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2013 | 72 | 2 |

Tytuł artykułu

The pneumatisation of anterior clinoid process is not associated with any predictors that might be recognised preoperatively

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
The anterior clinoid process (ACP) is usually removed during surgeries of proximal internal carotid artery (ICA) aneurysms. However, some ACPs present with air cells originating from the sphenoid or/and ethmoid sinus. In surgeries containing a clinoidectomy of a pneumatised process, up to 40% of patients experience cerebrospinal fluid (CSF) rhinorrhoea. The aim of this study was to explore the potential predictors of pneumatisation of the ACP, as well as to compare the occurrence of CSF rhinorrhoea between total and partial anterior clinoidectomies. This study comprised 2 different groups, with 2 different analyses. Firstly, the pneumatisation of the ACP was evaluated in 496 ACPs and was based on 248 computer tomography exams (CT). The χ² test and ROC curve comparisons were utilised in conjunction, to explore possible predictors of air cell accumulation in the ACP. The overall pneumatisation rate was 9.7%, unilateral and bilateral aerial ACP was found in 4.4% and 2.6% of all patients respectively, while at least one pneumatised ACP was found in 14.1% of examined patients. The route of pneumatisation was established in 87.5% of cases. The side of the ACP, gender, and patient age were not significantly associated with both pneumatisation of ACP or route of pneumatisation. Secondly, a clinical group of 23 patients after operative securing of an ICA aneurysm were retrospectively assessed with regards to the extent of anterior clinoidectomy and the occurrence of CSF rhinorrhoea. A total of 23 ACPs were removed, 17 ACPs were totally resected, and 6 underwent partial resection. CSF rhinorrhoea was not noted in any patients, thus the comparison between clinical groups was not valid. Moreover, we described a novel method of partial removal of the lateral aspect of ACP, which was applied in 6 patients treated for an ICA — ophthalmic artery junction aneurysm. (Folia Morphol 2013; 72, 2: 100–106)

Słowa kluczowe

Wydawca

-

Czasopismo

Rocznik

Tom

72

Numer

2

Opis fizyczny

p.100-106,fig.,ref.

Twórcy

autor
  • Neurosurgery Department, Medical University of Gdansk, Debinki 7, 80–952 Gdansk, Poland
  • Neurosurgery Department, Medical University of Gdansk, Debinki 7, 80–952 Gdansk, Poland
autor
  • Students Scientific Association, Neurosurgery Department, Medical University of Gdansk, Poland
autor
  • Students Scientific Association, Neurosurgery Department, Medical University of Gdansk, Poland
autor
  • Students Scientific Association, Neurosurgery Department, Medical University of Gdansk, Poland
  • Students Scientific Association, Neurosurgery Department, Medical University of Gdansk, Poland
autor
  • Students Scientific Association, Neurosurgery Department, Medical University of Gdansk, Poland
  • Students Scientific Association, Neurosurgery Department, Medical University of Gdansk, Poland

