JOURNAL ARTICLE

Expanding the boundaries of the transsphenoidal approach: a microanatomic study

A Romano, M Zuccarello, H R van Loveren, J T Keller
Clinical Anatomy 2001, 14 (1): 1-9
11135390
The anatomic features of a transsphenoidal approach are reviewed, focusing on the microsurgical anatomy of parasellar structures. Pertinent microsurgical anatomy is described in sufficient detail for the neurosurgeon to successfully extend a standard transsphenoidal approach for treatment of lesions involving the region of the tuberculum sellae, planum sphenoidale, supradiaphragmatic intradural space, and medial cavernous sinus. The parasellar region of 50 formalin-fixed cadaveric heads was examined by using magnification 3x to 40x. The arterial and venous systems of five cadaveric specimens were injected under pressure with colored silicone rubber. The sellar region of three specimens was examined histologically. Important anatomic landmarks identified in the roof of the sphenoid sinus include a carotid and trigeminal prominence, as well as a tubercular, clival, and opticocarotid recess. The diaphragma sella is actually comprised of two layers of dura, with a venous system (circular sinus) interposed between the layers. The dura mater of the pituitary gland separates the gland from the medial compartment of the cavernous sinus. The microanatomic detail necessary to extend the transsphenoidal approach to the supradiaphragmatic intradural space and medial compartment of the cavernous sinus is described. These data are presented to facilitate the clinical application of these extended approaches.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read
11135390
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"