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Folia Morphologica 2022This study aimed to investigate the incidence, number, diameter, and relative location of the parietal foramen (PF) as well as communication of intracranial and...
BACKGROUND
This study aimed to investigate the incidence, number, diameter, and relative location of the parietal foramen (PF) as well as communication of intracranial and extracranial orifices and their direction, and sagittal suture morphology and length.
MATERIALS AND METHODS
A total of 280 dry Chinese adult skull specimens from the Department of Anatomy, Southern Medical University, were observed and measured. The occurrence rate and quantity of the PF near the sagittal suture were recorded. The aperture of the PF, the vertical distance between PF and sagittal suture, and the linear distance between PF and lambda were measured using a Vernier calliper. The length of the sagittal suture was measured by a flexible ruler; the direction and communication of intracranial and extracranial orifices were detected using a probe.
RESULTS
The total incidence of the PF was 82.86%, slightly higher on the right side than on the left side. The single-foramen type was the most prevalent. The mean diameter of the PF on the left and right sides were 1.02 ± 0.72 mm and 1.07 ± 0.67 mm, respectively, and the diameter of the PF on the sagittal suture was 1.77 ± 0.44 mm. The mean vertical distance between the PF and the sagittal suture was 5.90 ± 2.78 mm and 5.85 ± 2.75 mm on the left and right sides, respectively. The shape of the sagittal suture in the PF area was primarily dentate shaped, with an average arc length of χ = 124.36 ± 7.76 mm, of which the majority were completely healed type. The intracranial and extracranial communication was 39.97%, and the majority of the PF were anteromedial direction.
CONCLUSIONS
The current study provided an anatomical basis for imaging diagnosis and neurosurgery by investigating the incidence, diameter, and relative location of the PF and intracranial and extracranial communication and direction.
Topics: Adult; Humans; East Asian People; Sphenoid Bone; Cranial Sutures
PubMed: 34699055
DOI: 10.5603/FM.a2021.0106 -
Neurology India 2022Despite the evolution of endoscopic techniques, large pituitary adenomas with unfavorable characteristics and irregular anatomical configurations continue to pose a...
BACKGROUND
Despite the evolution of endoscopic techniques, large pituitary adenomas with unfavorable characteristics and irregular anatomical configurations continue to pose a challenge for the dexterity, skills, and patience of endoscopic surgeons. Transcranial surgery retains a significant role in these situations where the tumor access, hemostasis, and dissection around adjoining neurovascular tissues can be controlled efficaciously.
OBJECTIVE
In this report, we describe our experience with transcranial surgery for pituitary adenomas highlighting its safety and versatility in peripheral centers.
METHODS
We accessed the case files and imaging records of pituitary tumors operated between 2001 and 2019 at a private hospital in a major Indian city. The records were analyzed with emphasis on postoperative clinical course, visual, and endocrinological outcomes. The data was analyzed with respect to differences between transcranial and transsphenoidal procedures. Categorical variables were compared with Chi-square test/Fischer's exact test and difference in means evaluated with Welch's t-test.
RESULTS
A total of 178 procedures were performed in 173 patients with pituitary adenoma, who were the subjects of this study. Ninety-eight (56.7%) patients were treated by transsphenoidal excision whereas 80 (46.2%) underwent transcranial procedures (75 primary and five secondary). In the patients operated transcranially, we observed three deaths and nine patients suffered from significant morbidity. Visual outcomes were similar to the group operated transsphenoidally. However, incidence of panhypopituitarism was significantly higher in transcranial procedures; the extent of resection was poorer than transsphenoidal surgeries owing to more extensive nature of tumors.
CONCLUSIONS
In low-volume centers, the endoscopic skills required for transsphenoidal resection of large and complex pituitary adenomas may be scarce. Transcranial surgery, dependent on familiar microsurgical techniques and equipment, may still be viable, safe, and an effective option.
