Anatomical Variations of the Anterior Clinoid Process: A Study of 597 Skull Base Computerized Tomography Scans

Anatomical Variations of the Anterior Clinoid Process: A Study of 597 Skull Base Computerized Tomography Scans

Author Silva da Costa, Marcos Devanir Autor UNIFESP Google Scholar
de Oliveira Santos, Bruno Fernandes Autor UNIFESP Google Scholar
Paz, Daniel de Araujo Autor UNIFESP Google Scholar
Rodrigues, Thiago Pereira Autor UNIFESP Google Scholar
Abdala, Nitamar Autor UNIFESP Google Scholar
Centeno, Ricardo Silva Autor UNIFESP Google Scholar
Cavalheiro, Sergio Autor UNIFESP Google Scholar
Lawton, Michael T. Google Scholar
Chaddad-Neto, Feres Autor UNIFESP Google Scholar
Abstract BACKGROUND: The anterior clinoid process (ACP) is surrounded by a complex anatomy

variations include pneumatization and the formation of bone bridges with the middle and posterior clinoid, which complicate surgery. The key to avoiding microsurgical complications is a perfect understanding of this anatomy. OBJECTIVE: To explore the anatomic variations of the ACP. METHODS: Between January 1, 2013, and September 6, 2014, 597 skull base computed tomography scans were performed to evaluate inner ear disease in patients with no history of paranasal sinus disease or endonasal surgery. The base width and length of the ACP, complete carotid-clinoid foramen and sella turcica bridge, and sphenoid sinus pneumatization volume were assessed. ACP pneumatization was assessed with the use of a novel classification system. RESULTS: The scans were derived from a population of 343 female patients (57.5%), with a mean age of 38.6 years (0.2-90 years). ACP base width and length were 7.7 +/- 1.73 and 10.31 +/- 2.1 mm, respectively. Anatomic variations were present in 38.7% of scans. ACP pneumatization was present in 25.5% of scans, and carotid-clinoid foramen and sella turcica bridge were present in 14.2% and 14.4% of scans, respectively. There was no pneumatization of the ACP in patients <10 years of age and no progression of the pneumatization of the sphenoid sinus in patients >10 years old. CONCLUSION: At least 1 variation in ACP anatomy was found in 38.7% of cases with this simple method. Thus, a preoperative computed tomography scan could improve surgical procedures that involve removal of the anterior clinoid process.
Keywords Anterior clinoid process
Anterior clinoidectomy
Cavernous sinus
Paraclinoid aneurysm
Sphenoid bone
Sphenoid sinus volume
Language English
Date 2016
Published in Operative Neurosurgery. Philadelphia, v. 12, n. 3, p. 289-297, 2016.
ISSN 2332-4252 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 289-297
Access rights Closed access
Type Article
Web of Science ID WOS:000381653600017

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