TY - JOUR
T1 - The Superior Hypophyseal Arteries: Anatomical Study with an Endoscopic Endonasal Perspective
AU - Doglietto, Francesco
AU - Prevedello, Daniel Monte-Serrat
AU - Belotti, Francesco
AU - Ferrari, Marco
AU - Lancini, Davide
AU - Schreiber, Alberto
AU - Raffetti, Elena
AU - La Rocca, Giuseppe
AU - Rigante, Mario
AU - Lauretti, Liverana
AU - Hirtler, Lena
AU - Buffoli, Barbara
AU - Nicolai, Piero
AU - Fontanella, Marco Maria
AU - Rodella, Luigi
AU - Rodella, Luigi Fabrizio
AU - Gentili, Fred
AU - Tschabitscher, Manfred
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
KW - Anatomical study
KW - Classification
KW - Endonasal endoscopic transsphenoidal
KW - Optic nerves and chiasm
KW - Pituitary stalk
KW - Superior hypophyseal arteries
KW - Anatomical study
KW - Classification
KW - Endonasal endoscopic transsphenoidal
KW - Optic nerves and chiasm
KW - Pituitary stalk
KW - Superior hypophyseal arteries
UR - http://hdl.handle.net/10807/162975
U2 - 10.1093/ons/opy393
DO - 10.1093/ons/opy393
M3 - Article
SN - 2332-4260
VL - 17
SP - 321
EP - 330
JO - Operative Neurosurgery
JF - Operative Neurosurgery
ER -