Topics: Humans; Pituitary Neoplasms; Neurosurgery; Sphenoid Bone; Microsurgery; Treatment Outcome; Retrospective Studies; Adenoma
PubMed: 36352606
DOI: 10.4103/0028-3886.359173 -
Arquivos de Neuro-psiquiatria Jun 2001We report a case of infrasellar craniopharyngioma in a 34 year-old woman who presented with progressive headache and diplopia. Computed tomographic and magnetic... (Review)
Review
We report a case of infrasellar craniopharyngioma in a 34 year-old woman who presented with progressive headache and diplopia. Computed tomographic and magnetic resonance images showed a heterogeneous tumor originating from the sphenoid bone with ethmoid sinus and sella turcica extension. A sublabial rhinoseptal transsphenoidal surgery was performed. Craniopharyngiomas with infrasellar development are very rare. Infrasellar craniopharyngioma is uncommon, thirty-five cases has been reported in literature. The embryology, clinical features and radiographic investigation of these tumors are discussed.
Topics: Adult; Craniopharyngioma; Ethmoid Sinus; Female; Humans; Magnetic Resonance Imaging; Paranasal Sinus Neoplasms; Sella Turcica; Skull Neoplasms; Sphenoid Bone; Sphenoid Sinus; Tomography, X-Ray Computed
PubMed: 11460192
DOI: 10.1590/s0004-282x2001000300022 -
World Neurosurgery May 2017Surgery for recurrent/residual pituitary adenomas is increasingly being performed through endoscopic surgery. Whether this new technology has altered the indications and... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVE
Surgery for recurrent/residual pituitary adenomas is increasingly being performed through endoscopic surgery. Whether this new technology has altered the indications and outcomes of surgery is unknown. We conducted a systematic review and meta-analysis of published studies to compare the indications and outcomes between microscopic and endoscopic approaches.
METHODS
A PubMed search was conducted (1985-2015) to identify surgical series of endoscopic endonasal and microscopic transsphenoidal resection of residual or recurrent pituitary adenomas. Data were extracted regarding tumor characteristics, surgical treatment, extent of resection, endocrine remission, visual outcome, and complications.
RESULTS
Twenty-one studies met inclusion criteria. A total of 292 patients were in the endoscopic group, and 648 patients were in the microscopic group. Endoscopic cases were more likely nonfunctional (P < 0.001) macroadenomas (P < 0.001) with higher rates of cavernous sinus invasion (P = 0.012). The pooled rate of gross total tumor resection was 53.5% for the endoscopic group and 46.6% for the microscopic group. Endocrine remission was achieved in 53.0% and 46.7% of patients, and visual improvement occurred in 73.2% and 49.6% for the endoscopic and microscopic groups. Cerebrospinal fluid leak and pituitary insufficiency were higher in the endoscopic group.
CONCLUSION
This meta-analysis indicates that the use of the endoscope to reoperate on residual or recurrent adenomas has only led to modest increases in resection rates. However, larger more complex cases are being tackled, so direct comparisons are misleading. The most dramatic change has been in visual improvement along with modest increases in risk. Reoperation for recurrent or residual adenomas is a safe and effective treatment option.
Topics: Adenoma; Humans; Microsurgery; Nasal Cavity; Neoplasm Recurrence, Local; Neuroendoscopy; Pituitary Neoplasms; Sphenoid Bone
PubMed: 28185971
DOI: 10.1016/j.wneu.2017.01.110 -
The Angle Orthodontist 1997
Topics: Cephalometry; Cranial Sutures; Humans; Malocclusion; Maxillofacial Development; Occipital Bone; Sella Turcica; Sphenoid Bone
PubMed: 9107370
DOI: 10.1043/0003-3219(1997)067<0083:MSOC>2.3.CO;2 -
Brazilian Journal of Otorhinolaryngology 2017The sphenoid sinus is an important structure in ventral skull base surgeries that is surrounded by several vital anatomical structures including the internal carotid...
INTRODUCTION
The sphenoid sinus is an important structure in ventral skull base surgeries that is surrounded by several vital anatomical structures including the internal carotid arteries, optic nerve and cranial nerves inside the cavernous sinus. In addition, the foramen rotundum is a small canal deeply situated in the base of the skull, which represents the way for exit of the maxillary nerve. Understanding of the sphenoid bone anatomical relationships is central to the expanded endonasal approaches to the skull base.
