Barañano Christopher F, Curé Joel, Palmer James N, Woodworth Bradford A
Department of Surgery, Division of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
Am J Rhinol Allergy. 2009 Mar-Apr;23(2):167-71. doi: 10.2500/ajra.2009.23.3290.
Sternberg's (lateral craniopharyngeal) canal was originally described in anatomic studies as a membranous space in the lateral wall of the sphenoid sinus. The canal has been etiologically associated with lateral sphenoid sinus "spontaneous" cerebrospinal fluid (CSF) leaks. A patent Sternberg's canal has been reported in up to 4% of adults, and persistent vestiges have been reported in up to 30%. However, no modern studies analyzing high-resolution CT scans have been published.
A consecutive analysis of 1000 high-resolution CT scans of sphenoid bones was performed. Scans were analyzed for a lateral recess, bony defects, arachnoid pits, and holes possibly representing Sternberg's canal. Data were compared with a case series of lateral sphenoid CSF leaks.
Average patient age was 38.7 years (10-92 years). A sphenoid lateral recess was present in 35.3% (17.4% bilateral) of cases. Arachnoid pits were present on the floor of the middle cranial fossa in 23.4% of cases. Seven skull base defects were identified. Only one traveling medial to V2 resembled the description of Sternberg's canal. In contrast, a case series of 25 patients with lateral sphenoid sinus CSF leaks all had a lateral recess, defects, and arachnoid pits lateral to V2 (p < 0.00001).
Sternberg's canal as historically defined is not nearly as prevalent as previously reported. Furthermore, the presence of arachnoid pits in all sphenoid CSF leaks and the predominant leak location lateral to the sites of fusion of ossification centers suggests that the leaks are acquired. Contributing factors may include arachnoid pits/weaknesses in the skull base and intracranial hypertension.
施特恩贝格（外侧颅咽）管最初在解剖学研究中被描述为蝶窦外侧壁的一个膜性间隙。该管在病因上与蝶窦外侧“自发性”脑脊液漏有关。据报道，高达4%的成年人存在开放的施特恩贝格管，高达30%的人存在残留痕迹。然而，尚未发表分析高分辨率CT扫描的现代研究。
对1000例蝶骨的高分辨率CT扫描进行连续分析。分析扫描图像，观察外侧隐窝、骨缺损、蛛网膜凹和可能代表施特恩贝格管的孔。将数据与一组蝶窦外侧脑脊液漏病例进行比较。
患者平均年龄为38.7岁（10 - 92岁）。35.3%的病例存在蝶窦外侧隐窝（双侧17.4%）。23.4%的病例中颅窝底部存在蛛网膜凹。共识别出7处颅底缺损。只有一处位于V2内侧的结构类似于施特恩贝格管的描述。相比之下，一组25例蝶窦外侧脑脊液漏患者均有外侧隐窝、缺损以及V2外侧的蛛网膜凹（p < 0.00001）。
历史定义的施特恩贝格管并不像之前报道的那样普遍。此外，所有蝶窦脑脊液漏病例中均存在蛛网膜凹，且漏口主要位于骨化中心融合部位的外侧，这表明这些漏口是后天形成的。促成因素可能包括颅底的蛛网膜凹/薄弱点以及颅内高压。
