Skip to main content
Log in

Morphometric analysis of the medial opticocarotid recess and its anatomical relations relevant to the transsphenoidal endoscopic endonasal approaches

  • Experimental research - Neurosurgical Anatomy
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

The medial opticocarotid recess (MOCR) is located in the posterior wall of the sphenoid sinus, medial to the junction of the optic canal (OC) and the carotid prominence (CP). There is controversy in the literature in relation to the presence of the MOCR and its constancy, which is relevant when approaching the skull base through an endoscopic route.

Methods

The morphometric relations of the MOCR with the surrounding structures were studied in 18 cadaveric specimens after endoscopic endonasal approach (EEA).

Results

The distance between both MOCR was 11.06 ± 1.14 mm; the distance between the MOCR and the lateral opticocarotid (LOCR) recess was 5.56 ± 0.85 mm; the distance between the MOCR and the suprasellar recess was 3.72 ± 0.49 mm; the angle between the MOCR plane and the OC 13.32 ± 2.30°; the angle between the MOCR plane and the CP 13.50 ± 2.68° and; the angle between the OC and the CP 26.81 ± 4.26°. All measurements showed low variability, with low standard deviation and interquartile range. No relations were found between any of the measurements.

Conclusions

The MOCR may be used as a reference point for precise location of structures during EEA. Objective measurements may be especially useful in cases with distorted sphenoid bone anatomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Ahuja A, Guterman LR, Hopkins LN (1992) Carotid cavernous fistula and false aneurysm of the cavernous carotid artery: complications of transsphenoidal surgery. Neurosurgery 31(4):774–778

    Article  PubMed  CAS  Google Scholar 

  2. Fernandez-Miranda JC, Gardner PA, Prevedello DM, Kassam AB (2009) Expanded endonasal approach for olfactory groove meningioma. Acta Neurochir 151(3):287–288

    Article  PubMed  CAS  Google Scholar 

  3. Gardner PA, Tormenti MJ, Pant H, Fernandez-Miranda JC, Snyderman CH, Horowitz MB (2013) Carotid artery injury during endoscopic endonasal skull base surgery: incidence and outcomes. Neurosurgery 73(2 Suppl Operative):261–269

    Google Scholar 

  4. Hamberger CA, Hammer G, Norlen G, Sjogren B (1961) Transantrosphenoidal hypophysectomy. Arch Otolaryngol 74:22–28

    Article  Google Scholar 

  5. Hamid O, El Fiky L, Hassan O, Kotb A, El Fiky S (2008) Anatomic variations of the sphenoid sinus and their impact on trans-sphenoid pituitary surgery. Skull Base 18(1):9–15

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hyde-Rowan MD, Roessmann U, Brodkey JS (1983) Vasospasm following transsphenoidal tumor removal associated with the arterial changes of oral contraception. Surg Neurol 20(2):120–124

    Article  PubMed  CAS  Google Scholar 

  7. Jho HD (1999) Endoscopic pituitary surgery. Pituitary 2(2):139–154

    Article  PubMed  CAS  Google Scholar 

  8. Kassam AB, Snyderman CH, Mintz A, Gardner P, Carrau RL (2005) Expanded endonasal approach: the rostrocaudal axis. Part I. Crista galli to the Sella turcica. Neurosurg Focus 19(1):E3

    PubMed  Google Scholar 

  9. Kassam AB, Gardner PA, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM (2008) Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum. J Neurosurg 108(4):715–728

    Article  PubMed  Google Scholar 

  10. Labib MA, Prevedello DM, Fernandez-Miranda JC, Sivakanthan S, Benet A, Morera V, Carrau R, Kassam A (2013) The medial opticocarotid recess: an anatomic study of an endoscopic “key landmark” for the ventral cranial base. Neurosurgery 72(1 Suppl Operative):66–76

    PubMed  Google Scholar 

  11. Laws EW (1991) Complications of transsphenoidal surgery. In: Samii M (ed) Surgery of the sellar region and paranasal sinuses. Springer, Berlin Heidelberg, pp 336–340

    Chapter  Google Scholar 

  12. Lee KJ (1978) The sublabial transseptal transsphenoidal approach to the hypophysis. Laryngoscope 88(7 Pt 2 Suppl 10):1–65

    PubMed  Google Scholar 

  13. Ozcan T, Yilmazlar S, Aker S, Korfali E (2010) Surgical limits in transnasal approach to opticocarotid region and planum sphenoidale: an anatomic cadaveric study. World Neurosurg 73(4):326–33

    Article  PubMed  Google Scholar 

  14. Paluzzi A, Fernandez-Miranda JC, Tonya Stefko S, Challinor S, Snyderman CH, Gardner PA (2014) Endoscopic endonasal approach for pituitary adenomas: a series of 555 patients. Pituitary 17(4):307–19

    Article  PubMed  Google Scholar 

  15. Peris-Celda M, Kucukyuruk B, Monroy-Sosa A, Funaki T, Valentine R, Rhoton AL (2013) The recesses of the sellar wall of the sphenoid sinus and their intracranial relationships. Neurosurgery 73(2 Suppl Operative):117–31

    Google Scholar 

  16. Romano A, Zuccarello M, van Loveren HR, Keller JT (2001) Expanding the boundaries of the transsphenoidal approach: a microanatomic study. Clin Anat 14(1):1–9

    Article  PubMed  CAS  Google Scholar 

  17. Zada G, Agarwalla PK, Mukundan S Jr, Dunn I, Golby AJ, Laws ER Jr (2011) The neurosurgical anatomy of the sphenoid sinus and sellar floor in endoscopic transsphenoidal surgery. J Neurosurg 114(5):1319–30

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cristian Ferrareze Nunes.

Ethics declarations

Funding

No funding was received for this research.

Conflict of interest

The author(s) declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Formal consent

For this type of study formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nunes, C.F., Prevedello, D.MS., Carrau, R.L. et al. Morphometric analysis of the medial opticocarotid recess and its anatomical relations relevant to the transsphenoidal endoscopic endonasal approaches. Acta Neurochir 158, 319–324 (2016). https://doi.org/10.1007/s00701-015-2662-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-015-2662-7

Keywords

Navigation