OBJECTIVE
To record and analyze the measurement indexes of the sphenoid sinus and foramen rotundum in the coronal plane of normal computer tomography scans.
METHODS
Patients underwent paranasal sinuses computer tomography scan from June 2014 to November 2015 were retrospectively entered this cross-sectional study. We obtained several morphometric measurements from both the right and left sides using computer software. We also classified foramen rotundum and vidian canal types and determined position of the foramen rotundum regarding to base of lateral pterygoid plate.
RESULTS
One-hundred patients with the mean age of 38.56±18.51 years entered this study. Mean bilateral FR distances were 38.48±3.87mm. Average right and left FRs distances to midline were 19.00±2.07 and 19.34±2.17mm, respectively (p=0.03). Twenty-eight cases (28%) had type I vidian canal, 48% and 24% had type II and III vidian canals, respectively. Four patients (4%) had type I rotundum foramen, 28% and 44% had type IIa and IIb, respectively and 24% had type III rotundum foramen. The position of foramen rotundums regarding to the base of lateral pterygoid plate was online in 50% of cases, medially placed in 47% and laterally placed in 3% of cases.
CONCLUSION
The results of this study can be used to provide a better anatomical understanding of the area, which is necessary for endoscopic skull base surgeons.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Retrospective Studies; Sphenoid Bone; Sphenoid Sinus; Tomography, X-Ray Computed; Young Adult
PubMed: 27283380
DOI: 10.1016/j.bjorl.2016.04.013 -
AJNR. American Journal of Neuroradiology Aug 2016A thorough knowledge of fetal growth and development is key to understanding both the normal and abnormal fetal MR imaging findings. We investigated the size and signal...
BACKGROUND AND PURPOSE
A thorough knowledge of fetal growth and development is key to understanding both the normal and abnormal fetal MR imaging findings. We investigated the size and signal intensity of the normal pituitary gland and the intrasphenoidal ossification around the Rathke pouch in formalin-fixed fetuses on MR imaging.
MATERIALS AND METHODS
Thirty-two fetuses with undamaged brains were included in this study (mean age, 19.93 weeks; age range, 12-31 weeks). Visual inspection of the pituitary and ossification around the Rathke pouch in the sphenoid bone or the postsphenoid ossification was conducted. The extent of pituitary and postsphenoid ossification, pituitary/pons signal ratio, and postsphenoidal ossification/sphenoid bone signal ratio was compared according to gestational age.
RESULTS
The pituitary gland was identified as a hyperintense intrasellar structure in all cases, and postsphenoid ossification was identified as an intrasphenoidal hyperintense area in 27 of the 32 cases (84%). The mean pituitary/pons signal ratio was 1.13 ± 0.18 and correlated weakly with gestational age (R(2) = 0.243), while the mean postsphenoid ossification/sphenoid bone signal ratio was 2.14 ± 0.56 and did not show any increase with gestational age (R(2) = 0.05). No apparent change in the size of pituitary hyperintensity was seen with gestational age (R(2) = 0.001). Postsphenoid ossification showed an increase in size with gestational age (R(2) = 0.307).
CONCLUSIONS
The fetal pituitary gland was hyperintense on T1-weighted images and the pituitary/pons ratio and extent of postsphenoid ossification correlated weakly with gestational age.
Topics: Fetus; Gestational Age; Humans; Magnetic Resonance Imaging; Osteogenesis; Pituitary Gland; Sphenoid Bone
PubMed: 27127005
DOI: 10.3174/ajnr.A4808 -
Neurology India 2020The sphenoid ostium (SO) is an important landmark for the endoscopic surgeon. Changes in size and position of the SO and variations in other skull base landmarks in...
BACKGROUND
The sphenoid ostium (SO) is an important landmark for the endoscopic surgeon. Changes in size and position of the SO and variations in other skull base landmarks in acromegalics have not been adequately evaluated.
AIMS
The authors evaluated the morphometry and location of the SO and other landmarks in acromegaly and compared these findings with those in nonfunctioning pituitary adenomas (NFPAs).
METHODS
In this retrospective case-control study, the dimensions and location of the SO and other skull base landmarks were radiologically evaluated in 18 patients with growth hormone (GH)-secreting adenomas. These findings were analyzed in relation to preoperative GH levels and compared with 18 age- and sex-matched controls with NFPAs.