Bibliografia

  • 1. Abuzayed B, Tanriover N, Biceroglu H, Yuksel O, Tanriover O, Albayram S, Akar Z (2010) Pneumatization degree of the anterior clinoid process: a new classification. Neurosurg Rev, 33: 367–373.
  • 2. Chang DJ (2009) The „no-drill” technique of anterior clinoidectomy: a cranial base approach to the paraclinoid and parasellar region. Neurosurgery, 64 (3 suppl.): ONS96–ONS105.
  • 3. Chi JH, Sughrue M, Kunwar S, Lawton MT (2006) The ”yo-yo” technique to prevent cerebrospinal fluid rhinorrhea after anterior clinoidectomy for proximal internal carotid artery aneurysms. Neurosurgery, 59 (1 suppl. 1): ONS101–ONS107.
  • 4. Citardi MJ, Gallivan RP, Batra PS, Maurer CR, Jr., Rohlfing T, Roh HJ, Lanza DC (2004) Quantitative computer-aided computed tomography analysis of sphenoid sinus anatomical relationships. Am J Rhinol, 18:173–178.
  • 5. DeLano MC, Fun FY, Zinreich SJ (1996) Relationship of the optic nerve to the posterior paranasal sinuses: a CT anatomic study. Am J Neuroradiol, 17: 669–675.
  • 6. Dolenc VV (1985) A combined epi- and subdural direct approach to carotid-ophthalmic artery aneurysms. J Neurosurg, 62:667–672.
  • 7. Evans JJ, Hwang YS, Lee JH (2000) Pre- versus post-anterior clinoidectomy measurements of the optic nerve, internal carotid artery, and opticocarotid triangle: a cadaveric morphometric study. Neurosurgery, 46:1018–1021.
  • 8. Huynh-Le P, Natori Y, Sasaki T (2004) Surgical anatomy of the anterior clinoid process. J Clin Neurosci, 11: 283–287.
  • 9. Inoue T, Rhoton AL, Jr., Theele D, Barry ME (1990) Surgical approaches to the cavernous sinus: a microsurgical study. Neurosurgery, 26: 903–932.
  • 10. Kapur E, Mehic A (2012) Anatomical variations and morphometric study of the optic strut and the anterior clinoid process. Bosn J Basic Med Sci, 12: 88–93.
  • 11. Kim JH, Kim JM, Cheong JH, Bak KH, Kim CH (2009) Simple anterior petroclinoid fold resection in the treatment of low-lying internal carotid-posterior communicating artery aneurysms. Surg Neurol, 72: 142–145.
  • 12. Krisht AF, Kadri PA (2005) Surgical clipping of complex basilar apex aneurysms: a strategy for successful outcome using the pretemporal transzygomatic transcavernous approach. Neurosurgery, 56 (2 suppl.): 261–273.
  • 13. Lee HY, Chung IH, Choi BY, Lee KS (1997) Anterior clinoid process and optic strut in Koreans. Yonsei Med J, 38: 151–154.
  • 14. Mikami T, Minamida Y, Koyanagi I, Baba T, Houkin K (2007) Anatomical variations in pneumatization of the anterior clinoid process. J Neurosurg, 106:170–174.
  • 15. Nagasawa S, Kikuchi H, Kim NG, Yonekawa Y (1988) Analysis of internal carotid–posterior communicating artery aneurysms with difficulty in clipping: with special reference to radiometry. No Shinkei Geka, 16: 959–964.
  • 16. Natori Y, Rhoton AL, Jr. (1995) Microsurgical anatomy of the superior orbital fissure. Neurosurgery, 36: 762–775.
  • 17. Noguchi A, Balasingam V, Shiokawa Y, McMenomey SO, Delashaw JB, Jr. (2005) Extradural anterior clinoidectomy. Technical note. J Neurosurg, 102: 945–950.
  • 18. Nutik SL (1988) Removal of the anterior clinoid process for exposure of the proximal intracranial carotid artery. J Neurosurg, 69: 529–534.
  • 19. Romani R, Elsharkawy A, Laakso A, Kangasniemi M, Hernesniemi J (2012) Tailored anterior clinoidectomy through the lateral supraorbital approach: experience with 82 consecutive patients. World Neurosurg, 77: 512–517.
  • 20. Sapci T, Derin E, Almac S, Cumali R, Saydam B, Karavus M (2004) The relationship between the sphenoid and the posterior ethmoid sinuses and the optic nerves in Turkish patients. Rhinology, 42: 30–34.
  • 21. Sirikci A, Bayazit YA, Bayram M, Mumbuc S, Gungor K, Kanlikama M (2000) Variations of sphenoid and related structures. Eur Radiol, 10: 844–848.
  • 22. Son HE, Park MS, Kim SM, Jung SS, Park KS, Chung SY (2010) The avoidance of microsurgical complications in the extradural anterior clinoidectomy to paraclinoid aneurysms. J Korean Neurosurg Soc, 48:199–206.
  • 23. Szmuda T, Sloniewski P (2011) Early and long-term outcome of surgically treated giant internal carotid artery aneurysms — comparison with smaller aneurysms. Acta Neurochir, 153: 1611–1619.23.
  • 24. Szmuda T, Sloniewski P, Dzierzanowski J, Rut M (2011) Predictors of postoperative mortality in ruptured aneurysms of internal carotid artery. Neurol Neurochir Pol, 45:543–555.
  • 25. Yonekawa Y, Ogata N, Imhof HG, Olivecrona M, Strommer K, Kwak TE, Roth P, Groscurth P (1997) Selective extradural anterior clinoidectomy for supra- and parasellar processes. Technical note. J Neurosurg, 87: 636–642.
  • 26. Vajkoczy P (2012) Intradural versus extradural removal of the anterior clinoid process. World Neurosurg, 77: 615–616.

Typ dokumentu

Bibliografia

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