etd Ege Tıp Dergisi 1016-9113 2147-6500 Ege Üniversitesi 10.19161/etd.442590 Health Care Administration Sağlık Kurumları Yönetimi Asterion yerleşiminin posterolateral intrakraniyal girişimler açısından morfometrik değerlendirilmesi Morphometric evaluation of localisation of asterion for intracranial approaches posterolaterally https://orcid.org/0000-0002-0654-9139 Çırpan Sibel DOKUZ EYLÜL ÜNİVERSİTESİ, TIP FAKÜLTESİ https://orcid.org/0000-0002-6300-5365 Yonguç Gökşin Nilüfer DOKUZ EYLÜL ÜNİVERSİTESİ, TIP FAKÜLTESİ https://orcid.org/0000-0003-3594-8937 Sayhan Salih DOKUZ EYLÜL ÜNİVERSİTESİ, TIP FAKÜLTESİ https://orcid.org/0000-0001-9833-6263 Eyüboğlu Canan DOKUZ EYLÜL ÜNİVERSİTESİ, TIP FAKÜLTESİ https://orcid.org/0000-0001-6953-2898 Güvençer Mustafa DOKUZ EYLÜL ÜNİVERSİTESİ, TIP FAKÜLTESİ 06 28 2019 58 2 108 114 03 22 2018 04 19 2018 Copyright © 1962, Ege Tıp Dergisi 1962 Ege Tıp Dergisi

Amaç: Beyin cerrahisinde, fossa craniiposterior’a ulaşmayı gerektiren cerrahi girişimlerde, cranium’a giriş noktası yüzeyel anatomik belirgin noktalarınyardımıyla belirlenir. Asterion’un, cranium’un posteroateralinde kemikyüzeyindeki belirgin noktalar ve sulcussinus transversi (SST), sulcus sinussigmoidei (SSS) veya bunlara ait bileşke ile olan ilişkisinin morfometrikolarak incelenmesi amaçlandı.Gereç ve Yöntem:Çalışmada, Dokuz Eylül Üniversitesi Tıp FakültesiAnatomi Anabilim Dalı Laboratuvarı kemik koleksiyonunda mevcut, yaşı vecinsiyeti bilinmeyen 172 adet erişkine ait bütün kuru kemik cranium’lar ile 10 adet calvaria’sı kaldırılmış kuru kemik cranium’lar değerlendirildi. Ölçümler0.01 mm’ye duyarlı dijital kumpas ve 1 mm’ye duyarlı mezura kullanılarakyapıldı.Bulgular: Asterion-inion 61,61±4,08 mm, asterion-processusmastoideus 47,81±5,09 mm, asterion-Henleçıkıntısı 41,63±3,95 mm, asterion-opisthion61,71±3,69 mm, asterion-processuszygomaticus’un kökü sağda 55,11±3,86 mm, solda 54,37±4,35 mm olarakölçüldü. Calvaria’sı kaldırılmış kurukemik cranium’larda asterion’un dört cranium’da bilateral, bir cranium’daunilateral sol tarafta SST içinde olduğu, diğerlerinde SSS-SST bileşkesi içindelokalize olduğu gözlendi.Sonuç: Asterion, SST, SSS veya bunlara ait bileşkenin içinde yer aldığı ve asterion’un izdüşümü hizasında sinusyapılara ait oluk genişliğinin 10,25±2,18 mm olduğu saptandı. Asterion’dan yaklaşık 10 mm üstü vealtının girişim açısından sinustransversus veya sinus sigmoideusyaralanma riski taşıyacağı için, fossacranii posterior’a yapılacak cerrahi girişimlerde, yüzeyel belirginnoktaların yardımıyla asterion’unyerinin belirlenmesi, venöz sinüslerin korunmasını sağlayabilir.

Aim: In neurosurgery, surgical approaches that requireaccess to fossa crani posterior is done with the help of superficial anatomiclandmarks to determine the entrance point. It was aimed to morphometrically examineasterion and its relation with superficial landmarks in the postero-lateralaspect of cranium, groove for transverse sinus (GTS), groove for sigmoid sinus(GSS) and GTS-GSS junction.Materials and Methods: In this study, 172 dry adulthuman crania and 10 crania with removed calvaria studied which are belong toAnatomy Laboratory, School of Medicine, Dokuz Eylul University. Measurementswere performed by using a digital caliper sensitive to 0.01 mm and tape measuresensitive 1 mm.Results: Measured parameters were as asterion-inion61.61±4.08 mm, asterion-mastoid process 47.81±5.09 mm, asterion-Henle spine41.63±3.95 mm, asterion-opisthion 61.71±3.69 mm, asterion-posterior root ofzygomatic process 55.11±3.86 mm on the right side and 54.37±4.35 mm on the leftside. In crania with removed calvaria, asterion was found to be locatedbilaterally in GTS in four crania, unilaterally on left side in one cranium andin others in GTS-GSS complex.Conclusion: Asterion takes place withinthe GSS, GTS or its junction. At the projection point of asterion width of thegroove related to venous sinuses was determined as 10.25±2.18 mm. Determinationof location of asterion with the help of superficial landmarks may provideprotection of venous sinuses during surgical procedures performed in posteriorcranial fossa, since transverse or sigmoid sinus will be at risk of injury 10mm above or below from the asterion.

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