Anatomy and Cell Biology

Korean Association of Anatomists (대한해부학회)
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Morphology of the groove of the inferior petrosal sinus: application to better understanding variations and surgery of the skull base

  • Uduak-Obong I. Ekanem (Tulane University School of Medicine) ;
  • Lukasz Olewnik (Department of Anatomical Dissection and Donation, Medical University of Lodz) ;
  • Andrea Porzionato (Section of Human Anatomy, Department of Neuroscience, University of Padova) ;
  • Veronica Macchi (Section of Human Anatomy, Department of Neuroscience, University of Padova) ;
  • Joe Iwanaga (Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine) ;
  • Marios Loukas (Department of Anatomical Sciences, St. George's University ) ;
  • Aaron S. Dumont (Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine) ;
  • Raffaele De Caro (Section of Human Anatomy, Department of Neuroscience, University of Padova) ;
  • R. Shane Tubbs (Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine)
  • Received : 2022.02.03
  • Accepted : 2022.03.30
  • Published : 2022.06.30
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Abstract

Although adequate venous drainage from the cranium is imperative for maintaining normal intracranial pressure, the bony anatomy surrounding the inferior petrosal sinus and the potential for a compressive canal or tunnel has, to our knowledge, not been previously investigated. One hundred adult human skulls (200 sides) were observed and documented for the presence or absence of an inferior petrosal groove or canal. Measurements were made and a classification developed to help better understand their anatomy and discuss it in future reports. We identified an inferior petrosal sinus groove (IPSG) in the majority of specimens. The IPSG began anteriorly where the apex of the petrous part of the temporal bone articulated with the sphenoid part of the clivus, traveled posteriorly, in a slight medial to lateral course, primarily just medial to the petro-occipital fissure, and ended at the anteromedial aspect of the jugular foramen. When the IPSGs were grouped into five types. In type I specimens, no IPSG was identified (10.0%), in type II specimens, a partial IPSG was identified (6.5%), in type III specimens, a complete IPSG (80.0%) was identified, in type IV specimens, a partial IPS tunnel was identified (2.5%), and in type V specimens, a complete tunnel (1.0%) was identified. An improved knowledge of the bony pathways that the intracranial dural venous sinuses take as they exit the cranium is clinically useful. Radiological interpretation of such bony landmarks might improve patient diagnoses and surgically, such anatomy could decrease patient morbidity during approaches to the posterior cranial fossa.

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 that can then improve patient care. Therefore, these donors and their families deserve our highest gratitude [22]. The authors state that every effort was made to follow all local and international ethical guidelines and laws that pertain to the use of human cadaveric donors in anatomical research [23].

