scholarly journals Shapes and Sizes of Sella Turcica Using Computerized Tomography (CT) from Tertiary Hospital in Sokoto, Nigeria

2020 ◽  
pp. 8-15
Author(s):  
Z. Usman ◽  
A. D. Zagga ◽  
G. H. Yunusa ◽  
U. Abubakar ◽  
A. Bello ◽  
...  
Keyword(s):  
Sella Turcica ◽  
Posterior Wall ◽  
Middle Cranial Fossa ◽  
Tertiary Hospital ◽  
Transverse Diameter ◽  
Body Parts ◽  
Shape Variation ◽  
Significant Difference ◽  
Cranial Fossa

Cephalometry deals with measurement of body parts or radiological specimen. Sella turcica is an important anatomical structure located in the middle cranial fossa, housing the pituitary gland. Various shapes and sizes of the sellae turcica were reported. In this study, using computerized tomographic (CT) scans from a tertiary hospital, one hundred and seventy five (175) scans were analyzed using Radiant version 4.2 (Medixant 2017) for determination of sizes and shapes of the sella. Average dimensions from the study include: Length (12.4 mm), A-P diameter (14.1 mm), depth (9.6 mm) and transverse diameter (13.8 mm). Shapes were classified as being round (56.6%), oval (32%) and flat (11.4%). In another classification of shape variation, the findings are: Normal (68.6%), anterior oblique (9.1%), pyramidal (6.9%), double contour floor (5.7%), notching on the posterior wall (5.1%) and sella bridge (4.6%). Males tend to have higher sella sizes than females and there is statistical significant difference between them especially in respect to A-P diameter and length parameters. However, there is no sex predilection to shapes.

scholarly journals Cephalometric Analysis of Sella Turcica for Age Determination from Sokoto, Nigeria: A Radiological Study

2019 ◽  
pp. 1-7
Author(s):  
Z. Usman ◽  
G. H. Yunusa ◽  
A. Bello ◽  
J. D. Usman ◽  
A. Aliu ◽  
...  
Keyword(s):  
Age Groups ◽  
Age Determination ◽  
Sella Turcica ◽  
Middle Cranial Fossa ◽  
Anatomical Structure ◽  
Ct Scans ◽  
Transverse Diameter ◽  
Radiological Study ◽  
Cranial Fossa

Cephalometry deals with the measurement of the head or radiological specimen of the head. Sella turcica is an important anatomical structure located in the middle cranial fossa, housing the pituitary gland. Various shapes and sizes of the sellae turcica have been reported. However, in this study, using computerized tomographic (CT) scans, one hundred and seventy-five (175) scans were analyzed using Radiant version 4.2 for determination of sizes and shapes of the sella. Average dimensions from the study include length (12.4mm), A-P diameter (14.1 m), depth (9.6 mm) and transverse diameter (13.8mm). Shapes were classified as being round (56.6%), oval (32%) and flat (11.4%). Males tend to have higher sella sizes than females and there are statistically               significant differences between them especially in respect to A-P diameter and length parameters. Also, there is a statistically significant relationship between age groups in terms of A-P diameter and depth of the sella turcica. However, there is no correlation between age and shapes found in the study.

The So-Called Cavernous Sinus: A Review of the Controversy and Its Implications for Neurosurgeons

Neurosurgery ◽  
1982 ◽  
Vol 11 (5) ◽  
pp. 712-717 ◽  
Author(s):  
John N. Taptas
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Cranial Nerves ◽  
Sella Turcica ◽  
Middle Cranial Fossa ◽  
Cranial Fossa ◽  
Base Of The Skull ◽  
Extradural Space

Abstract The so-called cavernous sinus is a venous pathway, an irregular network of veins that is part of the extradural venous network of the base of the skull, not a trabeculated venous channel. This venous pathway, the internal carotid artery, and the oculomotor cranial nerves cross the medial portion of the middle cranial fossa in an extradural space formed on each side of the sella turcica by the diverging aspects of a dural fold. In this space the venous pathway has only neighborhood relations with the internal carotid artery and the cranial nerves. The space itself must be distinguished from the vascular and nervous elements that it contains. The revision of the anatomy of this region has not only theoretical interest but also important clinical implications.

scholarly journals Variations of sphenoid pneumatization: a CBCT study

2015 ◽  
Vol 5 (18) ◽  
pp. 107-113
Author(s):  
Catalina Craiu ◽  
Mihai Sandulescu ◽  
Mugurel Constantin Rusu
Keyword(s):  
Sphenoid Sinus ◽  
Anatomic Variation ◽  
Sella Turcica ◽  
Middle Cranial Fossa ◽  
Maxillary Nerve ◽  
Onodi Cell ◽  
Cranial Fossa ◽  
Left And Right ◽  
Air Cells ◽  
Case Basis

