; Alexander, A. Yohan; Pinheiro‐Neto, Carlos D.; Link, Michael J.; Meyer, Fredric B.; Peris-Celda, María

doi:10.1227/neu.0000000000002069

Cited by 3 publications

(20 citation statements)

References 11 publications

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“…The pituitary stalk and superior hypophyseal arteries with chiasmatic branches are located in the center of this corridor [19,20,21 ▪ ]. It is essential to preserve these chiasmatic branches that vascularize the optic nerves and chiasm [22].…”

Section: Transsphenoidal Corridormentioning

confidence: 99%

Neurosurgery for the rhinologist

Nizzola,

Leonel,

Peris-Celda

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review The purpose of this review is to provide a comprehensive anatomical appraisal of the neurosurgical anatomy exposed through the endonasal and paranasal sinuses routes, focusing on the most common expanded endonasal approaches (EEAs) as well as recent advances in this surgical field. Recent findings The EEAs are redefining the management of skull base pathology. Neurovascular structures previously considered a limitation, can be now approached through these surgical corridors. Advances in this field include the development of new surgical techniques and routes that allow better visualization and access to pathologies located in the ventral skull base. Understanding the surgical anatomy related to EEAs is essential not only for neurosurgeons but also for rhinologists. Summary Knowledge of the surgical anatomy of the most common EEAs that utilize paranasal sinuses as a surgical corridor enables more effective management of complex skull base pathologies. Comprehensive anatomical knowledge of these corridors and the surrounding neurovascular structures is crucial to maximize benefits of EEAs and improve outcomes.

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Section: Transsphenoidal Corridormentioning

confidence: 99%

Neurosurgery for the rhinologist

Nizzola,

Leonel,

Peris-Celda

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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“…2 Our findings align closely with Agosti et al concerning the origin of arterial supplies for the superior and inferior surfaces of the OCh. 1,2 An added value of our study is the objective assessment of the intrinsic vascularization of the OCh through the use of 3 microscanners on barium sulfate-injected OCh. In our work, we studied existing literature and reported our results.…”

mentioning

confidence: 99%

“…We concur with Agosti et al regarding the involvement of the vascularization of the optic chiasm (OCh) in visual deficits due to inferior compression of the OCh. 1…”

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confidence: 99%

“…We agree with Agosti et al about the importance of the superior hypophyseal artery, but our findings indicate the involvement of the posterior communicating artery rather than the first segment of the posterior cerebral artery. 1,2…”

mentioning

confidence: 99%

“…e concur with Agosti et al regarding the involvement of the vascularization of the optic chiasm (OCh) in visual deficits due to inferior compression of the OCh. 1 In a previous study, we dissected 13 different formalin-fixed colored (latex or barium sulfate injected) anatomic specimens and investigated the extrinsic and intrinsic vascularization of the OCh. 2 Our findings align closely with Agosti et al concerning the origin of arterial supplies for the superior and inferior surfaces of the OCh.…”

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Commentary: Visual Field Defects in the Setting of Suprasellar Lesions: Could Vascularization Patterns of the Optic Chiasm Play a Role?

Salaud

2024

Neurosurgery

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In Reply: Commentary: Letter: Visual Field Defects in the Setting of Suprasellar Lesions: Could Vascularization Patterns of the Optic Chiasm Play a Role?

Agosti,

Alexander,

Pinheiro-Neto

et al. 2024

Neurosurgery

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In her insightful commentary, Dr Salaud raises important points regarding the vascularization patterns of the optic chiasm (OCh) and their potential role in visual field defects associated with suprasellar lesions. Dr Salaud's comprehensive dissection of 13 different formalinfixed anatomic specimens and her investigation into the extrinsic and intrinsic vascularization of the OCh provide valuable insights that complement our findings. [2][3][4] One notable aspect of Dr Salaud's study is the objective assessment of the intrinsic vascularization of the OCh through the use of 3 microscanners on barium sulfateinjected OCh. 1 This approach enhances the understanding of the intrinsic networks, particularly the lateral and central intrinsic networks, providing a more detailed perspective on the blood supply to the OCh. The identification of capillary networks and their distribution in the lateral and central portions of the OCh enriches our understanding of the intricate vascular anatomy in this region.Our paper highlighted the involvement of the anterior communicating artery and the first segment of the anterior cerebral artery in vascularizing the superior surface of the OCh. 2 Dr Salaud's work adds depth to this understanding by emphasizing the role of the superior hypophyseal artery in vascularizing the anterosuperior part of the OCh. Additionally, her observations regarding the inferior surface's vascularization by the superior hypophyseal artery and the posterior communicating artery contribute valuable nuances to the discussion. 1 Furthermore, the identification of intrinsic networks and their detailed description, including the lateral intrinsic network extending into the lateral portions of the OCh and the optic tract, enhances our comprehension of the microvasculature supplying the OCh. 1 The convergence of capillaries from the left and right sides toward the center of the OCh underscores the complexity of the intrinsic vascularization and its potential implications for visual function.We concur with Dr Salaud regarding the dual responsibility of arterial and direct nerve compression in visual deficits associated with inferior compression of the OCh. 1,2 We acknowledge the relevance of the posterior communicating artery in the vascular supply to the inferior surface of the OCh, providing additional insights into the intricate network of vessels contributing to the blood supply in this region. 1,2 In conclusion, Dr Salaud's commentary significantly contributes to the ongoing discussion on the vascularization patterns of the OCh and their implications for visual function in the context of suprasellar lesions. This aligns with our recommendations for surgeons to exercise caution and respect these arteries to prevent adverse visual outcomes. 2 We deeply appreciate the interest in our paper and the opportunity for discussion. Ethical ApprovalApproval was granted by Mayo Clinic Institutional Review Board (17-005898). All human cadaveric studies have been performed in accordance with the ethical standards laid down i...

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Letter: Visual Field Defects in the Setting of Suprasellar Lesions: Could Vascularization Patterns of the Optic Chiasm Play a Role?

Cited by 3 publications

References 11 publications

Neurosurgery for the rhinologist

Neurosurgery for the rhinologist

Commentary: Visual Field Defects in the Setting of Suprasellar Lesions: Could Vascularization Patterns of the Optic Chiasm Play a Role?

In Reply: Commentary: Letter: Visual Field Defects in the Setting of Suprasellar Lesions: Could Vascularization Patterns of the Optic Chiasm Play a Role?

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