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Surgical Anatomy of the Sellar Region

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Transsphenoidal Surgery

Abstract

In addressing pathology of the sellar region, several approaches have been used, and a detailed knowledge of the associated anatomy is critical for successful surgery and to avoid complications. This chapter will address the anatomy of this region in a logical and detailed manner, focusing on specific approaches to the region and describing potential pitfalls associated with them. In addition, this chapter will describe the critical neurovascular structures associated with this area as a helpful guide when exploring not only the sella but also the perisellar space, which includes the cavernous sinus, suprasellar, and interpeduncular cistern.

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References

  1. Rhoton Jr AL, Hardy DG, Chambers SM. Microsurgical anatomy and dissection of the sphenoid bone, cavernous sinus and sellar region. Surg Neurol. 1979;12(1):63–104. PubMed PMID: 451866. Epub 1979/07/01. eng

    PubMed  Google Scholar 

  2. Harris FS, Rhoton AL. Anatomy of the cavernous sinus. A microsurgical study. J Neurosurg. 1976;45(2):169–80. PubMed PMID: 939976. Epub 1976/08/01. eng

    Article  CAS  Google Scholar 

  3. Renn WH, Rhoton Jr AL. Microsurgical anatomy of the sellar region. J Neurosurg. 1975;43(3):288–98. PubMed PMID: 1151464. Epub 1975/09/11. eng

    Article  CAS  Google Scholar 

  4. Bergland RM, Ray BS, Torack RM. Anatomical variations in the pituitary gland and adjacent structures in 225 human autopsy cases. J Neurosurg. 1968;28(2):93–9. PubMed PMID: 5638016. Epub 1968/02/01. eng

    Article  CAS  Google Scholar 

  5. Laws Jr ER, Kern EB. Complications of trans-sphenoidal surgery. Clin Neurosurg. 1976;23:401–16. PubMed PMID: 975691. Epub 1976/01/01. eng

    Article  Google Scholar 

  6. Fernandez-Miranda JC, Tormenti M, Latorre F, Gardner P, Snyderman C. Endoscopic endonasal middle clinoidectomy: anatomic, radiological, and technical note. Neurosurgery. 2012;71(2 Suppl Operative):ons233–9. discussion ons9. PubMed PMID: 22806082.

    PubMed  Google Scholar 

  7. Labib MA, Prevedello DM, Fernandez-Miranda JC, Sivakanthan S, Benet A, Morera V, et al. The medial opticocarotid recess: an anatomic study of an endoscopic “key landmark” for the ventral cranial base. Neurosurgery. 2013;72(1 Suppl Operative):66–76. discussion PubMed PMID: 23271222.

    PubMed  Google Scholar 

  8. Fernandez-Miranda JC, Gardner PA, Rastelli Jr MM, Peris-Celda M, Koutourousiou M, Peace D, et al. Endoscopic endonasal transcavernous posterior clinoidectomy with interdural pituitary transposition. J Neurosurg. 2014;121(1):91–9. PubMed PMID: 24816325. Epub 2014/05/13. eng

    Article  Google Scholar 

  9. Barges-Coll J, Fernandez-Miranda JC, Prevedello DM, Gardner P, Morera V, Madhok R, et al. Avoiding injury to the abducens nerve during expanded endonasal endoscopic surgery: anatomic and clinical case studies. Neurosurgery. 2010;67(1):144–54. discussion 54. PubMed PMID: 20559102.

    Article  Google Scholar 

  10. Ceylan S, Koc K, Anik I. Endoscopic endonasal transsphenoidal approach for pituitary adenomas invading the cavernous sinus. J Neurosurg. 2010;112(1):99–107. PubMed PMID: 19480546.

    Article  Google Scholar 

  11. Cappabianca P, Cavallo LM, Colao A, de Divitiis E. Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas. J Neurosurg. 2002;97(2):293–8. PubMed PMID: 12186456.

    Article  Google Scholar 

  12. Kassam AB, Gardner P, Snyderman C, Mintz A, Carrau R. Expanded endonasal approach: fully endoscopic, completely transnasal approach to the middle third of the clivus, petrous bone, middle cranial fossa, and infratemporal fossa. Neurosurg Focus. 2005;19(1):E6. PubMed PMID: 16078820.

    PubMed  Google Scholar 

  13. Fujii K, Chambers SM, Rhoton Jr AL. Neurovascular relationships of the sphenoid sinus. A microsurgical study. J Neurosurg. 1979;50(1):31–9. PubMed PMID: 758376. Epub 1979/01/01. eng

    Article  CAS  Google Scholar 

  14. Gibo H, Lenkey C, Rhoton Jr AL. Microsurgical anatomy of the supraclinoid portion of the internal carotid artery. J Neurosurg. 1981;55(4):560–74. PubMed PMID: 7277004. Epub 1981/10/01. eng

    Article  CAS  Google Scholar 

  15. Saeki N, Rhoton Jr AL. Microsurgical anatomy of the upper basilar artery and the posterior circle of Willis. J Neurosurg. 1977;46(5):563–78. PubMed PMID: 845644. Epub 1977/05/01. eng

    Article  CAS  Google Scholar 

  16. Rosner SS, Rhoton Jr AL, Ono M, Barry M. Microsurgical anatomy of the anterior perforating arteries. J Neurosurg. 1984;61(3):468–85. PubMed PMID: 6747683. Epub 1984/09/01. eng

    Article  CAS  Google Scholar 

  17. Zwagerman NT, Zenonos G, Lieber S, Wang WH, Wang EW, Fernandez-Miranda JC, Snyderman CH, Gardner PA. Endoscopic transnasal skull base surgery: pushing the boundaries. J Neurooncol. 2016;130(2):319–30.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Nathan T. Zwagerman MD, Stefan Lieber MD & Juan C. Fernandez-Miranda MD

Authors
  1. Nathan T. Zwagerman MD
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  2. Stefan Lieber MD
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  3. Juan C. Fernandez-Miranda MD
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Corresponding author

Correspondence to Juan C. Fernandez-Miranda MD .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Harvard Medical School Brigham and Women’s Hospital, Boston, MA, USA

    Edward R. Laws, Jr

  2. Department of Neurosurgery, Indianapolis Methodist Hospital, Indianapolis, IN, USA

    Aaron A. Cohen-Gadol

  3. Department of Neurosurgery, Weill Cornell Medical College New York Presbyterian Hospital, New York, NY, USA

    Theodore H. Schwartz

  4. Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA

    Jason P. Sheehan

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Zwagerman, N.T., Lieber, S., Fernandez-Miranda, J.C. (2017). Surgical Anatomy of the Sellar Region. In: Laws, Jr, E.R., Cohen-Gadol, A.A., Schwartz, T.H., Sheehan, J.P. (eds) Transsphenoidal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-56691-7_10

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  • DOI: https://doi.org/10.1007/978-3-319-56691-7_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56689-4

  • Online ISBN: 978-3-319-56691-7

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