The anatomic variations and surgical windows among optic chiasm/nerves and carotid arteries in the sellar region play a role in choosing the best surgical approaches: A Cadaveric study

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(b) Inferior view of sellar and parasellar region. ON: optic nerve, OC: optic chiasm, Acomm: anterior communicating artery, HS: hypophysis stalk, OcN: oculomotor nerve, BA: basilar artery, Cl: clivus, TS: tuberculum sella, Tc: tuber cinereum." ] ] ] "textoCompleto" => "IntroductionSellar and parasellar region is a critical anatomical structure in the middle of skull base, which is limited to optic nerve, chiasm and Willis polygon superiorly, cavernous sinuses and internal carotid artery (ICA) laterally, and brainstem and basilar artery posteriorly.<a class="elsevierStyleCrossRef" href="#bib0070">1</a> In this region, the most easily affected neural structure by the pathologies is optical apparatus. Anterior cerebral arteries and anterior communicating artery are located superiorly to the chiasm. Tuber cinereum and infundibulum are located postero-inferiorly to the optic chiasm, internal carotid arteries are laterally, and diaphragma sellae and pituitary gland are inferiorly.<a class="elsevierStyleCrossRef" href="#bib0070">1</a>Most pathologies in sellar and parasellar region are located inferiorly to optic nerve and chiasm, and just posteriorly to chiasmatic sulcus. Chiasm is located centrally (normal location) in 70% of humans, and overlies diaphragma sellae. Optic chiasm might be in 3 different locations as prefix chiasm, central chiasm and postfix chiasm, according to diaphragma sellae, pituitary gland and pituitary stalk. This location variety determines clinical symptomatology and surgical approaches significantly.<a class="elsevierStyleCrossRef" href="#bib0070">1</a>Understanding the relation between carotid artery, optic nerve and anterior clinoid process is the basis of surgical approaches performed in subchiasmal, sellar–presellar regions. Surgical approaches of pathologies located in sellar–parasellar, subchiasmal region differ according to the region where pathology extends, and to the structures affected by the pathology. Although approaches according to the type of pathology are mostly clear nowadays, it is significant in each case to determine the structures which were affected by the pathology, and to choose the best surgical approach without damaging the surrounding tissues. The location of the optic chiasm, the length of the optic nerves, the distance and angle between the optic nerves determine the morbidity and mortality of surgical approaches. Approach to subchiasmal and parachiasmal region might be challenging due to the critical anatomy of optic nerves, optic chiasm, carotid arteries. Although transnasal endoscopic approaches to this region increased recently, transcranial approach should be considered evidently in resistible lesions.Albeit some studies on cadavers related to the anatomy of sellar–parasellar region, cavernous sinus, and diaphragma sellae are present, there are few studies in literature where neural and vascular anatomy of subchiasmal–parachiasmal region were compared in terms of transcranial and transnasal approaches.<a class="elsevierStyleCrossRefs" href="#bib0075">2–5</a> In the current study, the relationship of anatomic structures with one another was investigated in order to prefer surgical approach to optico-chiasmatic region in such a way that it does not harm anatomic structures.Materials and methodsThe current study was done in 30 adult human autopsy cases performed by Bursa Uludag University School of Medicine Department of Forensic Medicine and the Institute of Forensic Medicine Morgue Department, with the approval by Uludag University School of Medicine Neurosurgery Department (n=30). The study was approved by Uludag University Ethical Committee on 08.07.2014 with an approval number of 2014-14/14, and by Bursa Forensic Institute Education and Scientific Research Commission on 15.12.2015 with an approval number of 21589509/1021.The technic, which was defined by Yılmazlar et al.,<a class="elsevierStyleCrossRef" href="#bib0095">6</a> was modified as sellar and parasellar region was removed en bloc with preserving the lower part of mesencephalon including optic nerves, chiasm, Willis polygon, basilar artery, pons and hypothalamic region. Thirty fresh cadaveric blocks were kept and fixed in formaldehyde for 3 days. In the course of dissection of thirty anatomical block samples, sellar and parasellar region was explored in accordance with the microsurgical