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Title: | Anatomical landmarks to locate the junction between transverse and sigmoid sinuses in translabyrinthine and retrosigmoid open surgical approaches |
Authors: | Mathangasinghe, Yasith Samaranayake, U.M.J.E. Silva, S.S.A. Prematilaka, H.C. Perera, M.H.S. Shantha, S.S.W. |
Keywords: | Transverse sinus; sigmoid sinus; translabyrinthine approach; retrosigmoid approach; cerebellopontine angle |
Issue Date: | 2018 |
Publisher: | The College of Surgeons of Sri Lanka. |
Citation: | Anatomical landmarks to locate the junction between transverse and sigmoid sinuses in translabyrinthine and retrosigmoid open surgical approaches |
Abstract: | Abstract Introduction Hematoma due to dural-sinus damage is a known complication when introducing burr holes in open transcranial surgery. Our objective was to identify safe areas to avoid dural-sinus damage based on anatomical landmarks in translabyrinthine and retrosigmoid open surgical approaches where neuronavigation facilities are not available. Methods A descriptive anatomical study was conducted on adult skulls. Distances to transverse and sigmoid sinuses on either side were measured using fixed anatomical landmarks: asterion, inion, margins of suprameatal triangle and superior nuchal line. Measurements were standardized according to the cranial indices (cranial index=anteroposterior diameter/transverse diameter) of each skull. Results Thirty-two adult skulls (male:female=22:10) were studied. Mean cranial index, width of transverse and sigmoid sinuses were 0.785±0.045, 9.1±2.3mm and 9.7±1.2mm respectively. Mean vertical distances from asterion and inion to the transverse sinus were 1.1±3.4mm and 14.7±5.9mm respectively. Posterior border of the sigmoid sinus was located 14.7±5.9mm, and 59.9±7.4mm anterior to asterion and inion respectively. t-tests did not show significant differences of these distances on either sides (p>.05). Pearson's correlations were insignificant between the measurements and the cranial indices (p>.05). Measurements from the suprameatal triangle to the dural-sinuses had the minimum variance. In >95% of the times the sigmoid sinus was located ≤23 mm posterior and ≤7 mm superior to the suprameatal triangle. Discussion and conclusions Suprameatal triangle was a consistent surface landmark to locate dural-sinuses. Dural-sinus damage could be avoided in 95% of the times by placing burr hole at least 7mm superior and 23 mm posterior to the suprameatal triangle. |
URI: | http://archive.cmb.ac.lk:8080/xmlui/handle/70130/5620 |
Appears in Collections: | Articles (local / International) |
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