Eda Didem YALÇIN, Saliha Seda ADANIR, İlhan BAHŞİ, Mustafa ORHAN, Piraye KERVANCIOĞLU, Orhan BEGER

Radiologic Evaluation of the Prechiasmatic Sulcus in Adults and Clinical Implications

Background: The present work intended to analyze the prechiasmatic sulcus types in adults via cone-beam computed tomographic images. Methods: Four hundred randomly selected adult patient files registered in the electronic system of Gaziantep University Faculty of Dentistry were investigated retrospectively. The morphological features of the prechiasmatic sulcus including its size, angulation, and classification were revealed. Results: The planum length was measured as 11.82±3.12 mm (4.70-20.72 mm), the sulcal length as 5.61±1.50 mm (1.82-11.20 mm), the sulcal angle (SA) as 18.66±9.90˚ (0-50.60˚), and the interoptic distance as 17.65±2.14 mm (8.60-24.52 mm). The interoptic distance was greater in male samples compared to females (P < .001); however, the sulcal angle (P=.834), sulcal length (P=.658), and planum length (P=.326) were similar in genders. Considering the average groove length and angle, the narrow steep sulcus was observed as 22.25% (89 cases), the narrow flat sulcus as 26.75% (107 cases), the wide steep sulcus as 25.5% (102 cases), and the wide flat sulcus as 25.5% (102 cases). Conclusions: The findings of this radiologic study may be helpful for neurosurgeons, neuroradiologists, and otorhinolaryngologists in selection of patients suitable for surgical approach (e.g., endonasal or transcranial), by providing categorization of the prechiasmatic sulcus during resection of sulcus-related pathological entities.

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1. Guthikonda B, Tobler WD, Jr, Froelich SC, et al. Anatomic study of the prechiasmatic sulcus and its surgical implications. Clin Anat. 2010;23(6):622-628. [CrossRef]
2. Mortazavi MM, Brito da Silva H, Ferreira M, Jr, Barber JK, Pridgeon JS, Sekhar LN. Planum sphenoidale and tuberculum sellae meningiomas: operative nuances of a modern surgical technique with outcome and proposal of a new classification system. World Neurosurg. 2016;86:270-286. [CrossRef]
3. Beger O, Ten B, Balcı Y, et al. A computed tomography study of the prechiasmatic sulcus anatomy in children. World Neurosurg. 2020;141:e118-e132. [CrossRef]
4. Kanellopoulou V, Efthymiou E, Thanopoulou V, et al. Prechiasmatic sulcus and optic strut: an anatomic study in dry skulls. Acta Neurochir (Wien). 2017;159(4):665-676. [CrossRef]
5. Uçar H, Bahşi I, Orhan M, Yalçin ED. The radiological evaluation of the crista galli and its clinical implications for anterior skull base surgery. J Craniofac Surg. 2021;32(5):1928-1930. [CrossRef]
6. Beger O, Taghipour P, Çakır S, et al. Fetal anatomy of the optic strut and prechiasmatic sulcus with a clinical perspective. World Neurosurg. 2020;136:e625-e634. [CrossRef]
7. Bahsi I. An anatomic study of the supratrochlear foramen of the humerus and review of the literature. Eur J Ther. 2019;25(4):295-303. [CrossRef]
8. Bahşi I, Orhan M, Kervancıoğlu P, Yalçın ED, Aktan AM. Anatomical evaluation of nasopalatine canal on cone beam computed tomography images. Folia Morphol. 2019;78(1):153-162. [CrossRef]
9. Gagliardi F, Donofrio CA, Spina A, et al. Endoscope-assisted transmaxillosphenoidal approach to the sellar and parasellar regions: an anatomic study. World Neurosurg. 2016;95:246-252. [CrossRef]
10. Kerr RG, Tobler WD, Leach JL, et al. Anatomic variation of the optic strut: classification schema, radiologic evaluation, and surgical relevance. J Neurol Surg B Skull Base. 2012;73(6):424-429. [CrossRef]
11. Locatelli M, Di Cristofori A, Draghi R, et al. Is complex sphenoidal sinus anatomy a contraindication to a transsphenoidal approach for resection of sellar lesions? Case series and review of the literature. World Neurosurg. 2017;100:173-179. [CrossRef]
12. Hamid O, El Fiky L, Hassan O, Kotb A, El Fiky S. Anatomic variations of the sphenoid sinus and their impact on trans-sphenoid pituitary surgery. Skull Base. 2008;18(1):9-15. [CrossRef]
13. Mazzatenta D, Zoli M, Guaraldi F, et al. Outcome of endoscopic endonasal surgery in pediatric craniopharyngiomas. World Neurosurg. 2020;134:e277-e288. [CrossRef]
14. Beger O, Bahşi I. Chiasmatic ridge: incidence, classification, and clinical implications. J Craniofac Surg. 2021;32(5):1910-1912. [CrossRef]
15. Cares HL, Bakay L. The clinical significance of the optic strut. J Neurosurg. 1971;34(3):355-364. [CrossRef]
16. Kassam AB, Gardner PA, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM. Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum. J Neurosurg. 2008;108(4):715-728. [CrossRef]
17. Ozcan T, Yilmazlar S, Aker S, Korfali E. Surgical limits in transnasal approach to opticocarotid region and planum sphenoidale: an anatomic cadaveric study. World Neurosurg. 2010;73(4):326-333. [CrossRef]
18. Peris-Celda M, Kucukyuruk B, Monroy-Sosa A, Funaki T, Valentine R, Rhoton AL, Jr. The recesses of the sellar wall of the sphenoid sinus and their intracranial relationships. Neurosurgery. 2013;73(suppl 2 Operative):ons117-ons131; discussion ons31. [CrossRef]
19. Beretta F, Sepahi AN, Zuccarello M, Tomsick TA, Keller JT. Radiographic imaging of the distal dural ring for determining the intradural or extradural location of aneurysms. Skull Base. 2005;15(4):253-261; discussion 61-62. [CrossRef]
20. Dagtekin A, Avci E, Uzmansel D, et al. Microsurgical anatomy and variations of the anterior clinoid process. Turk Neurosurg. 2014;24(4):484-493. [CrossRef]
21. de Notaris M, Solari D, Cavallo LM, et al. The "suprasellar notch," or the tuberculum sellae as seen from below: definition, features, and clinical implications from an endoscopic endonasal perspective. J Neurosurg. 2012;116(3):622-629. [CrossRef]
22. Gökce C, Cicekcibasi AE, Yilmaz MT, Kiresi D. The morphometric analysis of the important bone structures on skull base in living individuals with multidetector computed tomography. Int J Morphol. 2014;32(3):812-821. [CrossRef]
23. Lang J. Skull Base and Related Structures: Atlas of Clinical Anatomy. Stuttgart: Schattauer Verlag; 2001.
24. Kier EL, Rothman S, eds. Radiologically significant anatomic variations of the developing sphenoid in humans. Symposium on the Development of the Basicranium (Publication no. NIH 1976).
25. Zada G, Agarwalla PK, Mukundan S, Jr, Dunn I, Golby AJ, Laws ER, Jr. The neurosurgical anatomy of the sphenoid sinus and sellar floor in endoscopic transsphenoidal surgery. J Neurosurg. 2011;114(5):1319- 1330. [CrossRef]