Mato David, Yokota Hajime, Hirono Seiichiro, Martino Juan, Saeki Naokatsu
Neurosurgical Department, Hospital Universitario Marqués de Valdecilla.
Neurol Med Chir (Tokyo). 2015;55(1):71-6. doi: 10.2176/nmc.oa.2014-0173. Epub 2014 Dec 20.
The vidian canal (VC), a bony tunnel in which the vidian artery and nerve pass, has been widely known as an important landmark to identify the anterior genu of the petrous carotid artery (AGPCA) especially during lateral extended endoscopic endonasal approachs (LEEEAs). The objectives of this study in the Japanese population are to describe the radiological anatomic features and relationships between VC and its surrounding structures, and discuss the clinical implications. We studied 231 high-resolution computed tomography (CT) scans with a slice thickness of 0.5 mm. All the patients had known sellar or parasellar pathologies but without any involvement of VC. The following VC-related parameters were examined: its length, relationship to AGPCA, course from the pterygopalatine fossa to the carotid canal, its position relative to the medial pterygoid plate and pneumatization pattern of the sphenoid sinus. Mean length of VC is 14.6 mm. There is more tendency of straight-running VC compared to other populations. VC locates infero-lateral to AGPCA in all the cases. The protrusion of VC and the paraclival carotid artery to the sphenoid sinus, as well as well-pneumatization of the sinus is also observed more frequently in almost a half of the population. Surgeons who perform LEEEAs in Japanese patients must know these anatomical features. The characteristics particular to Japanese populations may facilitate better identification of VC and exposure to AGPCA intraoperatively.
翼管是一条容纳翼管动脉和神经通过的骨性管道，作为识别岩骨段颈内动脉前膝部（AGPCA）的重要标志已广为人知，尤其是在外侧扩大经鼻内镜入路（LEEEA）中。本研究针对日本人群的目的是描述翼管的放射解剖学特征及其与周围结构的关系，并探讨其临床意义。我们研究了231例层厚为0.5mm的高分辨率计算机断层扫描（CT）。所有患者均已知有鞍区或鞍旁病变，但翼管未受累。检查了以下与翼管相关的参数：其长度、与AGPCA的关系、从翼腭窝到颈动脉管的走行、其相对于翼内肌板的位置以及蝶窦的气化模式。翼管的平均长度为14.6mm。与其他人群相比，翼管走行较直的趋势更明显。在所有病例中，翼管均位于AGPCA的下外侧。在近一半的人群中，还更频繁地观察到翼管和岩斜段颈内动脉向蝶窦突出以及蝶窦的良好气化。在日本患者中进行LEEEA的外科医生必须了解这些解剖特征。日本人群特有的这些特征可能有助于术中更好地识别翼管并暴露AGPCA。
