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Original Article



Anatomical Study and Morphometric Evaluation of Optochiasmatic Apparatus and Clinoidal Region and Its Neurosurgical Implications

Salem Bajramagic, Eldan Kapur, Ibrahim Omerhodzic, Sadat Pusina, Emsad Halilovic, Edin Hodzic.




Abstract

Background: This study clarified some of anatomical relationships between the anterior clinoid process (ACP) and its surrounding structures, and identified a few major variations, important for clinical practice, especially for neurosurgeons in some skull base approaches to the cavernous sinus and paraclinoidal region lesions. Objective: The purpose of this paper is to show and prove morphometric variations of structures of sphenoid bone, the presence of caroticoclinoid foramen and types of ocular fissures and their practical significance primarily in neurosurgery in pituitary access and aneurysm surgery as well as comparison with other populations to prove the existence of difference between populations. Methods: By using classic anatomic methods-measurements 100 macerated and degenerated skulls were analyzed. With manual caliper, basal width, length and depth of anterior clinoid processes were measured. Furthermore, presence of different types of caroticoclinoid foramens, their diameters and presence of bone out-coming structures at the edges of superior orbital fissure (SOF) were analyzed. Results: We have found that optic strut (OS) was mainly adjusted in the first two fifths of the ACP (right side 42%, left 47.8%). We also noted that the basal width, length and depth of anterior clinoid process at the right side were 8.45±1.56 mm, 11.54 ±1.45 mm, 4.03±0.82 mm, and at the left side were 8.53±1.64 mm, 11.38±1.43 mm and 4.02±0.76 mm respectively. The greatest difference, due to sexes and side of skull, was presented with the incomplete type of caroticoclinoid foramen (CCF), which is much more frequent in males, placed to the right (39%) and to the left (31%). Same appearance at females is presented at the right side with 14% and at the left side with 9%. The average value of transversal foramen’s diameter was 3.55±2.55 mm. Conclusion: Incidence of appearance of interclinoid bone bridges in our study, on the sample of 100 skulls (200 sides) was 33% with significant difference between sexes. We used this sample to analyze the percent of different types of SOF in terms of analyzing the difference between sexes.

Key words: Keywords: Optic strut, anterior clinoid process, caroticoclinoid foramen, superior orbital fissure, skull base surgery.






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