scholarly journals Anatomical variations and morphometric study of the optic strut and the anterior clinoid process

2012 ◽  
Vol 12 (2) ◽  
pp. 88 ◽  
Author(s):  
Eldan Kapur ◽  
Amina Mehić
Keyword(s):  
Anatomical Variations ◽  
Morphometric Study ◽  
Anterior Clinoid Process ◽  
Optic Strut

Surgical Relevance of Pediatric Anterior Clinoid Process Maturation for Anterior Skull Base Approaches

2020 ◽  
Author(s):  
Robert C Rennert ◽  
Michael G Brandel ◽  
Jeffrey A Steinberg ◽  
Joel R Martin ◽  
David D Gonda ◽  
...  
Keyword(s):  
Skull Base ◽  
Age Groups ◽  
Anatomical Variations ◽  
Anterior Skull Base ◽  
High Resolution Computed Tomography ◽  
Anterior Clinoid Process ◽  
Patients Âgés ◽  
Optic Strut ◽  
Computed Tomography Scans ◽  
Remodeling Pattern

Abstract BACKGROUND Removal of the anterior clinoid process (ACP) can expand anterior skull base surgical corridors. ACP development and anatomical variations are poorly defined in children. OBJECTIVE To perform a morphometric analysis of the ACP during pediatric maturation. METHODS Measurements of ACP base thickness (ACP-BT), midpoint thickness (ACP-MT), length (ACP-L), length from optic strut to ACP tip (ACP-OS), pneumatization (ACP-pneumo), and the presence of an ossified carotico-clinoid ligament (OCCL) or interclinoid ligament (OIL) were made from high-resolution computed-tomography scans from 60 patients (ages 0-3, 4-7, 8-11 12-15, 16-18, and >18 yr). Data were analyzed by laterality, sex, and age groups using t-tests and linear regression. RESULTS There were no significant differences in ACP parameters by laterality or sex, and no significant growth in ACP-BT or ACP-MT during development. From ages 0-3 yr to adult, mean ACP-L increased 49%, from 7.7 to 11.5 mm. The majority of ACP-L growth occurred in 2 phases between ages 0-3 to 8-11 and ages 16-18 to adult. Conversely, ACP-OS was stable from ages 0-3 to 8-11 but increased by 63% between ages 8-11 to adult. Variations in ACP morphology (OCCL/OIL/ACP-pneumo) were found in 15% (9/60) of scans. OCCL and OIL occurred in patients as young as 3 yrs, whereas ACP-pneumo was not seen in patients younger than 11 yrs. CONCLUSION The ACP demonstrates stable thickness and a complex triphasic elongation and remodeling pattern with development, the understanding of which may facilitate removal in patients <12. Clinically relevant ACP anatomic variations can occur at any age.

Morphometric study of the optic strut and the anterior clinoid process

2015 ◽  
Vol 64 ◽  
pp. S52-S53
Author(s):  
Nivedita Nayak ◽  
Antony Sylvan D'Souza ◽  
D'Souza Anne ◽  
Vrinda Hari Ankolekar ◽  
Mamatha Hosapatna
Keyword(s):  
Morphometric Study ◽  
Anterior Clinoid Process ◽  
Optic Strut

scholarly journals Reproducibility of a new classification of the anterior clinoid process of the sphenoid bone

2020 ◽  
Vol 11 ◽  
pp. 281
Author(s):  
Feres Chaddad-Neto ◽  
Marcos Devanir Silva da Costa ◽  
Bruno Santos ◽  
Ricardo Lourenco Caramanti ◽  
Bruno Lourenco Costa ◽  
...  
Keyword(s):  
Interobserver Agreement ◽  
Anatomical Variation ◽  
Ct Scans ◽  
Multiplanar Reconstruction ◽  
Kappa Index ◽  
Anterior Clinoid Process ◽  
Kappa Test ◽  
Optic Strut ◽  
The Difference