AbstractBACKGROUND. The pneumatization pattern of the sphenoid sinus seems rather unpredictable, as resulted from previous studies. It is however extremely important for endoscopic approaches to target structures of the middle cranial fossa, such as the pituitary gland.MATERIAL AND METHODS. We aimed at documenting by Cone Beam Computed Tomography (CBCT) the possibilities of anatomic variation of the sphenoid sinus. 25 randomly selected patients were retrospectively analyzed.RESULTS. In 56%, the left and right sphenoidal sinuses were bilaterally symmetrical with respect to the sagittal pneumatization type: four patients had sellar types, one had presellar type and in nine cases the sphenoidal sinuses were reaching posteriorly to the sella turcica. Only in 8% of cases were found conchal types of pneumatization, but they were part of anatomical pictures including Onodi air cells. Such an Onodi cell presented a posterior (sphenoidal) recess reaching posteriorly and superiorly to the pterygopalatine fossa. The recesses of the sphenoid sinus were also documented: anterior or septal, ethmoidal, maxillary, clinoidal and lateral. In 32% was found a lateral recess only engaged between the vidian and maxillary nerve canals.CONCLUSION. It appears that CBCT is a reliable tool for accurate anatomic identification of the sphenoid sinus pneumatization pattern, on a case-by-case basis.

Facial Nerve Outcomes in Middle Cranial Fossa vs Translabyrinthine Approaches

2005 ◽  
Vol 133 (6) ◽  
pp. 906-910 ◽  
Author(s):  
Brandon Isaacson ◽  
Steven A. Telian ◽  
Hussam K. El-Kashlan
Keyword(s):  
Facial Nerve ◽  
Tertiary Care ◽  
Middle Cranial Fossa ◽  
Vestibular Schwannomas ◽  
Care Hospital ◽  
Case Review ◽  
Retrospective Case ◽  
Increased Risk ◽  
Significant Difference ◽  
Cranial Fossa

OBJECTIVE: To compare the final facial nerve outcomes between middle cranial fossa (MCF) vs translabyrinthine (TL) resection of size-matched vestibular schwannomas. STUDY DESIGN AND SETTING: Retrospective case review at a tertiary care hospital. All patients who underwent resection utilizing either MCF or TL approaches with tumors 18 mm or smaller and complete data were included in the analysis. One hundred twenty-four patients were identified meeting the above criteria, with sixty-three in the translabyrinthine group and sixty-one in the middle fossa group. One-week-postoperative and final facial nerve examinations were compared in the two surgical groups. Patients were separately analyzed in subgroups: tumors smaller than 10 mm and those that were between 10 and 18 mm. RESULTS: The tumor size range for the MCF group was 3-18 mm while it was 4-18 mm for the TL group. No statistically significant difference was found in facial nerve outcomes between the two surgical groups, at the first postoperative visit week and at last follow-up. CONCLUSION: Facial nerve outcomes are similar using TL and MCF approaches for resection of vestibular schwannomas up to 18 mm in size. SIGNIFICANCE: Patients undergoing the MCF approach for hearing preservation can be counseled that there is no increased risk of permanent facial nerve weakness, compared to the TL approach. EBM RATING: B-3

scholarly journals Numerical variations and localization of foramen spinosum in 3D-CT images

2021 ◽  
Vol 15 (1) ◽  
pp. 59-63
Author(s):  
Yadigar Kastamoni ◽  
Ahmet Dursun ◽  
Veysel Atilla Ayyıldız ◽  
Kenan Öztürk
Keyword(s):  
Transverse Section ◽  
Middle Cranial Fossa ◽  
Ct Images ◽  
3D Ct ◽  
Foramen Ovale ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Cranial Fossa ◽  
Neurovascular Structures

Objectives: The structures passing through the foramen spinosum and its neurovascular relationships are of great importance for surgical approches directed to middle cranial fossa. The aim of the present study was to examine the number and location of the foramen spinosum (FS) in 3D-CT images. Methods: The study was retrospectively conducted on 3D-CT images of 177 adults. Firstly, the transverse section passing through the upper edge of the orbit, extending parallel to the Frankfurt plane was chosen. Then, the x and y-axes were determined on that transverse section. The coordinates, number, and location of the FS with respect to the foramen ovale (FO) were identified accordingly on x and y-axes. Results: While 1 FS was present in 90.96% of a total of 354 sides of 177 heads, there were 2 FS and 3 FS in 8.76% and 0.28% of the sides, respectively. The FS was located posterolaterally in 97.68%, posteriorly in 2.06%, and laterally in 0.26% with respect to the FO. In terms of FS coordinates, there was no statistically significant difference between gender and sides in the distance of the FS to the x-axis, but there was a statistically significant difference between gender and sides in the distance of the FS to the y-axis. Conclusion: Evaluation of the number of the FS and its location would help identifying and preserving neighbouring neurovascular structures during surgical interventions directed to the middle cranial fossa.

