{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:33:48Z","timestamp":1789421628135,"version":"build-2803163510"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>A considerable degree of variability exists in the anatomy of the sphenoid sinus, sella turcica, and surrounding skull base structures. The authors aimed to characterize neuroimaging and intraoperative variations in the sagittal and coronal surgical anatomy of healthy controls and patients with sellar lesions.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Magnetic resonance imaging studies obtained in 100 healthy adults and 78 patients with sellar lesions were reviewed. The following measurements were made on midline sagittal images: sellar face, sellar prominence, sellar angle, tuberculum sellae angle, sellar-clival angle, length of planum sphenoidale, and length of clivus. The septal configuration of the sphenoid sinus was classified as either simple or complex, according to the number of septa, their symmetry, and their morphological features. The following measurements were made on coronal images: maximum width of the sphenoid sinus and sellar face, and the distance between the parasellar and midclivus internal carotid arteries. Neuroimaging results were correlated with intraoperative findings during endoscopic transsphenoidal surgery.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Three sellar floor morphologies were defined in normal adults: prominent (sellar angle of &lt; 90\u00b0) in 25%, curved (sellar angle 90\u2013150\u00b0) in 63%, flat (sellar angle &gt; 150\u00b0) in 11%, and no floor (conchal sphenoid) in 1%. In healthy adults, the following mean measurements were obtained: sellar face, 13.4 mm; sellar prominence, 3.0 mm; sellar angle, 112\u00b0; angle of tuberculum sellae, 112\u00b0; and sellar-clival angle, 117\u00b0. Compared with healthy adults, patients with sellar lesions were more likely to have prominent sellar types (43% vs 25%, p = 0.01), a more acute sellar angle (102\u00b0 vs 112\u00b0, p = 0.03), a more prominent sellar floor (3.8 vs 3.0 mm, p &lt; 0.005), and more acute tuberculum (105\u00b0 vs 112\u00b0, p &lt; 0.01) and sellar-clival (105\u00b0 vs 117\u00b0, p &lt; 0.003) angles. A flat sellar floor was more difficult to identify intraoperatively and more likely to require the use of a chisel or drill to expose (75% vs 25%, p = 0.01). A simple sphenoid sinus configuration (no septa, 1 vertical septum, or 2 symmetric vertical septa) was noted in 71% of studies, and the other 29% showed a complex configuration (2 or more asymmetrical septa, 3 or more septa of any kind, or the presence of a horizontal septum). Intraoperative correlation was more challenging in cases with complex sinus anatomy; the most reliable intraoperative midline markers were the vomer, superior sphenoid rostrum, and bilateral parasellar and clival carotid protuberances.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Preoperative assessment of neuroimaging studies is critical for characterizing the morphological characteristics of the sphenoid sinus, sellar floor, tuberculum sellae, and clivus. The flat sellar type identified in 11% of people) or a complex sphenoid sinus configuration (in 29% of people) may make intraoperative correlation substantially more challenging. An understanding of the regional anatomy and its variability can improve the safety and accuracy of transsphenoidal and extended endoscopic skull base approaches.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.11.jns10768","type":"journal-article","created":{"date-parts":[[2011,1,14]],"date-time":"2011-01-14T16:14:07Z","timestamp":1295021647000},"page":"1319-1330","source":"Crossref","is-referenced-by-count":89,"title":["The neurosurgical anatomy of the sphenoid sinus and sellar floor in endoscopic transsphenoidal surgery"],"prefix":"10.3171","volume":"114","author":[{"given":"Gabriel","family":"Zada","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj K.","family":"Agarwalla","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasan","family":"Mukundan","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Dunn","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra J.","family":"Golby","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R.","family":"Laws","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns10768","series-title":"Neurosurgery","first-page":"933","article-title":"Endoscopic endonasal transsphenoidal surgery","volume":"55","author":"Cappabianca","year":"2004"},{"issue":"6 Suppl 3","key":"b2-jns10768","series-title":"Neurosurgery","first-page":"1202","article-title":"Extended endoscopic endonasal transsphenoidal approach to the suprasellar area: anatomic considerations\u2014part 1","volume":"62","author":"Cavallo","year":"2008"},{"issue":"4 Suppl 2","key":"b3-jns10768","series-title":"Neurosurgery","first-page":"322","article-title":"Avoidance of carotid artery injuries in transsphenoidal surgery with the Doppler probe and micro-hook blades","volume":"60","author":"Dusick","year":"2007"},{"key":"b4-jns10768","series-title":"J Neurosurg","first-page":"31","article-title":"Neurovascular relationships of the sphenoid sinus. 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The bony structures","volume":"53","author":"Ouaknine","year":"1987"},{"issue":"2A","key":"b8-jns10768","series-title":"Arq Neuropsiquiatr","first-page":"355","article-title":"Intracranial intrasellar kissing carotid arteries: case report","volume":"65","author":"Pereira Filho Ade","year":"2007"},{"key":"b9-jns10768","series-title":"J Neurosurg","first-page":"288","article-title":"Microsurgical anatomy of the sellar region","volume":"43","author":"Renn","year":"1975"},{"issue":"4 Suppl","key":"b10-jns10768","series-title":"Neurosurgery","first-page":"S335","article-title":"The sellar region","volume":"51","author":"Rhoton","year":"2002"},{"key":"b11-jns10768","series-title":"Surg Neurol","first-page":"63","article-title":"Microsurgical anatomy and dissection of the sphenoid bone, cavernous sinus and sellar region","volume":"12","author":"Rhoton","year":"1979"},{"key":"b12-jns10768","series-title":"Wien Klin Wochenschr","first-page":"621","article-title":"Erfolgreiche operation eines hypophysentumors auf nasalem Wege","volume":"20","author":"Schloffer","year":"1907"},{"key":"b13-jns10768","series-title":"J Laryngol Otol","first-page":"951","article-title":"Endoscopic anatomy of the sphenoid sinus and sella turcica","volume":"109","author":"Sethi","year":"1995"},{"key":"b14-jns10768","series-title":"Am J Roentgenol Radium Ther Nucl Med","first-page":"46","article-title":"Prolactin-secreting pituitary microadenomas: roentgenologic diagnosis","volume":"120","author":"Vezina","year":"1974"},{"key":"b15-jns10768","series-title":"Neurosurgery","first-page":"797","article-title":"Extensions of the sphenoid sinus: a new classification","volume":"66","author":"Wang","year":"2010"},{"issue":"2 Suppl Operative","key":"b16-jns10768","series-title":"Neurosurgery","first-page":"391","article-title":"Midline filum of the sellar dura: a useful landmark during endoscopic transsphenoidal pituitary surgery","volume":"67","author":"Zada","year":"2010"},{"issue":"4","key":"b17-jns10768","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Patterns of extrasellar extension in growth hormone\u2013secreting and nonfunctional pituitary macroadenomas","volume":"29","author":"Zada","year":"2010"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/114\/5\/article-p1319.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/114\/5\/article-p1319.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/114\/5\/article-p1319.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T06:49:47Z","timestamp":1679899787000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/114\/5\/article-p1319.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2011,5]]},"references-count":17,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2010.11.jns10768","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,5]]}}}