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Optico-carotid recess and anterior clinoid process pneumatization – proposal for a novel classification and unified terminology: an anatomic and radiologic study

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Firstpage: 0 - Lastpage: 0

A. Andrianakis - P.V. Tomazic - A. Wolf - F. Anderhuber - C. Gerstenberger - U. Pilsl - H. Stammberger

BACKGROUND: The aims of this study were to propose a novel and unified classification system of the optico-carotid recess (OCR) and anterior clinoid process (ACP) pneumatization, determine their frequency in a Caucasian population and measure the size of the OCR.
METHODOLOGY: A total of 200 specimen (400 sphenoid sinuses) were evaluated in a separate anatomic cadaveric study (n=100) and radiologic study (n=100) by using sphenoidal sinus cast and computed tomography (CT) scan. OCR was divided according to its location to the optic nerve into sub-optical and latero-optical OCR grade I-III.
RESULTS: An OCR was found in 39% of the samples (78/200) and in 19% (38/200) it occurred bilaterally. Both, sub-optical and latero-optical OCR were identified in 14% of the sides (58/400), with a mean length and depth of 6.9 mm; 7.7 mm and 2.3 mm, 7.1 mm, respectively. We determined the pneumatized ACP frequency with 23% (46/200) and defined 3 unified different types of pneumatization.
CONCLUSIONS: The OCR is a reliable landmark to identify the optico-carotid region in endoscopic sphenoid sinus surgery, and can even be visualized by CT. Hence, preoperative investigation of the sphenoid region is mandatory. In our opinion, the classification presented in this study can be useful in order to avoid surgical complications.

A. Andrianakis - P.V. Tomazic - A. Wolf - F. Anderhuber - C. Gerstenberger - U. Pilsl - H. Stammberger - Optico-carotid recess and anterior clinoid process pneumatization – proposal for a novel classification and unified terminology: an anatomic and radiologic study
Rhinology -: 0-0, 0000