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Scientific Articles

Anatomical landmarks to locate the junction between transverse and sigmoid sinuses in translabyrinthine and retrosigmoid open surgical approaches

Authors:

Y Mathangasinghe ,

University of Colombo, LK
About Y
Department of Anatomy
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UMJE Samaranayake,

University of Colombo, LK
About UMJE
Department of Anatomy
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SSA Silva,

University of Colombo, LK
About SSA
Department of Anatomy
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HC Prematilaka,

University of Colombo, LK
About HC
Department of Anatomy
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MHS Perera,

University of Colombo, LK
About MHS
Department of Anatomy
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SSW Shantha

Neville Fernando Teaching Hospital, Malabe, LK
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Abstract

Introduction
Hematoma due to dural-sinus damage is a known complication when introducing burr holes in open transcranial surgery. Our objective was to identify safe areas to avoid dural-sinus damage based on anatomical landmarks in translabyrinthine and retrosigmoid open surgical approaches where neuronavigation facilities are not available.


Methods
A descriptive anatomical study was conducted on adult skulls. Distances to transverse and sigmoid sinuses on either side were measured using fixed anatomical landmarks: asterion, inion, margins of suprameatal triangle and superior nuchal line. Measurements were standardized according to the cranial indices (cranial index=anteroposterior diameter/transverse diameter) of each skull.


Results
Thirty-two adult skulls (male:female=22:10) were studied. Mean cranial index, width of transverse and sigmoid sinuses were 0.785±0.045, 9.1±2.3mm and 9.7±1.2mm respectively. Mean vertical distances from asterion and inion to the transverse sinus were 1.1±3.4mm and 14.7±5.9mm respectively. Posterior border of the sigmoid sinus was located 14.7±5.9mm, and 59.9±7.4mm anterior to asterion
and inion respectively. t-tests did not show significant differences of these distances on either sides (p>.05). Pearson's correlations were insignificant between the measurements and the cranial indices (p>.05). Measurements from the suprameatal triangle to the dural-sinuses had the minimum variance. In >95% of the times the sigmoid sinus was located ≤23 mm posterior and ≤7 mm superior to the
suprameatal triangle.


Discussion and conclusions
Suprameatal triangle was a consistent surface landmark to locate dural-sinuses. Dural-sinus damage could be avoided in 95% of the times by placing burr hole at least 7mm superior and 23 mm posterior to the suprameatal triangle.

How to Cite: Mathangasinghe, Y. et al., (2018). Anatomical landmarks to locate the junction between transverse and sigmoid sinuses in translabyrinthine and retrosigmoid open surgical approaches. Sri Lanka Journal of Surgery. 36(2), pp.8–12. DOI: http://doi.org/10.4038/sljs.v36i2.8509
Published on 31 Aug 2018.
Peer Reviewed

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