RESULTS
The dimensions of the SO were significantly larger in the GH-adenoma group (P < 0.05). The SO was further from the midline (P = 0.04) and closer to the sphenopalatine foramen (SPF) (P = 0.02) in the GH-adenoma group, and this finding correlated with increasing preoperative GH levels. Acromegalics demonstrated larger intracavernous carotid diameters (P = 0.05) and smaller intercarotid distances than the patients with NFPAs (P = 0.02).
CONCLUSION
The SO is larger and located higher up in the sphenoid face and closer to the SPF in patients with GH adenomas. Increasing GH levels in these patients correlate with the upward and lateral displacement of the SO. These patients demonstrate larger intracavernous carotid diameters and smaller intercarotid distances than patients with NFPAs. These morphological alterations are of particular relevance to the pituitary surgeon.
Topics: Acromegaly; Case-Control Studies; Humans; Pituitary Neoplasms; Retrospective Studies; Sphenoid Bone
PubMed: 32643665
DOI: 10.4103/0028-3886.288996 -
Australian Dental Journal Jun 2011A thorough knowledge of the anatomy of the pterygomandibular space is essential for the successful administration of the inferior alveolar nerve block. In addition to... (Review)
Review
A thorough knowledge of the anatomy of the pterygomandibular space is essential for the successful administration of the inferior alveolar nerve block. In addition to the inferior alveolar and lingual nerves, other structures in this space are of particular significance for local anaesthesia, including the inferior alveolar vessels, the sphenomandibular ligament and the interpterygoid fascia. These structures can all potentially have an impact on the effectiveness of local anaesthesia in this area. Greater understanding of the nature and extent of variation in intraoral landmarks and underlying structures should lead to improved success rates, and provide safer and more effective anaesthesia. The direct technique for the inferior alveolar nerve block is used frequently by most clinicians in Australia and this review evaluates its anatomical rationale and provides possible explanations for anaesthetic failures.
Topics: Alveolar Process; Anesthesia, Dental; Arteries; Fascia; Humans; Ligaments; Lingual Nerve; Mandible; Mandibular Nerve; Nerve Block; Pterygoid Muscles; Safety; Sphenoid Bone; Veins
PubMed: 21623801
DOI: 10.1111/j.1834-7819.2011.01312.x -
PloS One 2020The strains of inbred laboratory mice are isogenic and homogeneous for over 98.6% of their genomes. However, geometric morphometric studies have demonstrated clear...
The strains of inbred laboratory mice are isogenic and homogeneous for over 98.6% of their genomes. However, geometric morphometric studies have demonstrated clear differences among the skull shapes of various mice strains. The question now arises: why are skull shapes different among the mice strains? Epigenetic processes, such as morphological interaction between the muscles and bones, may cause differences in the skull shapes among various mice strains. To test these predictions, the objective of this study is to examine the morphological association between a specific part of the skull and its adjacent muscle. We examined C57BL6J, BALB/cA, and ICR mice on embryonic days (E) 12.5 and 16.5 as well as on postnatal days (P) 0, 10, and 90. As a result, we found morphological differences between C57BL6J and BALB/cA mice with respect to the inferior spine of the hypophyseal cartilage or basisphenoid (SP) and the tensor veli palatini muscle (TVP) during the prenatal and postnatal periods. There was a morphological correlation between the SP and the TVP in the C57BL6J, BALB/cA, and ICR mice during E15 and P0. However, there were not correlation between the TVP and the SP during P10. After discectomy, bone deformation was associated with a change in the shape of the adjacent muscle. Therefore, epigenetic modifications linked to the interaction between the muscles and bones might occur easily during the prenatal period, and inflammation seems to allow epigenetic modifications between the two to occur.
Topics: Anatomy, Comparative; Animals; Animals, Newborn; Female; Humans; Mice; Mice, Inbred BALB C; Mice, Inbred C57BL; Mice, Inbred ICR; Palatal Muscles; Pregnancy; Sphenoid Bone
PubMed: 31923241
DOI: 10.1371/journal.pone.0227301