Descriptive analysis of sphenovomerine suture and its importance in neurosurgery

Purpose: Articulation of rostrum of sphenoid bone with alae of vomer forms a schindylesis type of joint. The circumference of this joint, called sphenovomerine suture (SVS), is very important in establishing a reliable surgical field in the endoscopic transsphenoidal pituitary surgery. Because of its vital role in endoscopic transsphenoidal pituitary surgery, this radio-anatomical study was designed to establish the morphological properties of SVS. Methods: In this study, the authors examined SVS in 235 patients (121 females and 114 males) on the computed tomography images of the paranasal sinus and made 4 measurements to describe SVS. Results: The mean distance between superior margin of the upper labial philtrum and top of SVS was 6.66±0.43 cm for females and 7.44±0.54 cm for males. The distance between the top of SVS and dorsum sellae was 3.08±0.33 cm for females and 3.19±0.32 cm for males, the alae of vomer angle in the upper surface was 74.22±20.06° for females and 74.23±19.68° for males. The distance between the most lateral points of 2 alae of vomer was 0.99±0.17 and 1.01±0.19 cm for females and males, respectively. Conclusions: For an easy and successful operation, removal of the SVS is very important as it will provide a better view of the sellar base and make the management of the surgical instruments easier in the wider safe surgical field thus created. © 2016 Mutaz B. Habal, MD