Petroclival Clinoidal Folds and Arachnoidal Membranes of the Anteromedial Incisural Space: Clinical Anatomy for Neuro Critical Care.

A systematic and narrative literature review was performed, focusing attention on the anatomy of the area located at the junction of the sphenoid and the basal portion of the temporal bone (petrous bone, petrous apex, upper petro-clival region) encircled by the free edge of the tentorium, the insertion of the tentorium itself to the petrous apex and the anterior and posterior clinoid processes that give rise to three distinct dural folds or ligaments: the anterior petroclinoid ligament, the posterior petroclinoid ligament and the interclinoid ligament. These dural folds constitute the posterior portion of the roof of the cavernous sinus denominated "the oculomotor triangle". The main purpose of this review study was to describe this anatomical region, particularly in the light of the relationships between the anterior margin of the free edge of the tentorium and the above-mentioned components of the sphenoid and petrous bone.

Incidence and morphometry of sellar bridges and related foramina in dry skulls: Their significance in middle cranial fossa surgery.

PURPOSE: The current study investigated the incidence, morphology and morphometry of the ossified ligaments expanding between petrous bone and posterior clinoid processes and in between the anterior, middle and posterior clinoid processes. Side symmetry, gender dimorphism and age influence were also studied. MATERIALS AND METHODS: A total of 123 adult Greek dry skulls were observed. RESULTS: A caroticoclinoid bar (CCB) was found in 60.2%. Partial CCBs appeared more commonly (36.6%) than complete (23.6%). The caroticoclinoid foramen (CCF) was symmetrical on both sides and genders. An anterior interclinoid, a posterior petroclinoid and a partial posterior interclinoid bar appeared in 19.5%, 6.5% and 2.4%, respectively. Osseous spurs posterolateral to the posterior clinoid process were present in 5.7%. CONCLUSION: The study highlights important morphometric details about osseous bars of the sella region and the related CCF in Greek skulls. Notable differences in the incidence of these bars in Greek individuals compared with findings from other populations highlight the growing awareness of ethnic differences in skull base landmarks. Variations and surgically oriented measurements provided by this study may benefit clinicians involved in the treatment of the middle cranial fossa pathology, enriching understanding of the complicated regional anatomy. Preoperative sellar area mapping is essential, by using computed tomography images, since modification of the surgical approach may be required in cases of severe ossification.

Prevalence and Dimensions of Complete Sella Turcica Bridges and Its Clinical Significance.

The ossification of ligamentous structures in various part of the body may result in clinical problems. The complete sella turcica bridge corresponds to the complete ossification of the interclinoid ligaments. Fifty dry adult skull bones were studied for presence of ossified interclinoid ligaments. Three skull bones show sella turcica bridge, of which one shows bilateral and two show unilateral. The ligamentous or bony interclinoid connections have important neuronal and vascular relations and are both clinically and surgically important. The knowledge of detailed anatomy of the interclinoid ligament can increase the success of diagnostic evaluation and surgical approaches to the region. The existence of a bony caroticoclinoid foramen may cause compression, tightening, or stretching of the internal carotid artery. Further, removing the anterior clinoid process is an important step in regional surgery; the presence of a bony caroticoclinoid foramen may have high risk.

Ossification of the sella turcica and clinoid ligments: case report, morphological study and literature review

The morphology of the Sella Turcica is important both as a reference in cephalometric studies and in the pituitary gland, internal carotid artery and cavernous sinus surgical boarding. The present report describes a case of partial ossification of the sella turcica walls in a dry skull of 40-year-old Brazilian individual. We analyze the morphometric characteristics of the region.

La morfología de la silla turca tiene importancia tanto como referencia en los estudios cefalomé trieos como en los abordajes quirúrgicos de la glándula hipófisis, carótida interna y seno cavernoso. En el presente reporte se describe un caso de osificación parcial de las paredes de la silla turca, en un cráneo seco de un individuo brasilero de 40 años. Se analizan las características morfométricas de la región.