The Coexistence of Carotico-Clinoid Foramen and Interclinoidal Osseous Bridge: An Anatomo-Radiological Study With Surgical Implications.

Autor:	Serioli S; Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.; Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA.; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA., Plou P; Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA.; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.; Neurosurgery, Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Donato G; Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA.; Medical Sciences Center, Federal University of Paraiba, João Pessoa, Brazil., Graepel S; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA., Ajler P; Neurosurgery, Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., De Bonis A; Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA.; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.; Department of Neurosurgery and Gamma Knife Radiosurgery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy., Pinheiro-Neto CD; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.; Department of Otolaryngology/Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA., Leonel LCPC; Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA.; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA., Peris-Celda M; Rhoton Neurosurgery and Otolaryngology Surgical Anatomy Program, Mayo Clinic, Rochester, Minnesota, USA.; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.; Department of Otolaryngology/Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Jazyk:	angličtina
Zdroj:	Operative neurosurgery (Hagerstown, Md.) [Oper Neurosurg (Hagerstown)] 2024 Jul 05. Date of Electronic Publication: 2024 Jul 05.
DOI:	10.1227/ons.0000000000001258
Abstrakt:	Background and Objectives: The coexistence of complete carotico-clinoid bridge (CCB), an ossification between the anterior (ACP) and the middle clinoid (MCP), and an interclinoidal osseous bridge (ICB), between the ACP and the posterior clinoid (PCP), represents an uncommonly reported anatomic variant. If not adequately recognized, osseous bridges may complicate open or endoscopic surgery, along with the pneumatization of the ACP, especially when performing anterior or middle clinoidectomies. Methods: According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, a systematic scoping review was conducted up to June 5, 2023. PubMed, Scopus, Web of Science databases, and additional citations were searched. Two hundred high-resolution noncontrast computed tomography (CT) scans (400 sides) and 41 dry skulls (82 sides) were analyzed to identify the different morphology of sellar bridges, focusing on the coexistence of complete CCF and ICB. Two embalmed latex-injected heads with coexisting CCF and ICB were dissected step-by-step to show the anatomic relationship with the surrounding structures from an endoscopic and microscopic perspective. Results: A total of 19 articles were included. The review identified a complete CCF and ICB rate ranging from 4.92% to 6.3%. The analysis of 200 CT scans revealed a rate of coexistence in 4% of the cases, all encountered in White women. Two different types of interclinoid bridges were identified based on the degree of bone mineralization. Both endoscopic and macroscopic step-by-step dissections highlighted variability in morphology and consistency of the sellar bridges and the close relationship with the cavernous sinus neurovascular structures. Conclusion: The coexistence of CCF and ICB is an anatomic variation found in 4% of cases. Preoperative knowledge of the degree of mineralization and its relationship with surrounding structures is essential to performing safe surgery and minimizing cranial nerve and vascular injuries. Preoperative high-resolution CT scans can adequately identify these anatomic variations. (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)
Databáze:	MEDLINE
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