principles, without doing any harm on brain structures. Subsequent to optic nerves, chiasm, lamina terminalis and tractus opticus region, which constitute the anatomical structure of suprachiasmal region, were observed en bloc, first anatomical photographic imaging of suprasellar and parasellar regions was done (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Subchiasmal region, as a secondary exploration region, was approached in 30 anatomical block samples with a similar way to transnasal approach, and images were obtained (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b). In the 30 cadaveric block samples, the following measurements and evaluations were done for anatomical research, without doing any harm on the anatomical structures of suprachiasmal, parachiasmal, and subchiasmal regions. The openability limits of surgical windows were tested during dissections. Each stage of the anatomical dissection was recorded by operation microscope (Carl Zeiss OPMI Pentero™, Jena, Germany), and the measurements were done by ImageJ program.Qualitative and quantitative measurements<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">A.Qualitative measurementsThe location of optic chiasm according to sellae was noted in 30 cases. Chiasm was designated as central type if it was located on sellae, as prefix type if it was located anteriorly to sellae, and as postfix if it was located on dorsum sellae posteriorly to sellae.</li><li class="elsevierStyleListItem" id="lsti0010">B.Quantitative measurementsThe measurements on the cases were performed with digital caliper. Classifying of photographs obtained, detecting the anatomical variations and performing quantitative measurements were done on the computer.<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0015">B1: Measurements of suprachiasmal region<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0020">B1.1: The angle between both optic nerves was measured medially.</li><li class="elsevierStyleListItem" id="lsti0025">B1.2: The length of the distance between both optic nerves was measured in the plane of the nerve entering the optical channel.</li></ul></li><li class="elsevierStyleListItem" id="lsti0030">B2: Measurements of anterior subchiasmal region<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0035">B2.1: The midline length between tuberculum sellae and the posterior part of the pituitary stalk was measured (this is the endoscopic operating distance).</li><li class="elsevierStyleListItem" id="lsti0040">B2.2: The distance between the anterior clinoids was measured medially.</li></ul></li></ul></li></ul>Results<ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0045">A.Results of the qualitative measurementsIn the 30 cadaveric samples where the location of the optic chiasm according to sellae was noted, central type chiasm where chiasm is seen directly on the sellae was detected in 20 cases (67%) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>a), postfix type chiasm where chiasm is seen anteriorly to sellae was detected in 6 cases (20%) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>c), and prefix type chiasm where chiasm is seen on dorsum sellae posteriorly to sellae was detected in 4 cases (13%) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>b).<elsevierMultimedia ident="fig0010"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0050">B.Results of the quantitative measurements<ul class="elsevierStyleList" id="lis0030"><li class="elsevierStyleListItem" id="lsti0055">B1: Results of the measurements of subchiasmal region<ul class="elsevierStyleList" id="lis0035"><li class="elsevierStyleListItem" id="lsti0060">B1.1: The angle between the optic nerves was defined. The biggest one was 106.1°, and the smallest one was 65.9° (mean value 87.1±11.6°) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a).</li><li class="elsevierStyleListItem" id="lsti0065">B1.2: The distance between the optic nerves was measured medially, in the plane where the nerve enters the optical channel. The biggest one was 16.1mm, and the shortest one was 6.6mm (mean value 12.1±2.6mm) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a).</li></ul></li><li class="elsevierStyleListItem" id="lsti0070">B2: Results of the measurements of anterior subchiasmal region<ul class="elsevierStyleList" id="lis0040"><li class="elsevierStyleListItem" id="lsti0075">B2.1: The midline length between the anterior part of tuberculum sellae and the posterior part of the pituitary stalk was measured. The longest value was 11.9mm, and the shortest one was 4.9mm (mean value 9.1±1.7mm) (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).