Acta Neurochirurgica

, Volume 159, Issue 4, pp 665–676 | Cite as

Prechiasmatic sulcus and optic strut: an anatomic study in dry skulls

  • Vasiliki Kanellopoulou
  • Evgenia Efthymiou
  • Vasiliki Thanopoulou
  • Dimitra Kozompoli
  • Dimitrios Mytilinaios
  • Maria Piagkou
  • Elizabeth O. Johnson
Original Article - Neurosurgical Anatomy
  • 162 Downloads

Abstract

Background

Although safe surgical access to the cavernous sinus is related to understanding the anatomical and ethnic variants of the prechiasmatic sulcus and the optic strut, there remains a paucity of studies of the morphology and the bony relationships in the region. The present study provides a systematic morphological and morphometric analysis of the sulcal region and the optic strut anatomy and their relations in a Greek population.

Methods

The interoptic distance, length of planum sphenoidale, sulcal length and sulcal angle was determined in 96 Greek adult dry skulls. The prechiasmatic sulci and optic struts were morphologically classified and association of sulcal region measures according to type of prechiasmatic sulcus and optic strut were examined.

Results

Mean interoptic distance was 1.69 ± 0.25 cm; sulcal length, 0.72 ± 0.18 cm; length of planum sphenoidale, 1.86 ± 0.32 cm; sulcal angle, 24.05 ± 17.17°. The sulcal angle was significantly smaller in female skulls compared to males (14.82 ± 12.43 vs 28.29 ± 15.24; p < 0.05). Type I (narrow, steep) prechiasmatic sulci were the most commonly observed (35.8%), followed by Type IV (wide, flat) (32.1%), Type II (narrow, flat) (18.5%) and, finally, Type III (wide, steep) sulci (13.6%). The optic strut was presulcal in 8.3% of specimens, sulcal in 31%, postsulcal in 41.7% and asymmetric in 19%.

Conclusions

The present study augments the current knowledge of the morphology of key anatomical landmarks, prechiasmatic sulcus and the optic strut, for cavernous sinus surgery and indicates population and gender differences. We report significant anatomical variations in the prechiasmatic sulcus, optic strut and surrounding structures. In addition to providing a better understanding of the anatomical landmarks, necessary for the safe navigation in transcranial and endoscopic procedures, the present results also suggest that surgeons must consider population differences in determining the anatomical landmarks and navigation points in the sellar region.

