Neurosurgical Review

, Volume 27, Issue 1, pp 22–26 | Cite as

Anatomy of the clinoidal region with special emphasis on the caroticoclinoid foramen and interclinoid osseous bridge in a recent Turkish population

Original Article

Abstract

In this study we present the incidence of caroticoclinoid foramen and interclinoid osseous bridge and some topographic aspects regarding the clinoidal internal carotid artery (ICA) in a recent Turkish population to provide a guide for neurosurgeons in any surgical approach, especially to the cavernous sinus. One hundred nineteen adult dry skulls and 52 adult cadaveric heads were used for this purpose. Caroticoclinoid foramen and the interclinoid osseous bridge were divided into three types based on the classification of Keyers [13]. Caroticoclinoid foramen was observed in 35.67% of the specimens, unilaterally in 23.98%, and bilaterally in 11.69%. The complete-type caroticoclinoid foramen was observed in 4.09% of the specimens, the contact type in 4.68%, and the incomplete type in 14.91%. Transverse diameter of the foramen was 5.32±0.52 mm for the incomplete type. The incidence of interclinoid osseous bridge was 8.18%. The middle clinoid process was prominent in 15.12% of cases and rudimental in 13.23%. The mean distance between the proximal and distal dural rings of the clinoidal ICA was 4.51±0.44 mm, and mean diameter of the distal ring was 5.25±0.59 mm. Right-left differences were assessed for each parameter, and populational differences are discussed.

Keywords

Anatomy Anterior clinoid process Caroticoclinoid foramen Clinoidal internal carotid artery Interclinoid osseous bridge 

References

  1. 1.
    Azeredo RA, Liberti EA, Watanabe IS (1988) Anatomical variations of the clinoid process of the human sphenoid bone. Arq Cent Estud Curso Odontol Univ Fed Minas Gerais 25–26:9-11Google Scholar
  2. 2.
    Bouthillier A, van Loveren HR, Keller JT (1996) Segments of the internal carotid artery: a new classification. Neurosurgery 38:425–433PubMedGoogle Scholar
  3. 3.
    Cireli E, Ustun EE, Yurtseven M, Pala S (1990) Fossa sella turcica varyasyonlarının değerlendirilmesi I: Morfolojik ve antropolojik kriterlere göre. Ege Tıp Dergisi 29:364–367Google Scholar
  4. 4.
    Deda H, Tekdemir I, Arinci K, Gokalp HZ (1992) Sinus cavernosus mikroanatomisi, kemik yapılar ve varyasyonları. Ankara Tıp Mecmuası 45:477–486Google Scholar
  5. 5.
    De Jesus O (1997) The clinoid space: anatomical review and surgical implications. Acta Neurochir (Wien) 139:361–365Google Scholar
  6. 6.
    Dolenc V (1983) Direct microsurgical repair of intracavernous vascular lesions. J Neurosurg 58:824–831PubMedGoogle Scholar
  7. 7.
    Dolenc VV (1989) Anatomy and surgery of the cavernous sinus. Springer, New YorkGoogle Scholar
  8. 8.
    Dodo Y, Ishida H (1987) Incidence of nonmetric cranial variant in several population samples from East Asia and North America. J Anthrop Soc Nippon 95:161–167Google Scholar
  9. 9.
    Gurun R, Magden O, Ertem AD (1994) Foramen corticoclinoideum. Cerrahpaşa Tıp Dergisi 25:685–691Google Scholar
  10. 10.
    Harris FS, Rhoton AL Jr (1976) Anatomy of the cavernous sinus: a microsurgical study. J Neurosurg 45:169–180PubMedGoogle Scholar
  11. 11.
    Henle J (1855) Handbuch der systematischen Anatomie des Menschen, erster Band. Vieweg und Sohn, Braunschweig, p 99Google Scholar
  12. 12.
    Inoue T, Rhoton AL, Theele D, Barry ME (1990) Surgical approaches to the cavernous sinus: a microsurgical study. Neurosurgery 26:903–932PubMedGoogle Scholar
  13. 13.
    Keyers JEL (1935) Observations on four thousand optic foramina in human skulls of known origin. Arch Ophthalmol 13:538–568Google Scholar
  14. 14.
    Kim JM, Romano A, Sanan A, van Loveren HR, Keller JT (2000) Microsurgical anatomic features and nomenclature of the paraclinoid region. Neurosurgery 46:670–680PubMedGoogle Scholar
  15. 15.
    Kobayashi S, Kyoshima K, Gibo H, Hedge SA, Takemae T, Sugita K (1989) Carotid cave aneurysms of the internal carotid artery. J Neurosurg 70:216PubMedGoogle Scholar
  16. 16.
    Korouse K, Heros RC (1992) Subclinoid carotid aneurysm with erosion of the anterior clinoid process and fatal intraoperative rupture. Neurosurgery 31:356–360PubMedGoogle Scholar
  17. 17.
    Lang J (1977) Structure and postnatal organization of heretofore uninvestigated and infrequent ossifications of the sella turcica region. Acta Anat 99:121–139Google Scholar
  18. 18.
    Lang J (1995) Skull base and related structures. Schattauer, Stuttgart, pp 172–174, 177Google Scholar
  19. 19.
    Lee HY, Chung IH, Choi BY (1997) Anterior clinoid process and optic strut in Koreans. Yonsei Med J 38:151–154PubMedGoogle Scholar
  20. 20.
    Maxia C (1950) Sul significato morfologico della frequenza dei processi clinoidei e della fusione nel cranio umano. Rass Med Sarda 1:1-7Google Scholar
  21. 21.
    Nutik SL (1988) Removal of the anterior clinoid process for exposure of the proximal intracranial carotid artery. J Neurosurg 69:529–534PubMedGoogle Scholar
  22. 22.
    Perneczky A, Knosp E, Vorkapic P, Czech T (1985) Direct surgical approach to infraclinoidal aneurysms. Acta Neurochir 76:36–44Google Scholar
  23. 23.
    Reisch R, Vutskits L, Filippi R, Patonay L, Fries G, Perneczky A (2002) Topographic microsurgical anatomy of the paraclinoid carotid artery. Neurosurg Rev 25:177–83CrossRefPubMedGoogle Scholar
  24. 24.
    Renn WH, Rhoton AL Jr (1975) Microsurgical anatomy of the sellar region. J Neurosurg 43:288–298PubMedGoogle Scholar
  25. 25.
    Sekhar LN, Akin O (1987) Anatomical study of the cavernous sinus emphasizing operative approaches and related vascular and neural reconstruction. Neurosurgery 21:806–816PubMedGoogle Scholar
  26. 26.
    Seoane E, Rhoton AL Jr, Oliveira E (1998) Microsurgical anatomy of the dural collar (carotid collar) and rings around the clinoid segment of the internal carotid artery. Neurosurgery 42:869–886PubMedGoogle Scholar
  27. 27.
    Umansky F, Valarezo A, Elidan J (1994) The superior wall of the cavernous sinus: a microanatomical study. J Neurosurg 81:914–920PubMedGoogle Scholar
  28. 28.
    Williams P, Bannister L (1995) Gray's anatomy, 38th edn. Churchill Livingstone, New York, pp 569–570, 588Google Scholar
  29. 29.
    Yaşargil MG (1984) Microneurosurgery, vol II. Thieme, Stuttgart, pp 45–46Google Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  1. 1.Department of Anatomy, Faculty of MedicineEge UniversityBornovaTurkey

Personalised recommendations