Download PDF
J Neurol Surg B Skull Base 2022; 83(01): 028-032
DOI: 10.1055/s-0040-1716890
Original Article

The Longissimus Capitis Insertion as a Superficial Landmark for the Sigmoid Sinus: An Anatomical Study

Joe Iwanaga
1   Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, United States
2   Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
,
Koichi Watanabe
2   Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
,
Pervez A. Khan
1   Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, United States
,
John D. Nerva
1   Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, United States
,
Peter S. Amenta
1   Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, United States
,
Aaron S. Dumont
1   Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, United States
,
R. Shane Tubbs
1   Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, United States
3   Department of Anatomical Sciences, St. George's University, St. George's, Grenada
4   Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, United States
5   Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, United States
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Objective Many external anatomical landmarks have been used for approximating deeper, intracranial structures. Herein, we evaluate the attachment of the longissimus capitis (LC) on the mastoid process as a landmark for the underlying sigmoid sinus.

Methods Adult cadavers underwent dissection of the posterior occiput with special attention to the attachment of the LC muscle. Once the periphery of the muscle's tendon of attachment was determined, a burr hole was made in this area and evaluated internally for its relationship to the sigmoid sinus.

Results From an intracranial view, burr holes on all sides were over the sigmoid sinus and just slightly lateral to the center of the sinus. The distance from the midline to the medial border of the insertion of the LC had a mean of 63.0 ± 7.2 mm. The width of the tendon of insertion of the LC on the mastoid process had a mean of 17.6 ± 5.7 mm. The length of the tendon insertion of the LC had a mean of 14.7 ± 4.7 mm. The distance from the inferior border of the insertion of the LC to the tip of the mastoid process had a mean of 6.2 ± 4.5 mm.

Conclusion To our knowledge, use of the attachment site of the LC on the mastoid process as an external landmark for the underlying sigmoid sinus has not previously been reported. Based on our cadaveric findings, the sigmoid sinus is centered under the attachment of the LC regardless of the width of its tendon.

Keywords

posterior cranial fossa - anatomy - longissimus capitis - craniotomy - transmastoid - neurosurgery


Publication History

Received: 08 June 2020

Accepted: 20 July 2020

Article published online:
12 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Day JD, Kellogg JX, Tschabitscher M, Fukushima T. Surface and superficial surgical anatomy of the posterolateral cranial base: significance for surgical planning and approach. Neurosurgery 1996; 38 (06) 1079-1083 , discussion 1083–1084
    PubMedGoogle Scholar
  • 2 Day JD, Tschabitscher M. Anatomic position of the asterion. Neurosurgery 1998; 42 (01) 198-199
    CrossrefPubMedGoogle Scholar
  • 3 Morone PJ, Dewan MC, Zuckerman SL, Tubbs RS, Singer RJ. Craniometrics and ventricular access: a review of Kocher's, Kaufman's, Paine's, Menovksy's, Tubbs', Keen's, Frazier's, Dandy's, and Sanchez's points. Oper Neurosurg (Hagerstown) 2020; 18 (05) 461-469
    CrossrefPubMedGoogle Scholar
  • 4 Suslu HT, Bozbuga M, Ozturk A, Sahinoglu K. Surface anatomy of the transverse sinus for the midline infratentorial supracerebellar approach. Turk Neurosurg 2010; 20 (01) 39-42
    PubMedGoogle Scholar
  • 5 Tubbs RS, Salter G, Elton S, Grabb PA, Oakes WJ. Sagittal suture as an external landmark for the superior sagittal sinus. J Neurosurg 2001; 94 (06) 985-987
    CrossrefPubMedGoogle Scholar
  • 6 Tubbs RS, Salter G, Oakes WJ. Superficial surgical landmarks for the transverse sinus and torcular herophili. J Neurosurg 2000; 93 (02) 279-281
    CrossrefPubMedGoogle Scholar
  • 7 Tubbs RS, Loukas M, Shoja MM, Bellew MP, Cohen-Gadol AA. Surface landmarks for the junction between the transverse and sigmoid sinuses: application of the “strategic” burr hole for suboccipital craniotomy. Neurosurgery 2009;65(6, suppl)37–41, discussion 41
    PubMedGoogle Scholar
  • 8 Tubbs RS, O'Neil Jr. JT, Key CD. et al. Superficial temporal artery as an external landmark for deeper-lying brain structures. Clin Anat 2007; 20 (05) 498-501
    CrossrefPubMedGoogle Scholar
  • 9 Ucerler H, Govsa F. Asterion as a surgical landmark for lateral cranial base approaches. J Craniomaxillofac Surg 2006; 34 (07) 415-420
    CrossrefPubMedGoogle Scholar
  • 10 Graffeo CS, Peris-Celda M, Perry A, Carlstrom LP, Driscoll CLW, Link MJ. Anatomical step-by-step dissection of complex skull base approaches for trainees: surgical anatomy of the posterior petrosal approach. J Neurol Surg B Skull Base 2019; 80 (04) 338-351
    Article in Thieme ConnectPubMedGoogle Scholar