Asterion as a surgical landmark for lateral cranial base approaches

Üçerler, Hülya; Gövsa, Figen

doi:10.1016/j.jcms.2006.05.003

Cited by 72 publications

(82 citation statements)

References 17 publications

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“…Classically, the asterion has been cited as an external landmark for the TSSJ. However, its position cannot be discerned because it is covered by the scalp (13). In this study, we used the root of the zygoma and the tip of the mastoid as the palpable landmarks to locate the asterion.…”

Section: █ Discussionmentioning

confidence: 99%

“…In this study, we used the root of the zygoma and the tip of the mastoid as the palpable landmarks to locate the asterion. Mwachaka et al (8,13) found that in Kenyans the distance from the asterion to the root of zygoma was 58.85 ± 2.50 mm on the right side and 58.44 ± 2.12 mm on the left side, and the distance from the asterion to the tip of the mastoid process was 47.89 ± 3.72 mm the distance from the asterion and 47.62 ± 2.87 mm on the left side, while the in Turks the corresponding fugure was 54.6 ± 5.50 mm and 54.1 ± 5.42 mm, and 49.10 ± 3.56 mm and 48.70 ± 2.23 mm (13). These studies show that the location of the asterion is different in different races and populations.…”

Section: █ Discussionmentioning

confidence: 99%

“…The asterion serves as the junction of the lambdoid, parietomastoid and occipitomastoid sutures, and has been used in retrosigmoid craniotomy to locate the transverse-sigmoid sinus junction (2,9,(12)(13)(14).…”

Section: █ Introductionmentioning

confidence: 99%

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Skull anatomic landmarks for retrosigmoid craniotomy in a chinese cohort: a 3D-CT study in vivo

Fan

Chen²,

Wang³

et al. 2013

Turkish Neurosurgery

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ABSTRACTas a surgical landmark has been questioned (8). Recent advances in 3D-computed tomography (CT) volume rendering techniques have made it possible to visualize minute bone sutures and venous structures of the posterior fossa (3,5,6,11).The purpose of this study is to determine the anatomic position of the asterion and the transverse-sigmoid sinus junction in Chinese population using the root of the zygoma and the tip of the mastoid process as palpable points. We also tried to clarify the relationship between the asterion and the inferior aspect of the transverse-sigmoid sinus junction using a 3D-CT procedure in vivo (8). █ MATERIAL and METHODSThe Zhejiang University ethics committee approval to fulfill the █ INTRODUCTIONThe correct location of an initial strategic burr hole for a retrosigmoid craniotomy to give access to the cerebellopontine angle (CPA) is paramount in obtaining optimal exposure in this region (12).As the transverse and sigmoid sinuses are the natural limits of these exposures, a knowledge about their cranial topography constitutes the main factor in the planning of these retrosigmoid approaches (10). The asterion serves as the junction of the lambdoid, parietomastoid and occipitomastoid sutures, and has been used in retrosigmoid craniotomy to locate the transverse-sigmoid sinus junction (2, 9, 12-14).As cadaveric studies have shown considerable variability in the relationship of the asterion to the underlying venous structures and its population-specific variability, its validity AIM: This study was designed to determine the anatomic position of the asterion and the relationship between the asterion and the transverse sigmoid sinus junction (TSSJ) in a Chinese cohort. MATERIAL and METHODS:Venous computed tomography (CT) angiography was performed in 32 patients to simultaneously obtain 3D-CT volume rendering images of the cranial bone and the dural sinus. The relationship between the TSSJ and the asterion was analyzed. RESULTS:The distance from the asterion to root of zygoma (ROZ) was 54.6 ± 5.50 mm on the right side and 54.1 ± 5.42 mm on the left side. The asterion was 49.10 ± 3.56 mm above the tip of mastoid process (TOP) on the right side and 48.70 ± 2.23 mm on the left side. The asterion's position was at the junction of the transverse-sigmoid sinus complex in 44 cases, below it in 19 cases, and above it in one case.CONCLUSION: 3D-CT volume rendering imaging is capable of accurately and simultaneously visualizing the bony landmark and the dural sinus structure outline in vivo, thus offering a new option for anatomic research and morphometric investigation. The accurate location of asterion can be found using the root of the zygoma and the tip of the mastoid process.