References

  1. Doepp F, Hoffmann O, Lehmann R, Einhaupl KM, Valdueza JM. The inferior petrosal sinus: assessment by transcranial Doppler ultrasound using the suboccipital approach. J Neuroimaging 1999;9:193-7.  https://doi.org/10.1111/jon199994193
  2. Benndorf G, Campi A. Aberrant inferior petrosal sinus: unusual transvenous approach to the cavernous sinus. Neuroradiology 2002;44:158-63.  https://doi.org/10.1007/s002340100659
  3. Mortazavi MM, Griessenauer CJ, Krishnamurthy S, Verma K, Loukas M, Tubbs RS. The inferior petrosal sinus: a comprehensive review with emphasis on clinical implications. Childs Nerv Syst 2014;30:831-4.  https://doi.org/10.1007/s00381-014-2378-7
  4. Mitsuhashi Y, Nishio A, Kawahara S, Ichinose T, Yamauchi S, Naruse H, Matsuoka Y, Ohata K, Hara M. Morphologic evaluation of the caudal end of the inferior petrosal sinus using 3D rotational venography. AJNR Am J Neuroradiol 2007;28:1179-84.  https://doi.org/10.3174/ajnr.A0489
  5. Paksoy Y, Genc BO, Genc E. Retrograde flow in the left inferior petrosal sinus and blood steal of the cavernous sinus associated with central vein stenosis: MR angiographic findings. AJNR Am J Neuroradiol 2003;24:1364-8. 
  6. Jia ZY, Song YS, Sheen JJ, Kim JG, Lee DH, Suh DC. Cannulation of occluded inferior petrosal sinuses for the transvenous embolization of cavernous sinus dural arteriovenous fistulas: usefulness of a frontier-wire probing technique. AJNR Am J Neuroradiol 2018;39:2301-6.  https://doi.org/10.3174/ajnr.A5868
  7. Deipolyi AR, Hirsch JA, Oklu R. Bilateral inferior petrosal sinus sampling. J Neurointerv Surg 2012;4:215-8.  https://doi.org/10.1136/neurintsurg-2011-010033
  8. Tomycz ND, Horowitz MB. Inferior petrosal sinus sampling in the diagnosis of sellar neuropathology. Neurosurg Clin N Am 2009;20:361-7.  https://doi.org/10.1016/j.nec.2009.01.003
  9. Doppman JL, Chang R, Oldfield EH, Chrousos G, Stratakis CA, Nieman LK. The hypoplastic inferior petrosal sinus: a potential source of false-negative results in petrosal sampling for Cushing's disease. J Clin Endocrinol Metab 1999;84:533-40. 
  10. Boolell M, Gilford E, Arnott R, McNeill P, Cummins J, Alford F. An overview of bilateral synchronous inferior petrosal sinus sampling (BSIPSS) in the pre-operative assessment of Cushing's disease. Aust N Z J Med 1990;20:765-70.  https://doi.org/10.1111/j.1445-5994.1990.tb00420.x
  11. Miller DL, Doppman JL, Chang R. Anatomy of the junction of the inferior petrosal sinus and the internal jugular vein. AJNR Am J Neuroradiol 1993;14:1075-83. 
  12. Lv X, Wu Z. Anatomic variations of internal jugular vein, inferior petrosal sinus and its confluence pattern: implications in inferior petrosal sinus catheterization. Interv Neuroradiol 2015;21:769-73.  https://doi.org/10.1177/1753425915590067
  13. Zhang L, Zeng F, Wang J, Chen F. Finding the inferior petrosal sinus for embolizing cavernous dural arteriovenous fistula using preoperative computed tomography angiography. World Neurosurg 2019;126:e1069-74.  https://doi.org/10.1016/j.wneu.2019.03.047
  14. Benndorf G, Bender A, Lehmann R, Lanksch W. Transvenous occlusion of dural cavernous sinus fistulas through the thrombosed inferior petrosal sinus: report of four cases and review of the literature. Surg Neurol 2000;54:42-54.  https://doi.org/10.1016/S0090-3019(00)00260-3
  15. Cho YD, Rhim JK, Yoo DH, Kang HS, Kim JE, Cho WS, Han MH. Transvenous microguidewire looping technique for breach of ipsilateral inferior petrosal sinus occlusions en route to cavernous sinus dural arteriovenous fistulas. Interv Neuroradiol 2016;22:590-5.  https://doi.org/10.1177/1591019916653251
  16. Robert T, Valsecchi D, Sylvestre P, Blanc R, Ciccio G, Smajda S, Redjem H, Piotin M. May the inferior petrosal sinus recanalization during endovascular treatment for carotid-cavernous fistulas increase the risk of sixth nerve palsy? World Neurosurg 2018;116:e246-51.  https://doi.org/10.1016/j.wneu.2018.04.182
  17. Raghuram K, Durgam A, Sartin S. Assessment of the inferior petrosal sinus on T1-weighted contrast-enhanced magnetic resonance imaging. J Clin Imaging Sci 2018;8:22. 
  18. Gebarski SS, Gebarski KS. Inferior petrosal sinus: imaging-anatomic correlation. Radiology 1995;194:239-47.  https://doi.org/10.1148/radiology.194.1.7997561
  19. Lo WW, Solti-Bohman LG. High-resolution CT of the jugular foramen: anatomy and vascular variants and anomalies. Radiology 1984;150:743-7.  https://doi.org/10.1148/radiology.150.3.6320256
  20. Shiu PC, Hanafee WN, Wilson GH, Rand RW. Cavernous sinus venography. Am J Roentgenol Radium Ther Nucl Med 1968;104:57-62.  https://doi.org/10.2214/ajr.104.1.57
  21. Day JD. Intradural jugular tubercle reduction to enhance exposure via the transcondylar approach: technical note. Neurosurgery 2004;55:247-50; discussion 251.  https://doi.org/10.1227/01.NEU.0000126884.63619.25
  22. 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
  23. Iwanaga J, Singh V, Takeda S, Ogeng'o J, Kim HJ, Morys J, Ravi KS, Ribatti D, Trainor PA, Sanudo JR, Apaydin N, Sharma A, Smith HF, Walocha JA, Hegazy AMS, Duparc F, Paulsen F, Del Sol M, Adds P, Louryan S, Fazan VPS, Boddeti RK, Tubbs RS. Standardized statement for the ethical use of human cadaveric tissues in anatomy research papers: recommendations from Anatomical Journal Editors-in-Chief. Clin Anat 2022 Feb 26 [Epub]. https://doi.org/10.1002/ca.23849.