<elsevierMultimedia ident="fig0015"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0080">B2.2: The distance between the anterior clinoids was measured medially. The biggest one was 26.3mm, and the shortest one was 15.6mm (mean value 21.1±2.4mm) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a).</li></ul></li></ul></li></ul>DiscussionIn determining the surgical approach to the region, the types of optic chiasm and openability of the approach windows must be into consideration. Optic chiasm is designated as prefix chiasm if it is located anterior to diaphragm sellae, pituitary stalk and pituitary gland; as central chiasm if it is located in the middle; and as postfix chiasm if it is located behind. Chiasm is located in 70% of humans centrally, and overlies diaphragma sellae.<a class="elsevierStyleCrossRef" href="#bib0100">7</a>The variations of optic chiasm, and the prefix and postfix terms were suggested for the first time by Schaeffer in 1924.<a class="elsevierStyleCrossRef" href="#bib0100">7</a> Recently, Griessenauer et al. emphasized that the relationship between the location of chiasm and the pituitary gland is significant to determinate the surgical approach, and concluded that cases with postfix chiasm type have the lowest risk for the injuries of optic chiasm and pituitary stalk during a surgical operation.<a class="elsevierStyleCrossRef" href="#bib0105">8</a> In various anatomical and radiological studies, prefix type chiasm was reported with a rate of 4–24%, central type chiasm with a rate of 65–88%, and postfix type chiasm with a rate of 4–17%.<a class="elsevierStyleCrossRefs" href="#bib0110">9–12</a>In the current study, 4 prefix types (13%), 6 postfix types (20%), and 20 central types (67%) of chiasm were defined. These proportions are concordant with the optic chiasm type results of the anatomical study, which was performed by Yohannan et al. on 100 cases autopsy series. Gulsen et al. discussed in human cadaver samples the anatomical location of pituitary gland associated with tuberculum sellae and dorsum sellae.<a class="elsevierStyleCrossRef" href="#bib0130">13</a> In that study, the team evaluated the location of the pituitary gland according to diaphragma sellae and dorsum sellae in 60 cadaveric brains where pituitary stalks were preserved. The chiasm located as normal in forty-seven (78%) cadaveric brains, while prefix types were defined in 3 (5%), and postfix types were defined in 10 (17%) cases. The distance between the tuberculum sellae and the posterior part of the pituitary stalk was measured as 1–8mm. In this study, it was emphasized that exploring the relationship between pituitary stalk and the surrounding structures during the opening of the chiasmatic cistern and removing of the tumor is significant to prevent the injuries of pituitary stalk.<a class="elsevierStyleCrossRef" href="#bib0130">13</a> In the current study, the length of the midline between tuberculum sellae and the posterior part of pituitary gland was measured as 4.9–11.9mm (mean value 9.1±1.7mm) (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>A further parameter indicates the location of optic chiasm according to sella turcica is the angle between optic nerves. The angle between the intracranial segments of optic nerves in median sagittal plane was first measured by Won et al.<a class="elsevierStyleCrossRef" href="#bib0125">12</a> Yohannan et al. suggested that the measurement of the angle between two optical nerves in preoperative imaging might be indicative to choose the subfrontal interoptical approach to pituitary adenomas.<a class="elsevierStyleCrossRef" href="#bib0100">7</a> The mean angle between optic nerves was measured as 69.9±9.2° in 100 autopsy cases performed by Yohannan et al. The authors defined this angle as 79.61° in cases with prefix chiasm, as 68.1° in cases with normofix chiasm, and as 59.48° in cases with postfix chiasm. The “limit” value was identified as ≥71.4° to designate a chiasm as prefix.<a class="elsevierStyleCrossRef" href="#bib0100">7</a> In our study, we first measured this angle between two optic nerves, which indirectly shows the location of chiasm according to diaphragma sellae, and then detected the mean value of this angle as 87.1±11.6°. The “limit” value to designate a chiasm as prefix was measured in the current study as ≥101.1°. The angle between optic nerves ranged between 65.9° and 75.0° in 6 cases with postfix chiasm (mean value 69.9±3.7°), between 101.1° and 106.1° in 4 cases with prefix chiasm (mean value 104.0±2.1°), and between 79.9° and 99.1° in 20 cases with central chiasm (mean value 88.8±6.7°) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Preoperative determining the angle radiologically might be a guiding light to surgeon, with suggesting the location of chiasm. In the current study, the angle between optic nerves in each 3 types of chiasm was measured bigger than those ones in the study of Yohannan et al.