Background: Pneumatization of the anterior clinoid process (ACP) affects paraclinoid region surgery, this anatomical variation occurs in 6.6–27.7% of individuals, making its preoperative recognition essential given the need for correction based on the anatomy of the pneumatized process. This study was conducted to evaluate the reproducibility of an optic strut-based ACP pneumatization classification by presenting radiological examinations to a group of surgeons. Methods: Thirty cranial computer tomography (CT) scans performed from 2013 to 2014 were selected for analysis by neurosurgery residents and neurosurgeons. The evaluators received Google Forms with questionnaires on each scan, DICOM files to be manipulated in the Horos software for multiplanar reconstruction, and a collection of slides demonstrating the steps for classifying each type of ACP pneumatization. Interobserver agreement was calculated by the Fleiss kappa test. Results: Thirty CT scans were analyzed by 37 evaluators, of whom 20 were neurosurgery residents and 17 were neurosurgeons. The overall reproducibility of the ACP pneumatization classification showed a Fleiss kappa index of 0.49 (95% confidence interval: 0.49–0.50). The interobserver agreement indices for the residents and neurosurgeons were 0.52 (0.51–0.53) and 0.49 (0.48–0.50), respectively, and the difference was statistically significant (P < 0.00001). Conclusion: The optic strut-based classification of ACP pneumatization showed acceptable concordance. Minor differences were observed in the agreement between the residents and neurosurgeons. These differences could be explained by the residents’ presumably higher familiarity with multiplanar reconstruction software.

Anatomical variations in pneumatization of the anterior clinoid process

2007 ◽  
Vol 106 (1) ◽  
pp. 170-174 ◽  
Author(s):  
Takeshi Mikami ◽  
Yoshihiro Minamida ◽  
Izumi Koyanagi ◽  
Takeo Baba ◽  
Kiyohiro Houkin
Keyword(s):  
Computed Tomography ◽  
Anatomical Variations ◽  
Statistical Dependence ◽  
Multidetector Row Computed Tomography ◽  
Type I ◽  
Anterior Clinoid Process ◽  
Anterior Clinoidectomy ◽  
Computed Tomography Scans ◽  
Preoperative Ct ◽  
Cerebrospinal Fluid Leaks

Object An anterior clinoidectomy can provide enormous benefits, facilitating the management of paraclinoid and upper basilar artery lesions, but it also carries the potential risk of cerebrospinal fluid leaks. The aim of this study was to assess the variation in the pneumatization of the anterior clinoid process (ACP) in an attempt to reduce the complications associated with an anterior clinoidectomy. Methods The authors analyzed the anatomical variations in the pneumatization of the ACP and optical strut (OS) in 600 sides of 300 consecutive patients by using multidetector-row computed tomography (CT). Computed tomography scans with a 0.5-mm thickness were obtained, and coronal and sagittal reconstructions of the images were displayed in all cases. Pneumatization of the ACP was found in 9.2% of all sides. The origin of pneumatization was the sphenoid sinus in 81.8% of all the sides, the ethmoid sinus in 10.9%, and both of these sinuses in 7.3%. Pneumatized patterns were divided into three groups according to the route: 74.5% were Type I, in which pneumatization occurred via the OS; 14.5% were Type II, pneumatization via the anterior root (AR); and 10.9% were Type III, pneumatization via both the OS and the AR. The origin of pneumatization and the pneumatization pattern showed statistical dependence (p < 0.001). Pneumatization of the OS beyond its narrowest point was found in 6.8% of all sides. Conclusions An awareness of the different variations in pneumatization can prevent destruction of the mucous membrane and facilitate orientation during reconstruction with cranialization. During an anterior clinoidectomy, preoperative CT assessments are necessary to evaluate pneumatization of the ACP.

Anterior clinoidectomy using an extradural and intradural 2-step hybrid technique

2018 ◽  
Vol 130 (1) ◽  
pp. 238-247 ◽  
Author(s):  
Ali Tayebi Meybodi ◽  
Michael T. Lawton ◽  
Sonia Yousef ◽  
Xiaoming Guo ◽  
Jose Juan González Sánchez ◽  
...  
Keyword(s):  
Internal Carotid ◽  
Surgical Simulation ◽  
Skull Base Surgery ◽  
The Body ◽  
Hybrid Technique ◽  
Dust Deposition ◽  
Anterior Clinoid Process ◽  
Anterior Clinoidectomy ◽  
Optic Strut ◽  
Neurovascular Structures

