gms | German Medical Science

ESBS 2005: Skull Base Surgery: An Interdisciplinary Challenge
7. Kongress der Europäischen Schädelbasisgesellschaft & 13. Jahrestagung der Deutschen Gesellschaft für Schädelbasischirurgie

18. - 21.05.2005, Fulda

Is the cribriform plate an effective border?

Meeting Contribution

Suche in Medline nach

  • J. Hemza - Neurosurgery Dpt., Hospital about Saint Ann, Anatomy and Physiology Institute, Faculty of Sport Study, Masaryc University, Brno, Czech Republic
  • J. Hanzlová - Neurosurgery Dpt., Hospital about Saint Ann, Anatomy and Physiology Institute, Faculty of Sport Study, Masaryc University, Brno, Czech Republic

ESBS 2005: Skull Base Surgery: An Interdisciplinary Challenge. 7th Congress of the European Skull Base Society held in association with the 13th Congress of the German Society of Skull Base Surgery. Fulda, 18.-21.05.2005. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc05esbs04

doi: 10.3205/05esbs04, urn:nbn:de:0183-05esbs047

Veröffentlicht: 27. Januar 2009

© 2009 Hemza et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction

The cribriform plate are „locus minoris resitentiae“ to the anterior skull base area. The cribriform plate set to area of anterior skull base about 3,0–3,5cm of frontal line of anterior skull base. The area of cribriforme plate is very important from aspect of intracranial function study, especially in relation to resobction problem of cerebrospinal fluid. The cribriform plate and olfactory structures are very important from function – as smelling, tasting and sexual-behavioral functions.

We issue from conception of our preceeding 2 studies of lamina cribrosa: partly osseous study which proved this so-called „plate“ as complicating osseous structures of labyrinth type and histological findings demonstrating that not only nerve structures, but vessels, which characters of cavernous veins or sinusoids, going through the complicating labyrinth’s canaliculi.

We issue from conception about lamina cribrosa anatomy as shoe-string oss multiple perforating, which oflactory nerves go through and developed plexus nervosus besides, after passage through lamina, in olfactory mucosa. From clinical and surgery reasons motive was given to careful anatomical study od quantitative and qualitative characters of this region.

Our main questions are:

  • Which are anatomical basis from liquor resorption in this area?
  • Which is function into skull base between structures going through it and brain mater?
  • Is the cribriform plate an effective border?

The material and methods: The study was executed in two divisions in reality – macroscopic bone study and microscopic study this area. The dry bone preparation of lamina cribrosa and surrounding bony structures and fresh preparation this area from cadavers futher more.

The material was processed multiple methods. The dry bone material was cut in thin slice in horizontal, sagital and vertical level, it was study macroscopically, 2,5–7,5 magnify. The endoscop Johnsons and Johnsons was used during study, when study was executed into water surrounding respect to character of endoscop (Figure 1 [Fig. 1]).

The study was executed as microscopic study this area. The fresh preparation from the cadavers of this area was materials. The fresh preparation of lamina cribrosa from cadavers was the first fixation on week in 10% formaldehyde, after this washed in water and subsequently decalcinate by Livre’s mixture (chromium oxid, HNO3, denaturated ethylalcohol, water destilled), the washing out was made in the water after, dehydrating by ethylalcohol in ascendent concentrations and acetone with xylene. The preparation was embedded to parafin and cut on microscopic sloves. After deparaffinating by xylene and dehydrating by ethylalcohol these were stained by agent hematoxylin-eosin (Figure 2 [Fig. 2], Figure 3 [Fig. 3], Figure 4 [Fig. 4]).

The second method was Bodian’s method of fresh preparations precessing – after fixation 4% formaldehyde in phosphated buffer with sacharosa, pH 7,4, and mixture 6% formaldehyde with acetone, and HNO with sacharose, was washing out in phosphated buffer with sacharose. The preparation was cut on frozen and take into 50% ethylalkohol, it was primed (saturated throughly) by Ag-proteinan, the processing was made in developer and stabilizing by fixative, dehydrating after, clearing and build on slide (Figure 5 [Fig. 5]).

The slide was study microscopically in different magnifications in turn sloves and space reconstruction was made by these slice.

