The Superior Hypophyseal Arteries: Anatomical Study with an Endoscopic Endonasal Perspective.

Humans Neuroendoscopy / methods Optic Chiasm / anatomy & histology Optic Nerve / anatomy & histology Pituitary Gland / anatomy & histology
Anatomical study Classification Endonasal endoscopic transsphenoidal Optic nerves and chiasm Pituitary stalk Superior hypophyseal arteries

Journal

Operative neurosurgery (Hagerstown, Md.)
ISSN: 2332-4260
Titre abrégé: Oper Neurosurg (Hagerstown)
Pays: United States
ID NLM: 101635417

Informations de publication

Date de publication:
01 09 2019
Historique:
received: 09 04 2018
accepted: 14 12 2018
pubmed: 17 1 2019
medline: 21 10 2020
entrez: 17 1 2019
Statut: ppublish

Résumé

The use of high-definition endoscopes in extended transsphenoidal approaches to the suprasellar area has significantly improved visualization of its vascularization. To systematically examine the superior hypophyseal arteries (SHAs) anatomy from an endonasal endoscopic perspective. 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. 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. 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.

Sections du résumé

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.

Identifiants

DOI: 10.1093/ons/opy393 PMID: 30649535
pubmed: 30649535
pii: 5288467
doi: 10.1093/ons/opy393
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

321-331

Informations de copyright

Copyright © 2019 by the Congress of Neurological Surgeons.

Auteurs

Francesco Doglietto (F)

Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Daniel Monte-Serrat Prevedello (DM)

Department of Neurological Surgery, Wexner Medical Centre, The Ohio State University College of Medicine, Columbus, Ohio.

Francesco Belotti (F)

Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Marco Ferrari (M)

Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Davide Lancini (D)

Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Alberto Schreiber (A)

Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Elena Raffetti (E)

Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.

Giuseppe La Rocca (G)

Neurosurgery, Catholic University School of Medicine, Rome, Italy.

Mario Rigante (M)

Otorhinolaryngology, Catholic University School of Medicine, Rome, Italy.

Liverana Lauretti (L)

Neurosurgery, Catholic University School of Medicine, Rome, Italy.

Lena Hirtler (L)

Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria.

Barbara Buffoli (B)

Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Piero Nicolai (P)

Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Marco Maria Fontanella (MM)

Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Luigi Rodella (L)

Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Fred Gentili (F)

Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Canada.

Manfred Tschabitscher (M)

Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria.
Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The Superior Hypophyseal Arteries: Anatomical...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de neurochirurgie › Neuroendoscopie › The Superior Hypophyseal Arteries: Anatomical...
questionsmedicales.fr › Système nerveux › Système nerveux périphérique › Nerfs périphériques › Nerfs crâniens › Nerf optique › Chiasma optique › The Superior Hypophyseal Arteries: Anatomical...
questionsmedicales.fr › Système nerveux › Système nerveux périphérique › Nerfs périphériques › Nerfs crâniens › Nerf optique › The Superior Hypophyseal Arteries: Anatomical...
questionsmedicales.fr › Système nerveux › Système neuroendocrinien › Axe hypothalamohypophysaire › Hypophyse › The Superior Hypophyseal Arteries: Anatomical...