Intrasphenoid septations inserted into the internal carotid arteries: a frequent and risky relationship in transsphenoidal surgeries

Introduction: When an expanded endonasal transsphenoidal surgical approach is performed, intrasphenoid septations must be completely resected. If these structures are close to the internal carotid artery (ICA), then their manipulation might cause vascular injury. Objective: The objective of this stu...

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Bibliographic Details
Authors: Ramalho, Clauder Oliveira [UNIFESP], Marenco, Horacio Armando [UNIFESP], Vaz Guimaraes Filho, Francisco de Assis [UNIFESP], Silva da Costa, Marcos Devanir [UNIFESP], de Oliveira Santos, Bruno Fernandes [UNIFESP], Santos, Rodrigo de Paula [UNIFESP], Zymberg, Samuel Tau [UNIFESP]
Format: article
Status:Published version
Publication Date:2017
Country:Brasil
Institution:Universidade Federal de São Paulo (UNIFESP)
Repository:Repositório Institucional da UNIFESP
Language:English
OAI Identifier:oai:repositorio.unifesp.br:11600/55039
Online Access:http://dx.doi.org/10.1016/j.bjorl.2016.02.007
https://repositorio.unifesp.br/handle/11600/55039
Access Level:Open access
Keyword:Sphenoid sinus
Sphenoid septations
Skull base
Transsphenoidal surgery
Expanded endonasal approach
Description
Summary:Introduction: When an expanded endonasal transsphenoidal surgical approach is performed, intrasphenoid septations must be completely resected. If these structures are close to the internal carotid artery (ICA), then their manipulation might cause vascular injury. Objective: The objective of this study is to describe the frequency of intrasphenoid septations in the internal carotid artery protuberance (ICAp). Methods: Computed tomography (CT) scans of 421 patients were analysed. Intrasphenoid septations (classified as intersphenoid or accessory) and their relationship to the ICAp were described. Additionally, a sphenoid sinus classification was performed based on their degree of pneumatisation to determine whether a difference exists in the frequency of intrasphenoid septations inserted into ICAp with regard to sinus type. Results: The patient mean age was 39 +/- 21.4 years. Overall, 219 patients (52%) had septations in the ICAp