Anatomy and Cell Biology

Korean Association of Anatomists (대한해부학회)
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Discovery of a trans-sellar vascular supply for the pituitary gland

  • Casey P. Spinelli (Tulane University & Ochsner Clinic Neurosurgery Program, Tulane University School of Medicine) ;
  • Joe Iwanaga (Department of Neurosurgery, Tulane University School of Medicine) ;
  • Mi-Sun Hur (Department of Anatomy, Catholic Kwandong University College of Medicine) ;
  • Aaron S. Dumont (Department of Neurosurgery, Tulane University School of Medicine) ;
  • R. Shane Tubbs (Department of Neurosurgery, Tulane University School of Medicine)
  • Received : 2021.12.29
  • Accepted : 2022.03.03
  • Published : 2022.06.30
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Abstract

The vasculature of the pituitary gland is discussed briefly and the details of an anatomical discovery of the vessels supplying the pituitary gland provided. Twenty latex injected cadaveric heads were dissected. Any vessels that were found to penetrate the sella turcica and travel to the pituitary gland were documented and measured. Additionally, 25 adult skulls were evaluated for the presence, size, and sites of bony foramina in the floor of sella turcica. Trans-sellar vessels were identified in 65% of specimens. There was a mean of 1.5 vessels per specimen consisting usually of a mixture of veins and arteries. The mean diameter of these vessels was 0.3 mm and the mean length from the sella turcica to the pituitary gland was 2.3 mm. These vessels were concentrated in the most concave part of the sella turcica. In bony specimens, the mean number of trans-sellar foramina was four. The diameter of these foramina ranged from 0.3 to 0.6 mm in size. The trans-sellar foramina were concentrated near the center part of the sella turcica and had no regular pattern. The pituitary gland receives at least some blood supply and drainage via vessels traveling along the septum of the sphenoidal sinuses and through the sella turcica. Knowledge of such vessels might lead to a better understanding of the vascular supply and drainage of the pituitary gland and would be useful during skull base approaches such as trans-nasal approaches to the pituitary gland.

Keywords

Acknowledgement

The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind's overall knowledge, which can then improve patient care. Therefore, these donors and their families deserve our highest gratitude [13].

References

  1. Cironi KA, Decater T, Iwanaga J, Dumont AS, Tubbs RS. Arterial supply to the pituitary gland: a comprehensive review. World Neurosurg 2020;142:206-11.  https://doi.org/10.1016/j.wneu.2020.06.221
  2. McCormack IG, Xu L, Nerva J, Berry JF, Melgar M, Wysiadecki G, Walocha J, Iwanaga J, Dumont AS, Tubbs RS. Anatomy of the dorsal meningeal artery including its variations: application to skull base surgery and diagnostic and interventional imaging. World Neurosurg 2021;155:e41-8.  https://doi.org/10.1016/j.wneu.2021.07.132
  3. Cappello ZJ, Minutello K, Dublin AB. Anatomy, head and neck, nose paranasal sinuses. StatPearls. Treasure Island: StatPearls Publishing; 2022. 
  4. Alsaied AS. Paranasal sinus anatomy: what the surgeon needs to know. In: Gendeh BS, editors. Paranasal Sinuses. London: IntechOpen; 2017. 
  5. Harju T, Alanko J, Numminen J. Pituitary apoplexy following endoscopic nasal surgery: a case report. SAGE Open Med Case Rep 2019;7:2050313X19855867. 
  6. Fyrmpas G, Constantinidis J, Foroglou N, Selviaridis P. Pituitary apoplexy following endoscopic sinus surgery. J Laryngol Otol 2010;124:677-9.  https://doi.org/10.1017/S0022215109991915
  7. Briet C, Salenave S, Chanson P. Pituitary apoplexy. Endocrinol Metab Clin North Am 2015;44:199-209.  https://doi.org/10.1016/j.ecl.2014.10.016
  8. Agrawal B, Dziurzynski K, Salamat MS, Baskaya M. The temporal association of sphenoid sinus mucosal thickening on MR imaging with pituitary apoplexy. Turk Neurosurg 2012;22:785-90.  https://doi.org/10.5137/1019-5149.JTN.4273-11.1
  9. Liu JK, Couldwell WT. Pituitary apoplexy in the magnetic resonance imaging era: clinical significance of sphenoid sinus mucosal thickening. J Neurosurg. 2006;104:892-8.  https://doi.org/10.3171/jns.2006.104.6.892
  10. Arita K, Kurisu K, Tominaga A, Sugiyama K, Ikawa F, Yoshioka H, Sumida M, Kanou Y, Yajin K, Ogawa R. Thickening of sphenoid sinus mucosa during the acute stage of pituitary apoplexy. J Neurosurg 2001;95:897-901.  https://doi.org/10.3171/jns.2001.95.5.0897
  11. Carrau RL, Vescan AD, Snyderman CH, Kassam AB. Endoscopic management of cerebrospinal fluid leaks. In: Myers EN, Carrau RL, Eibling DE, Ferguson BJ, Ferris RL, Gillman GS, Golla S, Grandis JR, Hirsch BE, Johnson JT, Raz Y, Rosen CA, Schaitkin BM, Snyderman CH, Toh EH, editors. Operative Otolaryngology: Head and Neck Surgery. 2nd ed. Philadelphia: Saunders; 2008. 
  12. Tanaka A, Furubayashi T, Arai M, Inoue D, Kimura S, Kiriyama A, Kusamori K, Katsumi H, Yutani R, Sakane T, Yamamoto A. Delivery of oxytocin to the brain for the treatment of autism spectrum disorder by nasal application. Mol Pharm 2018;15:1105-111.  https://doi.org/10.1021/acs.molpharmaceut.7b00991
  13. Iwanaga J, Singh V, Ohtsuka A, Hwang Y, Kim HJ, Morys J, Ravi KS, Ribatti D, Trainor PA, Sanudo JR, Apaydin N, Sengul G, Albertine KH, Walocha JA, Loukas M, Duparc F, Paulsen F, Del Sol M, Adds P, Hegazy A, Tubbs RS. Acknowledging the use of human cadaveric tissues in research papers: recommendations from anatomical journal editors. Clin Anat 2021;34:2-4. https://doi.org/10.1002/ca.23671