<a class="elsevierStyleCrossRef" href="#bib0100">7</a> In particular, a prefix chiasm in subfrontal approach might complicate the approach to subchiasmal region, by reducing the range of surgical manipulation. Thus, defining this variation would definitely change the planning of the operation. Apart from the location and extent of the pathology, preoperative anatomical and radiological knowledge of the location of the optic nerves and chiasm might be useful in choosing a transsphenoidal or transcranial surgeries. During the surgery, the position and the boundaries of the optic nerves, optic chiasm, carotid and oculomotor nerves determine the corridor of the surgical approach (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>). Another factor is the ability to pull without damaging the nerve and vascular structures of surgical approach windows.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia>A further factor challenge the surgery to this region is the length between two optic nerves in the plane where the nerve enters to the optical channel. In the current study, the mean length between optical nerves was 12.1±2.6mm (ranging between 6.1mm and 16mm) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). In addition, the relationship of this length with the types of optic chiasm was evaluated. The length between optic nerves ranged between 9.4 and 13.7mm (mean value 11.5±1.4mm) in the samples with postfix chiasm, between 8.3 and 14.6mm (mean value 11.6±3.1mm) in the samples with prefix chiasm, and between 6.6 and 16mm (mean value 12.4±2.8mm) in the samples with central chiasm (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). As a conclusion, no relation between the type of chiasm and the distance between optic nerves was seen (P=0.0875). Concurrently, it was seen in the measurements we performed that the distance between optic nerves are naturally concordant with the distance between anterior clinoid processes. In our study, the mean distance between two optic nerves in the plane that nerve enters to the optic channel was 12.1±2.6mm (ranged between 16.1mm and 6.6mm), as well as the mean distance between anterior clinoid processes was 21.1±2.4mm (ranged between 26.3mm and 15.6mm). As the distance between optic nerves decreases, the risk of postoperative deficit development increases as the optic nerve retraction might be increased (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).ConclusionIn this study, we showed the importance of the types of chiasm in surgical approaches to sellar–parasellar and subchiasmal region by showing optic chiasm types. In the dissections we performed on 30 cadaveric samples, we showed 67% central type chiasm. Further, this study shows that the relationship among the chiasma, optic nerves, and bony structures is important in determining the surgical approach in the surgery of the sellar–parasellar and subchiasmal region. We have seen that the angle and length of the optic nerves distance between anterior clinoid processes is important as well as optical chiasm types to select the appropriate approach from transsphenoidal or transcranial surgical approaches.Author contributionsDuygu Baykal and Selcuk Yilmazlar contributed to the design and effective implementation of the cadaveric-anatomic study, to the analysis of the results and to the writing of the manuscript.Duygu Baykal carried out the dissection of the materials and performed the measurements and wrote the manuscript with support from Selcuk Yilmazlar.Recep Fedakar was involved in obtaining materials and supervised the study.All authors provided critical feedback and discussed the results and contributed to the final manuscript.Conflict of interestThe authors declare that they have no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres1331768" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1226873" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1331767" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1226874" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Qualitative and quantitative measurements" ] ] ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0035" "titulo" => "Author contributions" ] 10 