53
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Microsurgical Anatomy of the Inferomedial Paraclival Triangle: Contents, Topographical Relationships and Anatomical Variations

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The inferomedial triangle is one of the two surgical triangles in the paraclival subregion of the skull base. It is delineated by the posterior clinoid process, the dural entrance of the trochlear nerve and the dural entrance of the abducens nerve. The aim of the present article is to describe the anatomical variations within the inferomedial triangle. Measurements of the triangle’s borders and area were supplemented by detailed observations of the topographical anatomy and various arrangements of its contents. Nine adult cadaveric heads (18 sides) and 28 sagittal head sections were studied. The mean area of the inferomedial triangle was estimated to be 60.7 mm 2. The mean lengths of its medial, lateral and superior borders were 16.1 mm, 11.9 mm and 10.4 mm, respectively. The dorsal meningeal artery was identified within the inferomedial triangle in 37 out of 46 sides (80.4%). A well-developed petrosphenoidal ligament of Grüber was identified within the triangle on 36 sides (78.3%). Although some structures were variable, the constant contents of the inferomedial triangle were the posterior petroclinoid dural fold, the upper end of the petroclival suture, the gulfar segment of the abducens nerve and the posterior genu of the intracavernous internal carotid artery.

          Related collections

          Most cited references36

          • Record: found
          • Abstract: not found
          • Article: not found

          Acknowledging the use of human cadaveric tissues in research papers: Recommendations from anatomical journal editors

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Expanded endonasal approach: fully endoscopic, completely transnasal approach to the middle third of the clivus, petrous bone, middle cranial fossa, and infratemporal fossa.

            The middle third of the clivus and the region around the petrous internal carotid artery (ICA) is a difficult area of the skull base in terms of access. This is a deep area rich with critical neurovascular structures, which is often host to typical skull base diseases. Expanded endoscopic endonasal approaches offer a potential option for accessing this difficult region. The objective of this paper was to establish the clinical feasibility of gaining access to the paraclival space in the region of the middle third of the clivus, to provide a practical modular and clinically applicable classification, and to describe the relevant critical surgical anatomy for each module. The anatomical organization of the region around the petrous ICA, cavernous sinus, and middle clivus is presented, with approaches divided into zones. In an accompanying paper in this issue by Cavallo, et al., the anatomy of the pterygopalatine fossa is presented; this was observed through cadaveric dissection for which an expanded endonasal approach was used. In the current paper the authors translate the aforementioned anatomical study to provide a clinically applicable categorization of the endonasal approach to the region around the petrous ICA. A series of zones inferior and superior to the petrous ICA are described, with an illustrative case presented for each region. The expanded endonasal approach is a feasible approach to the middle third of the clivus, petrous ICA, cavernous sinus, and medial infratemporal fossa in cases in which the lesion is located centrally, with neurovascular structures displaced laterally.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Intracranial calcifications on CT.

              Computed tomography (CT) is very sensitive for detection and localization of intracranial calcifications. We reviewed in this pictorial essay the diseases associated with intracranial calcifications and emphasized the utility of CT for the differential diagnosis.
                Bookmark

                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Brain Sci
                Brain Sci
                brainsci
                Brain Sciences
                MDPI
                2076-3425
                04 May 2021
                May 2021
                : 11
                : 5
                : 596
                Affiliations
                [1 ]Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, 90-752 Łódź, Poland; michal.polguj@ 123456umed.lodz.pl
                [2 ]Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, University Hospital WAM-CSW, 90-549 Łódź, Poland; maciej.radek@ 123456umed.lodz.pl
                [3 ]Tulane Center for Clinical Neurosciences, Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA 70112, USA; shane.tubbs@ 123456icloud.com (R.S.T.); iwanagajoeca@ 123456gmail.com (J.I.)
                [4 ]Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA 70433, USA
                [5 ]Tulane Center for Clinical Neurosciences, Department of Neurology, Tulane University School of Medicine, New Orleans, LA 70112, USA
                [6 ]Department of Anatomical Sciences, St. George’s University, Grenada, West Indies
                [7 ]Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112, USA
                [8 ]Department of Anatomy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
                [9 ]Department of Anatomy, Jagiellonian University Medical College, 33-332 Kraków, Poland; jwalocha@ 123456cm-uj.krakow.pl
                [10 ]Department of Histology and Embryology, Chair of Anatomy and Histology, Medical University of Lodz, 90-752 Łódź, Poland; piotr.brzezinski@ 123456umed.lodz.pl
                Author notes
                [* ]Correspondence: grzegorz.wysiadecki@ 123456umed.lodz.pl ; Tel.: +48-505323393
                Author information
                https://orcid.org/0000-0003-3631-2295
                https://orcid.org/0000-0002-8502-7952
                https://orcid.org/0000-0001-8587-2315
                https://orcid.org/0000-0003-4146-4998
                Article
                brainsci-11-00596
                10.3390/brainsci11050596
                8147798
                34064376
                ab83d216-1f2f-4af2-bbc7-b3fc46c8e906
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 08 April 2021
                : 02 May 2021
                Categories
                Article

                abducens nerve,cavernous sinus,dorsal meningeal artery,dura mater/anatomy,microsurgery,skull base/anatomy

                Comments

                Comment on this article

                scite_
                0
                0
                0
                0
                Smart Citations
                0
                0
                0
                0
                Citing PublicationsSupportingMentioningContrasting
                View Citations

                See how this article has been cited at scite.ai

                scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

                Similar content62

                Cited by6

                Most referenced authors361