scholarly journals Middle Cranial Fossa Encephalocele and Cerebrospinal Fluid Leakage: Etiology, Approach, Outcomes

2019 ◽  
Vol 81 (03) ◽  
pp. 268-274
Author(s):  
Beth McNulty ◽  
Christopher A. Schutt ◽  
Dennis Bojrab ◽  
Seilesh Babu
Keyword(s):  
Cerebrospinal Fluid ◽  
Middle Cranial Fossa ◽  
Csf Leak ◽  
Surgical Approaches ◽  
Cerebrospinal Fluid Leakage ◽  
Combined Approach ◽  
Common Location ◽  
Significant Difference ◽  
Cranial Fossa ◽  
Transmastoid Approach

Objective To compare outcome data for surgical approaches in the management of a middle cranial fossa encephalocele or cerebrospinal fluid (CSF) leak and, secondarily, to evaluate the role of obesity and the etiology of the defect. Design Retrospective Setting Quaternary referral center Participants The study included 73 patients who underwent surgical repair of middle cranial fossa tegmen defects, two of which underwent bilateral repair. Outcome Measures Demographic characteristics, clinical presentation, etiology, imaging, audiometry, surgical findings, method and material for repair, and postoperative course. Results Fifty cases were spontaneous in origin, 2 were iatrogenic, and 23 were because of chronic otitis media. Of the 50, 18 underwent middle fossa craniotomy, 29 underwent a transmastoid approach, and 28 underwent a combined approach for repair. A postoperative CSF leak was seen in five patients: one who had undergone a transmastoid approach and four after a combined approach. There was no significant difference between the three approaches and risk of postoperative CSF fistulae. Two of the CSF fistulae resolved after a lumbar drain, and the remaining three patients required revision surgery. Conclusions Middle cranial fossa tegmen defects are most commonly seen in obese females and are spontaneous in origin. The most common location was the tegmen mastoideum, and these defects were most commonly repaired through the transmastoid approach, with no greater risk of recurrence.

Sella Turcica Dimensions and Morphology in a Yoruba Ethnic Population: A Computed Tomography Study

2021 ◽  
Vol 11 (9) ◽  
pp. 270-276
Author(s):  
Okon Etim Bassey ◽  
Hyacienth Uche Chiegwu ◽  
Chistopher Chukwuemeka Ohagwu
Keyword(s):  
Computed Tomography ◽  
Sella Turcica ◽  
Ct Images ◽  
Cranial Computed Tomography ◽  
Transverse Diameter ◽  
Ethnic Population ◽  
Male And Female ◽  
Anteroposterior Diameter ◽  
Significant Difference ◽  
The Mean

Background: Several sellar and parasellar pathologies affect the size and shape of sella turcica. A deviation from normal dimensions of sella turcica could be an indication of a pathological condition of the structure itself or the pituitary gland. Aim: This study was designed to assess the dimensions and morphology of the sella turcica of Yoruba ethnic population using cranial computed tomography (CT) images. Materials and Methods: This was a retrospective study involving 321 cranial CT images of the Yoruba subjects acquired in a tertiary health institution between January 2020 and April 2021. The sella turcica length, depth and anteroposterior diameter were measured using the digital calipers of the CT system while sella morphological shape was determined qualitatively by observing the floor of sella in the midsagittal slice and quantitatively by taking the ratio of superoinferior diameter to the transverse diameter. Result: In general, the mean and standard deviation value of sella turcica length was 12.2±`2.35mm. The mean sella length for males was 12.62`±2.50 and that for females was 11.69 ±`2.04mm. The result showed that males’ sella length differed significantly from that of females (t=3.635, p=0.000). A significant difference was noted between the sella depths of the two genders (p=0.032). The total mean anteroposterior diameter (APD) of sella turcica was 13.4`± 2.47mm. Male and female mean diameters were 13.6`± 2.45mm and 13.3±`2.17mm respectively. No significant difference was noted in sella length and APD across the age categories but sella depth showed a significant difference, which was noted to only exist between early adulthood (≤34 years) and late adulthood (≥65) (p=0.027). No statistically significant association was noted between sella shape and gender (c2=3.124, p=0.210) as well as age (c2=9.336, p=0.156). Conclusion: Only the mean sella length and depth differ significantly between male and female genders. Anteroposterior diameter is the same irrespective of gender. The sella turcica dimensions obtained from this study will serve as reference values for physicians in the assessment of sellar and parasellar pathologies in the study population. Key words: Computed tomography, sella turcica, morphology.

scholarly journals Craniotopographic characteristics of the distances between the foramina of the middle cranial fossa taking into account the human craniotype