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflict of interest" ] 11 => array:2 [ "identificador" => "xack460005" "titulo" => "Acknowledgments" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-07-21" "fechaAceptado" => "2019-10-08" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1226873" "palabras" => array:5 [ 0 => "Cadaveric study" 1 => "Optic chiasm" 2 => "Optic nerve" 3 => "Internal carotid artery" 4 => "Surgical approach" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1226874" "palabras" => array:5 [ 0 => "Estudio en cadáveres" 1 => "Quiasma óptico" 2 => "Nervio óptico" 3 => "Arteria carótida interna" 4 => "Acceso quirúrgico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveUnderstanding the relationship between the carotid artery, optic nerve and the anterior clinoid process is the basis of surgical approaches performed in the subchiasmal region. The location of the optic chiasm, the length of the optic nerves, and the distance and angle between the optic nerves determine the route of surgical approaches. We have determined the types of optic chiasm to study the relationship between vascular and neural structures in this region. Materials and methodsThirty autopsy specimens were investigated at the Bursa Forensic Medicine Institute for optic chiasm types and the relationship between the neural and vascular anatomical structures of the sellar–parasellar and subchiasmal region was examined between June 2016 and November 2016. ResultsIn this study, 4 prefix types (13%), 6 postfix types (20%), and 20 central types (67%) of chiasm were defined. Furthermore, we measured this angle between two optic nerves, which indirectly shows the location of chiasm according to the diaphragma sellae, and then detected the mean value of this angle as 87.1±11.6°. The “limit” value to designate a chiasm as prefix was measured in the current study as ≥101.1°. The angle between optic nerves ranged from a mean value of 69.9±3.7° in 6 cases with postfix chiasm, to a mean value of 104.0±2.1° in 4 cases with prefix chiasm and a mean value of 88.8±6.7° in 20 cases with central chiasm. ConclusionIn this study, we showed that the relationship among optic chiasma types, optic nerves and bony and vascular structures around the sellar area was effective at determining the surgical approach to this region." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivoComprender la relación entre la arteria carótida, el nervio óptico y la apófisis clinoides anterior es la base de los tratamientos quirúrgicos realizados en la región subquiasmática. La ubicación del quiasma óptico, la longitud de los nervios ópticos, y la distancia y el ángulo entre dichos nervios determinan la vía de acceso quirúrgico. Hemos determinado los tipos de quiasma óptico para estudiar la relación entre las estructuras vasculares y neurales en esta región. Materiales y métodosEntre junio y noviembre de 2016, se analizaron 30 muestras de autopsia en el Instituto de Medicina Legal de Bursa (Turquía) para determinar los tipos de quiasma óptico, y examinar la relación entre las estructuras anatómicas neurales y vasculares de las regiones selar-paraselar y subquiasmática. ResultadosEn este estudio, se definieron 4 casos de quiasma prefijado (13%), 6 de quiasma posfijado (20%) y 20 de quiasma central (67%). Además, medimos el ángulo entre 2 nervios ópticos que muestra indirectamente la ubicación del quiasma según el diafragma selar, y luego detectamos el valor medio de este ángulo (87,1±11,6°). El valor «límite» para designar un quiasma como «prefijado» se midió en el estudio actual como ≥101,1°. El valor medio del ángulo entre los nervios ópticos osciló entre 69,9±3,7° en los 6 casos de quiasma posfijado, 104,0±2,1° en los 4 casos de quiasma prefijado y 88,8±6,7° en los 20 casos de quiasma central. ConclusiónEn este estudio, pusimos de manifiesto que la relación entre los tipos de quiasma óptico, los nervios ópticos y las estructuras óseas y vasculares alrededor del área selar fue eficaz para determinar el acceso quirúrgico en esta región." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 837 "Ancho" => 2167 "Tamanyo" => 219118 ] ] "descripcion" => array:1 [ "en" => "(a) Superior view of sellar and parasellar region. (b) Inferior view of sellar and parasellar region. ON: optic nerve, OC: optic chiasm, Acomm: anterior communicating artery, HS: hypophysis stalk, OcN: oculomotor nerve, BA: basilar artery, Cl: clivus, TS: tuberculum sella, Tc: tuber cinereum." