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Surface and superficial surgical anatomy of the posterolateral cranial base: significance for surgical planning and approach.
Neurosurgery 1996; 38(6):1079-83; discussion 1083-4N

Abstract

We have performed an anatomic study, 15 using fixed cadaveric preparations, with the goal of identifying surface landmarks that will reliably locate the underlying transverse and sigmoid sinus complex. Simple morphometric relationships were first determined on both sides of each specimen to yield 30 sides measured. The following relationships were determined: 1) zygoma root-asterion, 2) asterion-mastoid tip, 3) zygoma root-suprameatal spine (Henle's spine), 4) asterion-suprameatal spine, 5) mastoid tip-suprameatal spine. The relationship of the asterion to the transverse-sigmoid junction was determined by bone removal. Also, the distances from the asterion to the sigmoid sinus-superior petrosal sinus junction and the superior margin of the transverse sinus were studied. Surface and marks were found to have definitive relationships to underlying anatomic substrates in all specimens studied. The critical relationships that were concluded from this study can be described in terms of two easily identified lines between bony surface structures. A line drawn from the zygoma root to the inion, i.e., the superior nuchal line, reliably located the rostrocaudal level of the transverse sinus in all specimens. Although the asterion did not consistently fall on this line, the transverse-sigmoid junction could reliably be placed at the anteroposterior level of the asterion. Further, a line drawn from the squamosal-parietomastoid suture junction to the mastoid tip reliably defined the axis of the sigmoid sinus through the mastoid. We also found that the junction of the squamosal and parietomastoid sutures lay over the anterior border of the upper curve of the sigmoid sinus. The anterior portion of the supramastoid crest correlated with the level of the middle fossa. These surface relationships all have significance for posterolateral approaches to the cranial base. Since performing this study, these relationships have been found reliable for operative planning in our clinical cases.

Authors+Show Affiliations

Department of Neurological Surgery, University of Southern California, Los Angeles.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8727136

Citation

Day, J D., et al. "Surface and Superficial Surgical Anatomy of the Posterolateral Cranial Base: Significance for Surgical Planning and Approach." Neurosurgery, vol. 38, no. 6, 1996, pp. 1079-83; discussion 1083-4.
Day JD, Kellogg JX, Tschabitscher M, et al. Surface and superficial surgical anatomy of the posterolateral cranial base: significance for surgical planning and approach. Neurosurgery. 1996;38(6):1079-83; discussion 1083-4.
Day, J. D., Kellogg, J. X., Tschabitscher, M., & Fukushima, T. (1996). Surface and superficial surgical anatomy of the posterolateral cranial base: significance for surgical planning and approach. Neurosurgery, 38(6), pp. 1079-83; discussion 1083-4.
Day JD, et al. Surface and Superficial Surgical Anatomy of the Posterolateral Cranial Base: Significance for Surgical Planning and Approach. Neurosurgery. 1996;38(6):1079-83; discussion 1083-4. PubMed PMID: 8727136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surface and superficial surgical anatomy of the posterolateral cranial base: significance for surgical planning and approach. AU - Day,J D, AU - Kellogg,J X, AU - Tschabitscher,M, AU - Fukushima,T, PY - 1996/6/1/pubmed PY - 1996/6/1/medline PY - 1996/6/1/entrez SP - 1079-83; discussion 1083-4 JF - Neurosurgery JO - Neurosurgery VL - 38 IS - 6 N2 - We have performed an anatomic study, 15 using fixed cadaveric preparations, with the goal of identifying surface landmarks that will reliably locate the underlying transverse and sigmoid sinus complex. Simple morphometric relationships were first determined on both sides of each specimen to yield 30 sides measured. The following relationships were determined: 1) zygoma root-asterion, 2) asterion-mastoid tip, 3) zygoma root-suprameatal spine (Henle's spine), 4) asterion-suprameatal spine, 5) mastoid tip-suprameatal spine. The relationship of the asterion to the transverse-sigmoid junction was determined by bone removal. Also, the distances from the asterion to the sigmoid sinus-superior petrosal sinus junction and the superior margin of the transverse sinus were studied. Surface and marks were found to have definitive relationships to underlying anatomic substrates in all specimens studied. The critical relationships that were concluded from this study can be described in terms of two easily identified lines between bony surface structures. A line drawn from the zygoma root to the inion, i.e., the superior nuchal line, reliably located the rostrocaudal level of the transverse sinus in all specimens. Although the asterion did not consistently fall on this line, the transverse-sigmoid junction could reliably be placed at the anteroposterior level of the asterion. Further, a line drawn from the squamosal-parietomastoid suture junction to the mastoid tip reliably defined the axis of the sigmoid sinus through the mastoid. We also found that the junction of the squamosal and parietomastoid sutures lay over the anterior border of the upper curve of the sigmoid sinus. The anterior portion of the supramastoid crest correlated with the level of the middle fossa. These surface relationships all have significance for posterolateral approaches to the cranial base. Since performing this study, these relationships have been found reliable for operative planning in our clinical cases. SN - 0148-396X UR - https://www.unboundmedicine.com/medline/citation/8727136/Surface_and_superficial_surgical_anatomy_of_the_posterolateral_cranial_base:_significance_for_surgical_planning_and_approach_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=8727136.ui DB - PRIME DP - Unbound Medicine ER -