Fig 5 - uploaded by Mennan Ece Pirzirenli
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The schematic appearance of inner surface of right hemicranium on sagittal section; the anatomical relationship between asterion and sigmoid-transverse sinus junction. Each grid measured 0.5x0.5 cm. On metric scale with 1.5x2 cm, the numbers represented the areas of localization of asterion.
Source publication
The purpose of this study was to determine the localization of the asterion according to the anatomical landmarks of posterior cranial fossa and its relation with sinuses for posterolateral surgical approaches in newborns. On 70 head-halves, a needle about 2 mm with diameter was placed on the centre point of asterion (posterolateral fontanel) by in...
Context in source publication
Context 1
... dural venous sinuses were exposed with internal landmarks on posterior cranial base. A needle about 2 mm with diameter was placed on the center point of asterion by inserting into the whole cranial bony tissue by forming an right angle with the bony surface (Fig. 1). A transparent scale diagram was formed with 1.5x2 cm sizes and the diagram was divided into 12 equal squares with the 0.25 cm2 areas. These squares were numbered from 1 to 12 for the determination of each small areas. The one third (1/3) upper part of this scale diagram, by an another definition; the mid point of lower border of 1., 2., 3., 4. squares was settled on superior mid point of sigmoid -transverse sinus junction (STJ). The localization of asterion on the scale diagram was determined (Fig. ...
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Background
Several cadaveric studies demonstrate reliable localization of the transverse sinus and the transverse sigmoid junction (TSJ). These studies use the line drawn from the inion to the posterior root of the zygoma (IZ) and the asterion, respectively. We investigated how the size difference between the right and left transverse sinuses (TS)...
A 52-year male patient reported with loosening of right upper jaw. He has no pain or discharge, or any acute symptoms and systemic disease. Intraoral examination reveals necrosed maxillary bone. He also has no sickle cell disease, hepatitis, HIV or tuberculosis. 3D CT scan reveals destruction of maxilla, maxillary sinus, lateral nasal wall, superio...
Citations
... Up to date, there is a limited number of studies concerning precise procedures on lateral approaches to the posterior cranial fossa; especially there is a paucity of such studies conducted on European (or descended recently from European) populations. Only few papers refer to Turkish population (Bozbuga et al. 2006;Demir et al. 2015), and none of them refers to the Polish population. Two samples from various socioeconomic conditions were selected for the study, in order to determine whether location of the asterion in relation to anatomical reference landmarks can be sufficiently defined for both surgical and anthropological relevance for lateral approaches to the posterior cranial fossa. ...
... This observed variation in asterion location limits its overall usefulness as a stable reference landmark for intracranial structures. Distance from the asterion to other important, relatively more stably located, structures on external surface of the cranial base may be useful for surgeons in the diagnosis and planning for surgical approaches in this area (Demir et al. 2015). However, because of the complex relations between bony landmarks, preoperative imaging assistance is required, and the asterion should only be used as auxiliary, not as a key superficial cranial landmark in surgical interventions. ...
This work aimed to study the variability in location of the asterion in a Polish population, which may be important for both surgical and anthropological procedures. In surgical approaches to the posterior cranial fossa, the asterion is of great importance as a reference landmark. Its accurate localization may be impeded by the presence of additional, irregular sutural bones. Dry adult human skulls (n = 113, 60.2% male and 39.8% female) were analyzed for asterion location in relation to the reference points (mastoidale, bregma, porion, inion, lambda, opisthion). The asterion exhibits wide variation in location. The range of ± 2 SD of measured distances demonstrated broad variation intra and interindividually (15.9-27.8 mm for male skulls and 13.1-24.6 mm for female skulls). Distances from the asterion to the reference landmarks were longer for males compared to females (p < 0.05), and some distances were longer for people of lower socioeconomic status. Because of its lesser variation, measurements to three reference landmarks (mastoidale, bregma and frontotemporale) may be particularly important for surgical purposes. Defining accurately the safe area for asterion is important but problematic. Because of the complex relations between bony landmarks, preoperative imaging assistance is required, and the asterion should only be used as auxiliary, not as a key superficial cranial landmark in surgical interventions.
