Mehmet Ozan DURMAZ, Navdar DOĞUŞ UZUN, Hamit Selim KARABEKİR, Nuket GÖÇMEN MAS, Gökşin Nilüfer YONGUÇ

Cerrahi yaklaşım açısından hipofizer fossa ile ilişkili yapıların morfometrik analizi

GİRİŞ ve AMAÇ: Kafa tabanının morfometrik ve topografik anatomisinin önemi birçok nöroşirürji ve radyoloji yazısında yer almaktadır. Çalışmamızın amacı cerrahi koridorları tanımlamak ve cerrahi yaklaşımda güvenli mesafeler oluşturulmasına yardımcı olunmasını sağlayacak ortalama mesafelerin belirlenmesidir. YÖNTEM ve GEREÇLER: Dokuz Eylül Üniversitesi Tıp Fakültesi Anatomi Anabilim Dalı Laboratuvarına ait 16 adet kuru kemik cranium incelendi. Tüm kafatası tabanlarında foramen lacerum, foramen rotundum, foramen ovale, fossa hypophysialis, processus clinoideus anterior ve processus clinoideus posterior belirlendi ve bu parametreler arasındaki mesafeler dijital Vernier kumpas ile ölçüldü. BULGULAR: Foramen rotundum'un sağ taraftaki processus clinoideus anterior'a olan uzaklığı soldan daha büyüktü (p: 0,41). Foramen ovale'nin sol taraftaki processus clinoides posterior'a olan uzaklığı sağdan daha büyüktü (p: 0.010). Diğer parametrelerde sol ve sağ taraflar arasında istatistiksel olarak anlamlı fark yoktu. TARTIŞMA ve SONUÇ: Operasyonlar sırasında komplikasyonlar ortaya çıksa da bölgesel anatomiye hakim olunması; ölüm ve morbidite insidansını azaltmaktadır. Yapmış olduğumuz morfometrik ve topografik değerlendirmelerimizin cerrah ve radyologlara rehberlik edeceğine inanmakla birlikte daha geniş ve çok merkezli serilere ihtiyaç vardır.

Morphometric Analysis of Hypophyseal Fosa Related Structure; in Terms of Surgical Aproach

INTRODUCTION: The importance of knowledge regardingboth the anatomy and the structures of the skull base are citedin many neurosurgery and radiology papers. Therefore, thepurposes of our study were to identify the surgical corridorsand to determine the mean distances to help establish the safestdistances for surgical approaches.METHODS: We examined 16 dry human skulls of unknowngender that belonged to the Anatomy Department Laboratoryof Dokuz Eylul University Medical School. Foramen lacerum(FL), foramen rotundum (FL), foramen ovale (FO),hypophyseal fossa, anterior clinoid process (ACP) andposterior clinoid process (PCP) were determined in all skullbases and distances between these parameters were recordedwith digital Vernier caliper which was accurate to millimeters.RESULTS: The FR’s distance to the ACP on the right side wasgreater than on the left side ( p: 0.41). The FO’s distance to thePCP on the left side was greater than on the right side (p:0.010). There were no other statistically significant differencesbetween the left and right sides.DISCUSSION and CONCLUSION: Although complicationscan occur, improved familiarity with the regional anatomywould lower incidences of death and morbidity duringsurgeries. While we believe that our morphometric andtopographic evaluations will help guide surgeons andradiologists, wider series and multi-center studies should bedone.

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