Surface Landmarks for the Junction Between the Transverse and Sigmoid Sinuses

Tubbs, R. Shane; Loukas, Marios; Shoja, Mohammadali Mohajel; Bellew, Michael P.; Cohen-Gadol, Aaron

doi:10.1227/01.neu.0000341517.65174.63

Cited by 39 publications

(56 citation statements)

References 11 publications

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“…Unfortunately, the squamosal and parietomastoid sutures are often difficult to recognize during craniotomy, especially in older adults. Therefore, the SP and the intersection of the SCSS are not reliable landmarks for the ASTS [8,17]. The asterion is located at the junction of the parietomastoid, lambdoid and occipitomastoid sutures.…”

Section: Discussionmentioning

confidence: 99%

“…The transverse-sigmoid sinus junction was defined as the transitional zone where the transverse sinus ended by the vertical descending segment of the sigmoid sinus; the ASTS and IMTS were identified as the anterosuperior and inferomedial points of the junction, respectively [8,11] (Fig. 1).…”

Section: Definations Of the Asts Imts And Tmnmentioning

confidence: 99%

“…Traditionally the squamosal-parietomastoid suture junction (SP) and asterion have been regarded as the classic landmarks for assisting with identifying the ASTS and IMTS, respectively [5][6][7]. However, the cranial sutures is covered by periosteum, and this condition often leads to the inability to recongnize the SP and asterion [7,8]. Therefore, it is necessary to find a more reliable and practical method to precisely locate the key points.…”

Section: Introductionmentioning

confidence: 99%

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Mastoid notch as a landmark for localization of the transverse-sigmoid sinus junction

Lei

et al. 2020

BMC Neurol

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Background: The top of the mastoid notch (TMN) is close to the transverse-sigmoid sinus junction. The spatial position relationship between the TMN and the key points (the anterosuperior and inferomedial points of the transverse-sigmoid sinus junction, ASTS and IMTS) can be used as a novel method to precisely locate the sinus junction during lateral skull base craniotomy.Methods: Forty-three dried adult skull samples (21 from males and 22 from females) were included in the study. A rectangular coordinate system on the lateral surface of the skull was defined to assist the analysis. According to sex and skull side, the data were divided into 4 groups: male&left, male&right, female&left and female&right. The distances from the ASTS and IMTS to the TMN were evaluated on the X-axis and Y-axis, symbolized as ASTS&TMN_ x, ASTS&TMN_y, IMTS&TMN_x and IMTS&TMN_y.Results: Among the four groups, there was no significant difference in ASTS&TMN_x (p = 0.05) and ASTS&TMN_y (p = 0.3059), but there were significant differences in IMTS&TMN_x (p < 0.001) and IMTS&TMN_y (p = 0.01), and multiple comparisons indicated that there were significant differences between male&left and female&left both in IMTS&TMN_x (p = 0.0006) and in IMTS&TMN_y (p = 0.0081). In general, the ASTS was located 1.92 mm anterior to the TMN on the X-axis and 27.01 mm superior to the TMN on the Y-axis. For the male skulls, the IMTS was located 3.60 mm posterior to the TMN on the X-axis and 14.40 mm superior to the TMN on the Y-axis; for the female skulls, the IMTS was located 7.84 mm posterior to the TMN on the X-axis and 19.70 mm superior to the TMN on the Y-axis. Conclusions:The TMN is a useful landmark for accurately locating the ASTS and IMTS.

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Section: Discussionmentioning

confidence: 99%

Section: Definations Of the Asts Imts And Tmnmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mastoid notch as a landmark for localization of the transverse-sigmoid sinus junction

Lei

et al. 2020

BMC Neurol

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“…In the retrosigmoid keyhole approach, the transversesigmoid sinus junction should be fully exposed (3,23). In the past, neurosurgeons generally depend on the asterion and related sutures to determine the position of the transversesigmoid sinus junction (25,27,29). However, the transversesigmoid sinuses and junction sites of different people exhibit different anatomical characteristics (13,18,21,28,30), The most common complication in the retrosigmoid approach is CSF leakage (5), which is partly caused by the incomplete sealing of the opened mastoid air cell (10).…”

Section: █ Discussionmentioning

confidence: 99%

Clinical application of scalp markers and three-dimensional sliced computer tomography reconstructions of the skull transverse-sigmoid sinus groove in the retrosigmoid approach

Wang

Han²,

You³

et al. 2017

Turkish Neurosurgery

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“…A vertical line is also drawn over the mastoid groove to intersect the first line. We have previously demonstrated that this point of intersection approximates the junction of transverse and sigmoid dural sinuses[3] and should therefore be designated as the summit of the curvilinear incision [Figure 3]. …”

Section: An Alternative Approach: the Curvilinear Incisionmentioning

confidence: 99%

A review of skin incisions and scalp flaps for the retromastoid approach and description of an alternative technique

Kemp

Cohen-Gadol²

2011

Surg Neurol Int

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Background:The retromastoid approach has been effective in exposing the cerebellopontine angle for resection of a variety of lesions, including vestibular schwannomas and decompression of cranial nerves. The following incisions and their variations have been most commonly used for the retromastoid approach: linear (and its variations, such as “lazy S-shaped”) and “C-shaped” incision.Methods:Herein, we describe a curvilinear incision and compare its advantages and disadvantages with the other previously described incisions based on the senior author's experience with 120 retromastoid operations.Results:The senior author has used the curvilinear incision for the last 70 of 120 patients who underwent retromastoid operations. Of these, one patient encountered postoperative cerebrospinal fluid (CSF) leakage through the incision, requiring a repeat operative wound revision, and one patient suffered from a soft asymptomatic pseudomeningocele. Among the initial 50 patients who underwent a linear incision, one patient suffered from a CSF leakage managed with local wound care and another patient required a repeat operation for a tense pseudomeningocele. No wound breakdown or infection was encountered in either group.Conclusions:The curvilinear incision is simple and efficient and may provide a shorter working distance and protect the suboccipital muscles and associated neurovascular bundle.

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Surface Landmarks for the Junction Between the Transverse and Sigmoid Sinuses

Cited by 39 publications

References 11 publications

Mastoid notch as a landmark for localization of the transverse-sigmoid sinus junction

Mastoid notch as a landmark for localization of the transverse-sigmoid sinus junction

Clinical application of scalp markers and three-dimensional sliced computer tomography reconstructions of the skull transverse-sigmoid sinus groove in the retrosigmoid approach

A review of skin incisions and scalp flaps for the retromastoid approach and description of an alternative technique

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