Endoscopic endonasal anatomy of the ophthalmic artery in the optic canal

Matteo Zoli, Lucia Manzoli, Rocco Bonfatti, Alessandra Ruggeri, Giulia Adalgisa Mariani, Antonella Bacci, Carmelo Sturiale, Ernesto Pasquini, Anna Maria Billi, Giorgio Frank, Lucio Cocco, Diego Mazzatenta

Research output: Contribution to journalArticle

Abstract

Background: The endoscopic endonasal opening of the optic canal has been recently proposed for tumors with medial invasion of this canal, such as tuberculum sellae meningiomas. Injury of the ophthalmic artery represents a dramatic risk during this maneuver. Therefore, the aim of this study was to analyze the endoscopic endonasal anatomy of the precanalicular and canalicular portion of this vessel, discussing its clinical implication. Methods: The course of the ophthalmic artery was analyzed through five endoscopic endonasal dissections, and 40 nonpathological consecutive MRAs were reviewed. Results: The ophthalmic artery arises from the intradural portion of the supraclinoid internal carotid artery, in 93 % of cases about 1.9 mm (range: 1–3) posterior to the falciform ligament. At the entrance into the optic canal, the ophthalmic artery is located infero-medially to the optic nerve in 13 % of cases. In 50 % of these cases the artery moves infero-laterally along its course, remaining in a medial position in the others. In cases with an non medial entrance of the ophthalmic artery, it runs infero-lateral to the optic nerve for its entire canalicular portion, with just one exception. Conclusion: The endoscopic endonasal approach gives a direct, extensive and panoramic view of the course of the precanalicular and canalicular portion of the ophthalmic artery. Dedicated high-field neuroimaging studies are of paramount importance in preoperative planning to evaluate the anatomy of the ophthalmic artery, reducing the risk of jeopardizing the vessel, particularly for those uncommon cases with an infero-medial course of the artery.

Original languageEnglish
Pages (from-to)1343-1350
Number of pages8
JournalActa Neurochirurgica
Volume158
Issue number7
DOIs
Publication statusPublished - Jul 1 2016

Keywords

  • Endoscopic endonasal approach
  • MRA
  • Ophthalmic artery
  • Optic canal
  • Optic nerve
  • Tuberculum sellae meningioma

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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  • Cite this

    Zoli, M., Manzoli, L., Bonfatti, R., Ruggeri, A., Mariani, G. A., Bacci, A., Sturiale, C., Pasquini, E., Billi, A. M., Frank, G., Cocco, L., & Mazzatenta, D. (2016). Endoscopic endonasal anatomy of the ophthalmic artery in the optic canal. Acta Neurochirurgica, 158(7), 1343-1350. https://doi.org/10.1007/s00701-016-2797-1