Anterior clinoidectomy is a difficult yet essential technique in skull base surgery. Two main techniques (extradural and intradural) with multiple modifications have been proposed to increase efficiency and avoid complications. In this study, the authors sought to develop a hybrid technique based on localization of the optic strut (OS) to combine the advantages and avoid the disadvantages of both techniques.Ten cadaveric specimens were prepared for surgical simulation. After a standard pterional craniotomy, the anterior clinoid process (ACP) was resected in 2 steps. The segment anterior to the OS was resected extradurally, while the segment posterior to the OS was resected intradurally. The proposed technique was performed in 6 clinical cases to evaluate its safety and efficiency.Anterior clinoidectomy was successfully performed in all cadaveric specimens and all 6 patients by using the proposed technique. The extradural phase enabled early decompression of the optic nerve while avoiding the adjacent internal carotid artery. The OS was drilled intradurally under direct visualization of the adjacent neurovascular structures. The described landmarks were easily identifiable and applicable in the surgically treated patients. No operative complication was encountered.A proposed 2-step hybrid technique combines the advantages of the extradural and intradural techniques while avoiding their disadvantages. This technique allows reduced intradural drilling and subarachnoid bone dust deposition. Moreover, the most critical part of the clinoidectomy—that is, drilling of the OS and removal of the body of the ACP—is left for the intradural phase, when critical neurovascular structures can be directly viewed.

scholarly journals Surgically Relevant Bony Anatomical Variations in Paraclinoid Aneurysms-Three-Dimensional Multi-Detector Row Computed Tomography-Based Study

2017 ◽  
Vol 08 (03) ◽  
pp. 330-334 ◽  
Author(s):  
K. Suprasanna ◽  
Ashvini Kumar
Keyword(s):  
Computed Tomography ◽  
Cerebral Angiography ◽  
Three Dimensional ◽  
Anatomical Variations ◽  
Type I ◽  
Anterior Clinoid Process ◽  
Multiplanar Reconstructions ◽  
Paraclinoid Aneurysm ◽  
Paraclinoid Aneurysms ◽  
Caroticoclinoid Foramen

ABSTRACT Objective: To evaluate the proportion of surgically relevant anatomical variations such as caroticoclinoid foramen, interclinoid osseous bridge, and anterior clinoid pneumatization in patients with paraclinoid aneurysms based on computed tomography (CT) cerebral angiography studies. Materials and Methods: Fifty-four CT cerebral angiography studies showing paraclinoid aneurysms involving the cavernous, clinoid, and supraclinoid internal carotid artery (ICA) were retrospectively evaluated. Source images were processed for three-dimensional reconstructions to evaluate the presence and type of caroticoclinoid foramen, interclinoid osseous bridge, and multiplanar reconstructions with bone algorithm to study the type of pneumatization. Results: The study included 30 female and 24 male patients with mean age of 45.61 (10.47) years. Among the 108 sides studied in 54 patients, caroticoclinoid foramen was seen in 24 cases (22.22%), interclinoid osseous bridge was seen unilaterally in 1 case (0.9%), and pneumatization of anterior clinoid process occurred in 12 cases (11.11%). Incomplete caroticoclinoid foramen (11 cases) and Type I pneumatization (7 cases) were seen to be predominant subtypes. There was no statistically significant gender difference in the occurrence of caroticoclinoid foramen and anterior clinoid pneumatization. Seventy-four aneurysms were detected in 54 patients. Based on their location, 46 aneurysms involved supraclinoid ICA, 18 aneurysms in the clinoid segment, and 10 aneurysms in the cavernous segment. Caroticoclinoid foramen was most prevalent in clinoid aneurysms with 12 cases occurring in the clinoid segment. Conclusion: Notable proportions of caroticoclinoid foramen and pneumatization occur in cases of paraclinoid aneurysm. Radiological reports should emphasize on these surgically relevant bony anatomical variations.

scholarly journals Anterior clinoid process and optic strut in Koreans

1997 ◽  
Vol 38 (3) ◽  
pp. 151 ◽  
Author(s):  
Hye Yeon Lee ◽  
In Hyuk Chung ◽  
Byoung Young Choi ◽  
Kyu Sung Lee
Keyword(s):  
Anterior Clinoid Process ◽  
Optic Strut
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