Anterior Clinoid Process and the Surrounding Structures

Background: The anterior clinoid process (ACP) is located close to the optic nerve, internal carotid artery, ophthalmic artery, and can be easily injured in an ACP-related surgery. An anatomical study clearly defining the ACP is of great importance. In addition, computed tomographic (CT) images may be a new tool for the anatomical analysis of ACP compared with the use of a cadaver and skull study, and more data related to ACP can be measured by CT images. Purpose: We studied the anatomical structure of ACP and the structures surrounding it to provide information to surgeons for ACP-related surgery. Methods: Computed tomography angiographic images of 102 individuals were reviewed. The measurement was performed on coronal, sagittal, and axis planes after multiplanar reformation. The length of ACP and the distance between apex of ACP and sagittal midline were measured in the axial plane; the classification of ACP and the occurrence rate of bone bridge were also viewed in axial plane. The thickness of ACP was measured in sagittal plane. Result: In Chinese population, 12.3% of the ACP is gasified, and the pneumatization of ACP has a relationship with the pneumatization of sphenoid sinus. The length and thickness of ACP are similar to that in previous studies in cadaver. The apex of ACP is relatively stationary to the C3 and C4 segments of the internal carotid artery. The occurrence rate of anterior and middle clinoid bone bridge was 7.8%; the occurrence rate of anterior and posterior clinoid bone bridge was 9.3%. Conclusions: The anatomical structure of ACP can be studied effectively in CT images. Recognizing the anatomical characteristics of the ACP and optic strut is important in decreasing the incidence of surgical complications of an anterior clinoidectomy and in the proper intraoperative management to prevent these complications.