Keywords

Prechiasmatic sulcus Optic strut Planum sphenoidale Sella turcica Morphometry 

References

  1. 1.
    Beretta F, Sepahi AN, Zuccarello M, Tomsick TA, Keller JT (2005) Radiographic imaging of the distal dural ring for determining the intradural or extradural location of aneurysms. Skull Base 15:253–261CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Boyan N, Ozsahin E, Kizilkanat E, Tekdemir I, Soames R, Oguz O (2011) Surgical importance of the morphometry of the anterior clinoid process, optic strut, caroticoclinoid foramen, and interclinoid osseous bridge. Neurosurg Q 21:133–136CrossRefGoogle Scholar
  3. 3.
    Cares H, Bakay L (1971) The clinical significance of the optic strut. J Neurosurg 34:355–364CrossRefPubMedGoogle Scholar
  4. 4.
    Collignon F, Link M (2005) Paraclinoid and cavernous sinus regions: measurement of critical structures relevant for surgical procedure. Clin Anat 18:3–9CrossRefPubMedGoogle Scholar
  5. 5.
    Dagtekin A, Avcı E, Uzmansel D, Kurtoglu Z, Kara E, Uluc K, Akture E, Baskaya M (2014) Microsurgical anatomy and variations of the anterior clinoid process. Turk Neurosurg 24:484–493PubMedGoogle Scholar
  6. 6.
    de Notaris M, Solari D, Cavallo LM, D’Enza AI, Enseñat J, Berenguer J, Ferrer E, Prats-Galino A, Cappabianca P (2012) The “suprasellar notch”, or the tuberculum sellae as seen from below: definition, features, and clinical implications from an endoscopic endonasal perspective. J Neurosurg 116:622–629CrossRefPubMedGoogle Scholar
  7. 7.
    Gonzalez LF, Walker MT, Zabramski JM, Partovi S, Wallace RC, Spetzler RF (2003) Distinction between paraclinoid and cavernous sinus aneurysms with computed tomographic angiography. Neurosurgery 52:1131–1137PubMedGoogle Scholar
  8. 8.
    Guthikonda B, Tobler WD, Froelich SC, Leach JL, Zimmer LA, Theodosopoulos PV, Tew JM, Keller JT (2010) Anatomic study of the prechiasmatic sulcus and its surgical implications. Clin Anat 23:622–628CrossRefPubMedGoogle Scholar
  9. 9.
    Hashimoto K, Nozaki K, Hashimoto N (2006) Optic strut as a radiographic landmark in evaluating neck location of a paraclinoid aneurysm. Neurosurgery 59:880–895CrossRefPubMedGoogle Scholar
  10. 10.
    Kerr RG, Tobler WD, Leach JL, Theodosopoulos PV, Kocaeli H, Zimmer LA, Keller JT (2012) Anatomic variation of the optic strut: classification schema, radiologic evaluation, and surgical relevance. J Neurol Surg B Skull Base 73:424–429CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Lang J (1995) Skull base and related structures: atlas of clinical anatomy, 2nd edn. Schattauer, Stuttgart, pp 172–173Google Scholar
  12. 12.
    Lee HY, Chung IH, Choi BY, Lee KS (1997) Anterior clinoid process and optic strut in Koreans. Yonsei Med J 38:151–154CrossRefPubMedGoogle Scholar
  13. 13.
    Liao CH, Lin CJ, Lin CF, Huang HY, Chen MH, Hsu SP, Shih YH (2016) Comparison of the effectiveness of using the optic strut and tuberculum sellae as radiological landmarks in diagnosing paraclinoid aneurysms with CT angiography. J Neurosurg 125:275–282. doi:10.3171/2015.7.JNS151046 CrossRefPubMedGoogle Scholar
  14. 14.
    Liu JK, Christiano LD, Patel SK, Eloy JA (2011) Surgical nuances for removal of retrochiasmatic craniopharyngioma via the endoscopic endonasal extended transsphenoidal transplanum transtuberculum approach. Neurosurg Focus 30(4), E14. doi:10.3171/2011.1.FOCUS10297 CrossRefPubMedGoogle Scholar
  15. 15.
    Liu JK, Christiano LD, Patel SK, Tubbs RS, Eloy JA (2011) Surgical nuances for removal of tuberculum sellae meningiomas with optic canal involvement using the endoscopic endonasal extended transsphenoidal transplanum transtuberculum approach. Neurosurg Focus 30(5), E2. doi:10.3171/2011.3.FOCUS115 CrossRefPubMedGoogle Scholar
  16. 16.
    Mahmoud M, Nader R, Al-Mefty O (2010) Optic canal involvement in tuberculum sellae meningiomas: influence on approach, recurrence, and visual recovery. Neurosurgery 67:108–119. doi:10.1227/01.NEU.0000383153.75695.24 Google Scholar
  17. 17.
    Ozcan T, Yilmazlar S, Aker S, Korfali E (2010) Surgical limits in transnasal approach to opticocarotid region and planum sphenoidale: an anatomic cadaveric study. World Neurosurg 73:326–333CrossRefPubMedGoogle Scholar
  18. 18.
    Parkinson D (1989) Optic strut: posterior root of sphenoid. Clin Anat 2:87–92CrossRefGoogle Scholar
  19. 19.
    Peris-Celda M, Kucukyuruk B, Monroy-Sosa A, Funaki T, Valentine R, Rhoton AL (2013) The recesses of the sellar wall of the sphenoid sinus and their intracranial relationships. Neurosurgery 73:117–131. doi:10.1227/NEU.0000000000000184 Google Scholar
  20. 20.
    Sandu K, Monnier P, Pasche P (2012) Anatomical landmarks for transnasal endoscopic skull base surgery. Eur Arch Otorhinolaryngol 269(1):171–178CrossRefPubMedGoogle Scholar
  21. 21.
    Stedman TL (2012) Stedman’s medical dictionary for the health professions and nursing, 7th edn. Wolters Kluwer/Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  22. 22.
    Suprasanna K, Ravikiran SR, Kumar A, Chavadi C, Pulastya S (2015) Optic strut and para-clinoid region—assessment by multi-detector computed tomography with multiplanar and 3 dimensional reconstructions. J Clin Diagn Res 9:TC06–TC09PubMedPubMedCentralGoogle Scholar
  23. 23.
    Zagga AD, Ahmed H, Tadros AA, Saidu SA (2008) Description of the normal variants of the anatomical shapes of the sella turcica using plain radiographs: experience from Sokoto, Northwestern Nigeria. Ann Afr Med 7:77–81CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  • Vasiliki Kanellopoulou
    • 1
  • Evgenia Efthymiou
    • 1
  • Vasiliki Thanopoulou
    • 1
  • Dimitra Kozompoli
    • 1
  • Dimitrios Mytilinaios
    • 2
  • Maria Piagkou
    • 1
  • Elizabeth O. Johnson
    • 1
  1. 1.Department of Anatomy, Laboratory for Education & Research in Neuroscience (LERNs), School of MedicineNational & Kapodistrian University of AthensAthensGreece
  2. 2.Forensic Pathologist, 251 General Air Forces Hospital, Scientific Collaborator, Laboratory of Forensic Pathology, School of MedicineNational & Kapodistrian University of AthensAthensGreece

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