视交叉
漏斗
垂体柄
医学
解剖
颈内动脉
鞍结节
枕神经刺激
眼动脉
视束
垂体
视神经
外科
放射科
病理
替代医学
血流
脑膜瘤
内科学
激素
作者
Francesco Doglietto,Daniel M. Prevedello,Francesco Belotti,Marco Ferrari,Davide Lancini,Alberto Schreiber,Elena Raffetti,Giuseppe La Rocca,Mario Rigante,Liverana Lauretti,Lena Hirtler,Barbara Buffoli,Piero Nicolai,Marco Maria Fontanella,Luigi Fabrizio Rodella,Fred Gentili,Manfred Tschabitscher
出处
期刊:Operative Neurosurgery
[Oxford University Press]
日期:2019-01-11
卷期号:17 (3): 321-331
被引量:14
摘要
Abstract BACKGROUND The use of high-definition endoscopes in extended transsphenoidal approaches to the suprasellar area has significantly improved visualization of its vascularization. OBJECTIVE To systematically examine the superior hypophyseal arteries (SHAs) anatomy from an endonasal endoscopic perspective. METHODS The endoscopic endonasal transsphenoidal trans-tuberculum approach was performed in 19 adult, fresh and latex injected specimens. Dissections recordings were reviewed to analyze SHAs type, number, and branches, as well as internal carotid arteries (ICA) branches that vascularized optic nerves and chiasm. RESULTS Identification of SHAs was possible in all specimens (37/38 sides). The number of SHAs varied from 1 to 3 per side (mean: 1.7). The anterior superior hypophyseal artery was visible in almost all cases (35/37 sides) and originated at the level of the carotid cave in 18/35 specimens; number of branches ranged from 1 to 6 (mean: 3.5), directed to the optic nerve (86%), chiasm (57%), infundibulum (86%), and/or parallel to the pituitary stalk (74%). The 4 main branches and patterns, originally described by McConnell in 1953, were confirmed. The posterior superior hypophyseal artery was evident in 28/37 sides with number of branches ranging from 0 to 4 (mean: 2.1), directed to the optic chiasm (50%), optic tract (32%), infundibulum (79%), and/or pituitary stalk (36%). The surgical implications of this study, together with anatomical and clinical videos, are also briefly discussed. CONCLUSION SHAs constitute a complex of anterior and posterior branches that stem from the medial ICA with different patterns, vascularizing the optic apparatus and pituitary stalk.
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