Does the sphenoid angle effect the operation strategy? Anatomical and radiological investigation

Area of Science:

• Neurosurgery
• Anatomy
• Radiology

Background:

• The sphenoid wing-lesser wing angulation (SWA) is a key anatomical landmark.
• Understanding SWA variations is important for surgical approaches to the middle cranial fossa.
• Previous studies have not fully elucidated the relationship between SWA and adjacent structures.

Purpose of the Study:

• To determine the importance of sphenoid wing-lesser wing angulation (SWA) in surgeries involving the sphenoid wing region.
• To establish a correlation between SWA and the depth of the middle cranial fossa (MCF).
• To assess the utility of preoperative CT scans in evaluating SWA and predicting MCF depth and superior orbital fissure (SOF) type.

Main Methods:

• Measurements of SWA and MCF depth were performed on 40 human skulls (80 sides).
• The same measurements were replicated on 40 randomly selected CT scans (80 sides).
• Specimens and CT scans were categorized into three groups based on SWA degree.

Main Results:

• Specimens were classified into three groups based on SWA: Group-A (>130°, 27%), Group-B (110-130°, 43%), and Group-C (<110°, 28%).
• MCF depth increased with increasing SWA (Group-A: 10.1 mm, Group-B: 6.4 mm, Group-C: 4.6 mm).
• CT scan results mirrored these classifications and correlations, with Group-A comprising 26%, Group-B 42%, and Group-C 31%.

Conclusions:

• Preoperative CT evaluation of SWA can accurately estimate MCF depth.
• This assessment also aids in predicting the type of superior orbital fissure.
• Knowledge of SWA is vital for surgical interventions requiring sphenoid wing manipulation or addressing pathologies in this area.