... The base of the skull base was quiet complex region having many neural and vascular structures that are connected with the cranial fossae, paranasal sinus, nasal cavity, orbit and the neck. Those structures are surgical challenges for the otolaryngologists and the neurosurgeons [1,2]. Otologic and neurologic skull base surgery requires a thorough knowledge of the anatomy of temporal bone, as the temporal bone is one of the main approach for the skull base surgery [3]. ...
... The petrous part of temporal bone gives passage for various important neurovascular structures such as internal carotid artery, vestibulocochlear nerve and facial nerve [4]. To identify and safely approach and manipulate the vital structures in the skull base surgeries, various anatomical surface landmarks like mastoid tip, styloid process, spine of sphenoid, spine of Henle, Macewan's triangle, the cribriform plate, tympanic plate, articular tubercle, temporal line, external auditory canal and the root of the zygoma [2] Henle's Spine (HS)/ spina suprameatica/ spina suprameatalis/ meatal spine or spina meatus, is a small bony prominence anterior to the supramastoid pit at the postero-superior margin of the bony external acoustic meatus. Jacob Henle reported it as a reliable guide in locating the antrum during the surgical intervention of the mastoid region [5]. ...
Background: Surface landmarks of the temporal bone are related to various anatomical structures. The surgical exposure of the middle cranial fossa, transpetrosal and transmastoid approaches for skull base surgeries would require identification of various surface landmarks for approaching the structures. Aim and Objectives: To determine whether Henle's spine could be used as a reliable and multipurpose landmark for the important structures and foramen of the skull base during surgeries. Materials and Methods: This study was done on 170 dry human skulls. Two imaginary lines and a parapetrosal triangle was constructed which encompasses nearly all the main structures and foramina of the skull base. The distance from the Henle's spine to certain useful surgical landmarks on the skull base was measured and tabulated. Results: The measurements were analysed and compared by student't' test both the sides and found to be have slight variations in the measurements of right and left. Distance from Henle's spine to stylomastoid foramen and jugular foramen were found to high when compared to earlier studies other measurements showed only a slight deviations. Conclusion: Henle's spine when present (85%) can be used as a reliable anatomical landmark for approaching various foramina during skull base surgeries when other land mark fails.
... It represents one of the latest surgical frontiers and poses surgical challenges for the otolaryngologists and the neurosurgeons. (1,2) Otologic and neurotologic skull base surgery requires a thorough knowledge of the temporal bone anatomy, as the temporal bone is one of the great gateways of the skull. (3) Its petrous portion gives the passage for the internal carotid artery, vestibulocochlear nerve and facial nerve. ...
... (3) Its petrous portion gives the passage for the internal carotid artery, vestibulocochlear nerve and facial nerve. (4) Therefore, in order to identify and safely approach the vital structures in the skull base during surgeries, many accessible anatomical surface landmarks like the mastoid tip, the digastric muscle, the spine of Henle, the cribriform area, the temporal line, the external auditory canal and the root of the zygomae (2) are used to relate and access the underlying anatomical structures. ...
Background:
Sub-Saharan neurosurgeons most likely need to perform invasive procedures without the latest imaging and navigation technology in the operating room. Therefore, these surgeons need to utilize other methods such as superficial surface landmarks for neuro-navigation. Bony landmarks, including the inion and asterion, are commonly used during invasive procedures to pinpoint the location of the confluence of sinuses and transverse-sigmoid sinus junction, respectively. The purpose of this study was to investigate whether the inion and asterion can be used as superficial landmarks for the confluence of sinuses and the transverse-sigmoid sinus junction, respectively, in a South African population.
Methods:
Fifty South African human skulls were used (25 male, 25 female). The micro-focus X-ray radiography and tomography facility (MIXRAD) at Necsa scanned and created three-dimensional virtual images of the skull specimens. Reference points were then inserted on the images and the relation between bony landmarks and venous sinuses was documented.
Results:
The inion was directly related to the confluence of sinuses in 4% of the sample, whereas the asterion was directly related to the transverse-sigmoid sinus junction in 28% of the cases, on both the right and left sides.
Conclusions:
This study confirmed that neither the inion, nor the asterion, are directly related the confluence of sinuses and transverse-sigmoid sinus junction, respectively. These bony landmarks are more likely to be located either inferior, or not related at all, to the investigated dural venous sinuses.
