The Superior Hypophyseal Arteries: Anatomical Study with an Endoscopic Endonasal Perspective

Liverana Lauretti, Francesco Doglietto, Giuseppe La Rocca, Mario Rigante, Marco Maria Fontanella, Luigi Fabrizio Rodella, Daniel Monte-Serrat Prevedello, Francesco Belotti, Marco Ferrari, Davide Lancini, Alberto Schreiber, Elena Raffetti, Lena Hirtler, Barbara Buffoli, Piero Nicolai, Luigi Rodella, Fred Gentili, Manfred Tschabitscher

Risultato della ricerca: Contributo in rivistaArticolo in rivista

4 Citazioni (Scopus)

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.
Lingua originaleEnglish
pagine (da-a)321-331
Numero di pagine11
RivistaOperative Neurosurgery
Volume17
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Anatomical study
  • Classification
  • Endonasal endoscopic transsphenoidal
  • Optic nerves and chiasm
  • Pituitary stalk
  • Superior hypophyseal arteries

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