Computed tomography morphometric analysis of the central clival depression and petroclival angle for application of the presigmoid approach in the pediatric population

Sohum Desai, Dámarcus Baymon, Eric Sieloff, Kenneth Maynard, Marc Moisi, Achal Patel, Joel Patterson

    Research output: Contribution to journalArticle

    1 Citation (Scopus)

    Abstract

    Aims: Lateral transtemporal approaches are useful for addressing lesions located ventral to the brainstem, especially when the pathologic diagnosis of the tumor dictates that a gross or near total resection improves outcomes. One approach, the presigmoid approach receives little attention in the pediatric population thus far. We sought to characterize morphometric changes, particularly the clival depth and the petroclival Cobb angle, that occur in the temporal bones of children and draw implications about doing a presigmoid approach in children. Settings and Design: This study was a retrospective study performed at John Sealy Hospital, a level-one trauma center that takes care of pediatric injuries as well. Subjects and Methods: We performed a morphometric analysis of noncontrast computed tomography head studies in 96 boys and 67 girls. Central clival depth and petroclival angle were obtained in the axial plane at the level of the internal auditory meatus using the method described by Abdel Aziz et al. Statistical Analysis Used: Descriptive statistics and Student's t-test to compare groups were calculated using Microsoft Excel. Results: We found no gender difference in mean central clival depth or petroclival angle (P = 0.98 and P = 0.61, respectively). However, when we broke our cohort by age into those younger than 9 years of age and those 10 years or older, we found the petroclival angle decreased by 6.2° which was statistically significant (P < 0.000000006). Conclusions: These findings suggest that a presigmoid retrolabyrinthine approach is useful for children 9 years of age and younger as the petroclival angle appears to decrease resulting in a shallower clival depression in these patients.

    Original languageEnglish (US)
    Pages (from-to)109-111
    Number of pages3
    JournalJournal of Pediatric Neurosciences
    Volume11
    Issue number2
    DOIs
    StatePublished - Apr 1 2016

    Fingerprint

    Tomography
    Pediatrics
    Population
    Temporal Bone
    Trauma Centers
    Brain Stem
    Retrospective Studies
    Head
    Students
    Wounds and Injuries
    Neoplasms

    Keywords

    • Central clival depression
    • children
    • lateral skull base
    • presigmoid retrolabyrinthine approach

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Neuroscience(all)

    Cite this

    Computed tomography morphometric analysis of the central clival depression and petroclival angle for application of the presigmoid approach in the pediatric population. / Desai, Sohum; Baymon, Dámarcus; Sieloff, Eric; Maynard, Kenneth; Moisi, Marc; Patel, Achal; Patterson, Joel.

    In: Journal of Pediatric Neurosciences, Vol. 11, No. 2, 01.04.2016, p. 109-111.

    Research output: Contribution to journalArticle

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    abstract = "Aims: Lateral transtemporal approaches are useful for addressing lesions located ventral to the brainstem, especially when the pathologic diagnosis of the tumor dictates that a gross or near total resection improves outcomes. One approach, the presigmoid approach receives little attention in the pediatric population thus far. We sought to characterize morphometric changes, particularly the clival depth and the petroclival Cobb angle, that occur in the temporal bones of children and draw implications about doing a presigmoid approach in children. Settings and Design: This study was a retrospective study performed at John Sealy Hospital, a level-one trauma center that takes care of pediatric injuries as well. Subjects and Methods: We performed a morphometric analysis of noncontrast computed tomography head studies in 96 boys and 67 girls. Central clival depth and petroclival angle were obtained in the axial plane at the level of the internal auditory meatus using the method described by Abdel Aziz et al. Statistical Analysis Used: Descriptive statistics and Student's t-test to compare groups were calculated using Microsoft Excel. Results: We found no gender difference in mean central clival depth or petroclival angle (P = 0.98 and P = 0.61, respectively). However, when we broke our cohort by age into those younger than 9 years of age and those 10 years or older, we found the petroclival angle decreased by 6.2° which was statistically significant (P < 0.000000006). Conclusions: These findings suggest that a presigmoid retrolabyrinthine approach is useful for children 9 years of age and younger as the petroclival angle appears to decrease resulting in a shallower clival depression in these patients.",
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    AU - Desai, Sohum

    AU - Baymon, Dámarcus

    AU - Sieloff, Eric

    AU - Maynard, Kenneth

    AU - Moisi, Marc

    AU - Patel, Achal

    AU - Patterson, Joel

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    N2 - Aims: Lateral transtemporal approaches are useful for addressing lesions located ventral to the brainstem, especially when the pathologic diagnosis of the tumor dictates that a gross or near total resection improves outcomes. One approach, the presigmoid approach receives little attention in the pediatric population thus far. We sought to characterize morphometric changes, particularly the clival depth and the petroclival Cobb angle, that occur in the temporal bones of children and draw implications about doing a presigmoid approach in children. Settings and Design: This study was a retrospective study performed at John Sealy Hospital, a level-one trauma center that takes care of pediatric injuries as well. Subjects and Methods: We performed a morphometric analysis of noncontrast computed tomography head studies in 96 boys and 67 girls. Central clival depth and petroclival angle were obtained in the axial plane at the level of the internal auditory meatus using the method described by Abdel Aziz et al. Statistical Analysis Used: Descriptive statistics and Student's t-test to compare groups were calculated using Microsoft Excel. Results: We found no gender difference in mean central clival depth or petroclival angle (P = 0.98 and P = 0.61, respectively). However, when we broke our cohort by age into those younger than 9 years of age and those 10 years or older, we found the petroclival angle decreased by 6.2° which was statistically significant (P < 0.000000006). Conclusions: These findings suggest that a presigmoid retrolabyrinthine approach is useful for children 9 years of age and younger as the petroclival angle appears to decrease resulting in a shallower clival depression in these patients.

    AB - Aims: Lateral transtemporal approaches are useful for addressing lesions located ventral to the brainstem, especially when the pathologic diagnosis of the tumor dictates that a gross or near total resection improves outcomes. One approach, the presigmoid approach receives little attention in the pediatric population thus far. We sought to characterize morphometric changes, particularly the clival depth and the petroclival Cobb angle, that occur in the temporal bones of children and draw implications about doing a presigmoid approach in children. Settings and Design: This study was a retrospective study performed at John Sealy Hospital, a level-one trauma center that takes care of pediatric injuries as well. Subjects and Methods: We performed a morphometric analysis of noncontrast computed tomography head studies in 96 boys and 67 girls. Central clival depth and petroclival angle were obtained in the axial plane at the level of the internal auditory meatus using the method described by Abdel Aziz et al. Statistical Analysis Used: Descriptive statistics and Student's t-test to compare groups were calculated using Microsoft Excel. Results: We found no gender difference in mean central clival depth or petroclival angle (P = 0.98 and P = 0.61, respectively). However, when we broke our cohort by age into those younger than 9 years of age and those 10 years or older, we found the petroclival angle decreased by 6.2° which was statistically significant (P < 0.000000006). Conclusions: These findings suggest that a presigmoid retrolabyrinthine approach is useful for children 9 years of age and younger as the petroclival angle appears to decrease resulting in a shallower clival depression in these patients.

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