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Section: █ Discussionmentioning

confidence: 99%

Section: █ Discussionmentioning

confidence: 99%

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Skull anatomic landmarks for retrosigmoid craniotomy in a chinese cohort: a 3D-CT study in vivo

Fan

Chen²,

Wang³

et al. 2013

Turkish Neurosurgery

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“…Use of surface anatomical landmarks to localize intracranial structures are used in bedside procedures, such as in the use of Kocher's point to mark the insertion site for a ventriculostomy. Intraoperatively, landmarks such as the anatomic keyhole and coronal suture are used during pterional and bicoronal craniotomies and astrion for retromastoid approaches, respectively [3][4][5][6]. Furthermore, in cases where navigation systems are not available or when the systems malfunction, surface landmarks are necessary for craniotomies to be carried out in an accurate and safe matter.…”

Section: Introductionmentioning

confidence: 99%

The Accuracy of Topographical Methods in Determining Central Sulcus: A Statistical Correlation Between Modern Imaging Data and These Historical Predications

Sun¹,

Hou²,

Cheshier³

et al. 2014

Cureus

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“…Üçerler ve Gövsa (14), asterion'un %87 vakada sinus transversus'un üzerinde lokalize olduğunu, bunların %11'inin sinus transversus'un kaudalinde ve %2'sinin rostralinde yer aldığını; sinus transversus, sinus sigmoideus ve bunların bileĢke geniĢliğini sırasıyla 10,4±2.4 mm, 10,4±1,5 mm, 10,7±1,4 mm olarak buldular. ÇalıĢmamızda, calvaria'sı kaldırılmıĢ kuru kemik cranium'larda, asterion'un, dört cranium'da bilateral olarak SST içinde, bir cranium'da unilateral sol tarafta, diğer cranium'larda bilateral olarak SSS-SST bileĢkesi içinde yer aldığı gözlendi.…”

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Morphometric evaluation of localisation of asterion for intracranial approaches posterolaterally

Çırpan¹,

Yonguç²,

Sayhan³

et al. 2019

Ege Tıp Dergisi

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Amaç: Beyin cerrahisinde, fossa cranii posterior'a ulaĢmayı gerektiren cerrahi giriĢimlerde, cranium'a giriĢ noktası yüzeyel anatomik belirgin noktaların yardımıyla belirlenir. Asterion'un, cranium'un posteroateralinde kemik yüzeyindeki belirgin noktalar ve sulcus sinus transversi (SST), sulcus sinus sigmoidei (SSS) veya bunlara ait bileĢke ile olan iliĢkisinin morfometrik olarak incelenmesi amaçlandı. Sonuç: Asterion, SST, SSS veya bunlara ait bileĢkenin içinde yer aldığı ve asterion'un izdüĢümü hizasında sinus yapılara ait oluk geniĢliğinin 10,25±2,18 mm olduğu saptandı. Asterion'dan yaklaĢık 10 mm üstü ve altının giriĢim açısından sinus transversus veya sinus sigmoideus yaralanma riski taĢıyacağı için, fossa cranii posterior'a yapılacak cerrahi giriĢimlerde, yüzeyel belirgin noktaların yardımıyla asterion'un yerinin belirlenmesi, venöz sinüslerin korunmasını sağlayabilir. Gereç veAnahtar Sözcükler: Asterion, cranium, kraniyotomi, sulcus sinus sigmoidei, sulcus sinus transversi. Abstract Aim: In neurosurgery, surgical approaches that require access to fossa crani posterior is done with the help of superficial anatomic landmarks to determine the entrance point. It was aimed to morphometrically examine asterion and its relation with superficial landmarks in the postero-lateral aspect of cranium, groove for transverse sinus (GTS), groove for sigmoid sinus (GSS) and GTS-GSS junction. Materials and Methods

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Asterion as a surgical landmark for lateral cranial base approaches

Cited by 72 publications

References 17 publications

Skull anatomic landmarks for retrosigmoid craniotomy in a chinese cohort: a 3D-CT study in vivo

Skull anatomic landmarks for retrosigmoid craniotomy in a chinese cohort: a 3D-CT study in vivo

The Accuracy of Topographical Methods in Determining Central Sulcus: A Statistical Correlation Between Modern Imaging Data and These Historical Predications

Morphometric evaluation of localisation of asterion for intracranial approaches posterolaterally

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