2020 ◽  
Vol 24 (4) ◽  
pp. 565-570
Author(s):  
I. V. Chekanova ◽  
O. Yu. Vovk ◽  
V. B. Ikramov ◽  
S. O. Dubina
Keyword(s):  
Imaging System ◽  
Statistical Processing ◽  
Human Head ◽  
Middle Cranial Fossa ◽  
Morphometric Study ◽  
Measuring Instruments ◽  
Significant Difference ◽  
Cranial Fossa ◽  
Left And Right ◽  
Average Size

Annotation. It is known that within the middle cranial fossa there are rotundum, ovale and spinosum foramina through which important vessels and nerves pass. That is why it is important for surgeons not to damage them during surgery. The aim of the work was to establish the craniotopographic characteristics of the distances between the foramens of the middle cranial fossa of a mature person depending on the extreme types of skull structure. The morphometric study was performed on 50 CT scans of the adult human head using the anatomical imaging system Anatomage table, with the installed program Launching Table 6.0 Application and 50 bone preparations of the skull of adults in standard craniological methods using a common set of measuring instruments. In our study, craniometry was performed between the rotundum, ovale and spinosum foramina of the middle cranial fossa. Statistical processing of the obtained digital material was performed by the variation-statistical method with the determination of the Mann-Whitney criterion (p<0.05). The performed morphometry showed there is a slight asymmetry of the distances between the foramens of the left and right parts of the middle cranial fossa. The study also showed that there is no significant difference in the average size between the foramens in the left and right halves of the middle cranial fossa depending on the extreme types of skull. The length between the foramina of the same name (rotundum, ovale and spinosum) is characterized by a gradual increase in parameters from dolichocranes to brachycranes, combined with an increase in latitudinal size in brachycranes, average values in mesocranes and a decrease in transverse parameters in dolichocranes. The obtained results complement the existing information on craniotopographic and craniometric features of the middle cranial fossa and can be the basis for further research.

scholarly journals Comparison of clinical and CSF profiles in 62 Adults with tuberculous and pyogenic meningitis

2017 ◽  
Vol 5 (5) ◽  
pp. 2168
Author(s):  
Munish Kumar ◽  
Durgesh Kumar ◽  
Alok Onkar Sahu ◽  
Manoj Kumar Rastogi
Keyword(s):  
Cerebrospinal Fluid ◽  
Tertiary Hospital ◽  
Pyogenic Meningitis ◽  
Protein Ratio ◽  
Cytochemical Analysis ◽  
Duration Of Illness ◽  
Cranial Fossa ◽  
The Mean ◽  
Symptoms And Signs

Background: Many a times differentiating tuberculous meningitis from pyogenic meningitis becomes very difficult. The diagnosis depends upon clinical manifestation and cytochemical analysis of cerebrospinal fluid (CSF). Many researchers found that the CSF glucose: protein ratio less than 0.5 and Adenosine deaminase levels (ADA) in cerebrospinal fluid are useful to differentiate tubercular disease from non-tubercular meningitis.Methods: Sixty-two patients admitted to our tertiary hospital with symptoms and signs of meningitis were selected and divided into two groups: tubercular (n=39) and pyogenic (n= 23), depending upon the accepted criteria. Clinical features and CSF parameters noted in each patient. Cut off value of ADA kept at or above 10 IU/L for tubercular meningitis.Results: The mean age of patients with tubercular meningitis was 39.07±16.67 years and that of pyogenic meningitis 34.35±16.73 years. Clinically fever was present in 60 (96.77%), headache in 49 (79.03%), and vomiting in 44 (70.96%) patients. Meningeal signs – neck rigidity in 46 (74.2%), Kernig’s sign in 37 (59.68%) and Brudzinski’s sign in 18 (29.03%) patients. On CSF cytological and biochemical analysis the mean total white blood cell count was 256.74±184.03 /cmm, mean protein 182.22±113.12 mg/dl and mean sugar 52.85±19.3mg/dl in TBM whereas in pyogenic meningitis 106.17±185.18 / cmm, 88.78±114.35 mg/ dl, and 63.47±19.48 mg/dl respectively. Out of 39 tuberculous patients, 33 patients were found to be having CSF ADA at or above the cutoff value of 10 IU/L while only one among pyogenic meningitis. On comparison between two groups, the CSF ADA level found to be statistically highly significant (P < 0.001) with overall accuracy of the test was 85.5 %.Conclusions: We found that the duration of illness, estimation of cerebrospinal fluid ADA with a cut off value of 10 IU/L and CSF glucose: protein ratio of 0.5 may useful in differentiating tuberculous from pyogenic meningitis. posterior cranial fossa surgeries. This work will also be useful to anthropologists, forensic science experts for determination of sex of the skull along with other parameters.

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