Results

I was established during study of macroscopic section with combine macroscopic and endoscopic technique thus reconstruction of section from discoveries the simple perforating bony plate don’t go to simple little canals, but developed exactly complicated labyrinth of little canals in this thin bone plate. The simple inlet penetrate under different angles into bone plates as canals, which branched or connected together in 3 levels, having divergent and convergent character, and developing complicated space structures those oss. The lamina cribrosa is complicated labyrinth oss, no simple perforated plate (Figure 1 [Fig. 1]).

The answers were searched for determined questions by microscopic study of slide indifferent magnification (63 x 2,12,5 x 2,25 x 2,50 x 2). We observed the place of relationship the osseous structures to vessels and nerves in detail hematoxylin-eosin stained slides. The vessels structures were thinwall vessels by observing by us, as character of sinusoid or cavernous vessels, these wall in made by endothelium layer in osseous canal only, the nuclei of endothelium cells protruding to vesel lumen (Figure 3 [Fig. 3]). Any vessels embrace the olfactory nerves during passage-way to canaliculus (Figure 2 [Fig. 2]). We searched the answer to second question. We started of transit structures from intracranium extracranially by canaliculli, that continuously to arachnoidodural layer, and it there are going, after passage-way by osseous canaliculus to surrounding tissue. The duroarachnoideal layer [1], [2] change continuously in the place of passage-way of structures to peripheral tissue of this structure – the adventitia or perineurium, than there in the nerve (Figure 4 [Fig. 4]). This junction intracranial – extracranial is described at the first time histologically.

We find system of cellules going together with the nerves in its passage-way, which connected with arachnoidea, subarachnoideal space and olfactoric cistern, with Bodian’s stain (Figure 5 [Fig. 5]). This arachnoideal villi have character „wine grape“ on basic reconstruction single slide going succesively. The faculty of physiological resorption of cerebrospinal fluid attributed a system arachnoideal villi and microvilli.

We established in our group that proportion of canaliculi, which the nerve passage-way, to other canaliculi is 1:5-9. Any canaliculi are apparently empty, but into penetrating arachnoideal villi.

The physiological undulation of the fibres, Fontana’s striated (1781), is perceptible on the nerve fibres (Figure 5 [Fig. 5]).This Fontana’s undulation into olfactory nerves has described at first time. As far as we make the space reconstruction of the lamina cribrosa with individual structures subsequently, we establish that osseous part is labyrinth, which on the one hand the nerve fibres passing through, which they develop together already to the plexus in osseous part and the vein structures of the cavernous or sinusoid character passing through additional canaliculi, which they the nerve fibres or individually, these make the plexus in area of lamina cribrosa likewise.

Discussion

The study answers on determinate questions. We found anatomical correlation for cerebrospinal resorption in histological slide. The finding a similar structures in cavum Meckeli Krivosic published [3]. We demonstrated during the study of the junction in area of the passing-way structures through skull base, that the special arrangement of junction is not, to the end that it was increased and fixed significantly to close the intracranium in the place of passing-way structures, but i tis very gently and fragile. The own arrangement duroarachnoideal layer, Haines [1], [2] describes this, this allow for it, that so the place was staying limited permeability for the cerebrospinal fluid, but together it allow the special arrangement to the resorption [4], [5], [6], [7], [8], [9], [10], [11]. The study of the cerebrospinal fluid resorption show to help by isotope of liquor on animal models (1994), that the resorption are happened on skull base from majority, the isotope show in lymphatic vessels in the splachnocranium, and under anterior skull base too. The thin wall veins and these diameter together the space order of vein plexus in lamina cribrosa, it could be given evidence for special physiological importance. The cribriforme plate is very gently border for trauma, tumors.

Conclusion

The lamina cribrosa is labyrinth bone, into which the plexus nervosum nervi olfactorii develop, the venous plexus of thinwall veins, with cavernous or sinusoid character,, the arachnoideal villi and microvilli passing-way into canaliculli togerther with nervi olfactorii, but partly independently to, the arachnoideal villi probably function to cerebrospinal fluid resorption. The junction of structures passing form intracranium to extracranium in this area is very gently, fragile, and developing limit permeability in arachnoideal layer.

Is the cribriforme plate an effective border?


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