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The Superior Hypophyseal Arteries: Anatomical Study with an Endoscopic Endonasal Perspective.
Doglietto, Francesco; Prevedello, Daniel Monte-Serrat; Belotti, Francesco; Ferrari, Marco; Lancini, Davide; Schreiber, Alberto; Raffetti, Elena; La Rocca, Giuseppe; Rigante, Mario; Lauretti, Liverana; Hirtler, Lena; Buffoli, Barbara; Nicolai, Piero; Fontanella, Marco Maria; Rodella, Luigi; Gentili, Fred; Tschabitscher, Manfred.
Afiliação
  • Doglietto F; Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
  • Prevedello DM; Department of Neurological Surgery, Wexner Medical Centre, The Ohio State University College of Medicine, Columbus, Ohio.
  • Belotti F; Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
  • Ferrari M; Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
  • Lancini D; Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
  • Schreiber A; Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
  • Raffetti E; Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
  • La Rocca G; Neurosurgery, Catholic University School of Medicine, Rome, Italy.
  • Rigante M; Otorhinolaryngology, Catholic University School of Medicine, Rome, Italy.
  • Lauretti L; Neurosurgery, Catholic University School of Medicine, Rome, Italy.
  • Hirtler L; Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria.
  • Buffoli B; Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
  • Nicolai P; Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
  • Fontanella MM; Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
  • Rodella L; Section of Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
  • Gentili F; Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Canada.
  • Tschabitscher M; Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria.
Oper Neurosurg (Hagerstown) ; 17(3): 321-331, 2019 09 01.
Article em En | MEDLINE | ID: mdl-30649535
ABSTRACT

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.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Quiasma Óptico / Nervo Óptico / Hipófise / Neuroendoscopia Limite: Humans Idioma: En Revista: Oper Neurosurg (Hagerstown) Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Itália

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Quiasma Óptico / Nervo Óptico / Hipófise / Neuroendoscopia Limite: Humans Idioma: En Revista: Oper Neurosurg (Hagerstown) Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Itália