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Posterior clinoid process in children: morphometric analysis, pneumatization ratio, and surgical implications
Baran Can Alpergin1, Orhan Beger2, Murat Zaimoglu1
1Faculty of Medicine, Department of Neurosurgery, Ankara University, Ankara, Turkey.
Insights
Pneumatization of the posterior clinoid process (PCP) occurs in 8.9% of children and is linked to age, not gender. This anatomical data aids neurosurgeons in pediatric skull base mapping.
Area of Science:
- Skull Base Anatomy
- Pediatric Neurosurgery
- Radiology
Background:
- The posterior clinoid process (PCP) is a key anatomical landmark in the skull base.
- Understanding its pneumatization and topographic relationship to adjacent structures is crucial for surgical planning.
Purpose of the Study:
- To detail the pneumatization patterns and positional anatomy of the posterior clinoid process (PCP) in healthy children.
- To provide reference data for neurosurgical approaches to the anterior and middle cranial fossae.
Main Methods:
- Analysis of computed tomography (CT) scans from 180 pediatric patients (aged 1-18 years).
- Evaluation of PCP pneumatization and measurement of distances from PCP to key landmarks (e.g., foramen ovale, anterior clinoid process).
Main Results:
- PCP pneumatization was observed in 8.9% of sides, correlating significantly with pediatric age (p < 0.001).
- Distances to various foramina and processes generally increased with age, while PCP-ACP distance showed irregular changes.
- Fusion between PCP and anterior clinoid process (ACP) occurred in 3.10% of cases.
Conclusions:
- The posterior clinoid process (PCP) serves as a valuable reference point for pediatric skull base mapping due to its central location.
- The findings offer essential anatomical data for neurosurgeons performing procedures in the pediatric skull base.
Purpose:
To describe pneumatization and topographic position of the posterior clinoid process (PCP) in healthy children when approaching the anterior and middle fossae.
Methods:
The study consisted of computed tomography images of 180 pediatric patients (90 males / 90 females), aged 1-18 years. The presence or absence of PCP pneumatization was noted, and the distances of certain landmarks to PCP were measured.
Results:
The distances of the foramen ovale, foramen rotundum, superior orbital fissure, anterior clinoid process (ACP), foramen magnum and crista galli to PCP were measured as 18.59 ± 3.36 mm, 15.37 ± 3.45 mm, 14.60 ± 3.05 mm, 5.27 ± 3.24 mm, 32.03 ± 3.27 mm, and 30.45 ± 3.93 mm, respectively. These parameters increased with growth (between 1-18 years), but the distance between PCP and ACP decreased with an irregular pattern. In 11 sides (3.10%), a fusion between PCP and ACP was determined. PCP pneumatization was identified in 32 sides (8.9%). Its pneumatization correlated with pediatric ages (p < 0.001), but not gender (p = 0.459) or side (p = 0.711). Most of PCP pneumatization appeared after late childhood period (i.e., between 10-18 years).
Conclusion:
Our study provides beneficial data for neurosurgeons to use PCP as a reference point for creating a skull base map in children, because of the incomparable position of PCP in the skull base center.
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