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 701 "Ancho" => 2917 "Tamanyo" => 254362 ] ] "descripcion" => array:1 [ "en" => "(a) Central type chiasm. ON: optic nerve, OC: optic chiasm, ICA: internal carotid artery, A1: A1 segment of anterior cerebral artery, A2: A2 segment of anterior cerebral artery, Acomm: anterior communicating artery, TS: tuberculum sellae, DS: diaphragma sellae. (Superior view of sellar–parasellar region.) (b) Prefixed type chiasm. ON: optic nerve, OC: optic chiasm, TS: tuberculum sellae, ICA: internal carotid artery, A1: A1 segment of anterior cerebral artery, A2: A2 segment of anterior cerebral artery. (Superior view of sellar–parasellar region.) (c) Postfixed type chiasm. ON: optic nerve, OC: optic chiasm, HS: hypophysis stalk, ICA: internal carotid artery, A1: A1 segment of anterior cerebral artery. (Superior view of sellar–parasellar region.)" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 935 "Ancho" => 2167 "Tamanyo" => 195485 ] ] "descripcion" => array:1 [ "en" => "(a) ON: optic nerve, OcN: oculomotor nerve, OC: optic chiasm, ICA: internal carotid artery, A1: A1 segment of anterior cerebral artery, A2: A2 segment of anterior cerebral artery, Acomm: anterior communicating artery, BA: basilar artery, Pcom: posterior communicating artery, V: vein, Cp: posterior clinoid process, TS: tuberculum sellae, LT: lamina terminalis. (Right anterolateral view of sellar–parasellar and subchiasmal region.) (b) ON: optic nerve, Ocn: oculomotor nerve, OC: optic chiasm, S: hypophysis stalk, ICA: internal carotid artery, A1: A1 segment of anterior cerebral artery, A2: A2 segment of anterior cerebral artery, Acomm: anterior communicating artery, MCA: middle cerebral artery, BT: basilar tip. (Right anterolateral view of sellar–parasellar region.)" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 720 "Ancho" => 2917 "Tamanyo" => 357189 ] ] "descripcion" => array:1 [ "en" => "Selection of surgical approaches and surgical corridors according to position of optic nerves and optic chiasm. (a) Usage of interoptic (io), lamina terminalis (lt) and opticocarotid (oc) corridors in superior approach with a transcranial technique. (b) Usage of interoptic (io), opticocarotid (oc), caroticooculomotor (co) and inferior oculomotor nerve (iocn) corridors in superior-lateral approach with a transcranial skull base technique. (c) Usage of interoculomotor nerves (interocn) corridors in inferior approach with a transsphenoidal endoscopic technique. ON: optic nerve, ICA: internal carotid artery, A1: A1 segment of anterior cerebral artery, M1: M1 segment of middle cerebral artery, Acomm: anterior communicating artery, OcN: oculomotor nerve, HS: hypophysis stalk, DS: dorsum sella, MB: mamillary body, BA: basilar artery, SCA: superior cerebellar artery, P1: P1 segment of posterior cerebral artery." ] ] 4 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sample no. \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Distance between tuberculum sellae and pituitary stalk (mm) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Distance between the anterior clinoids (mm) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.9. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ort±SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.1±1.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.1±2.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2282307.png" ] ] ] ] "descripcion" => array:1 [ "en" => "The structures that limit the anterior subchiasmal region in surgical approaches." ] ] 5 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "tllt: the transversal (coronal) length of lamina terminalis; sllt: sagittal length of lamina terminalis; abon: angle between the optic nerves; dbon: distance between the optic nerves; ICArc: internal carotid artery right clinoidal segment; ICAlc: internal carotid artery left clinoidal segment." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sample no. \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">tllt \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">sllt \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">abon \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">dbon \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ICAcr \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ICAcl \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">81.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">104.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">76.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">89.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">94.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">99.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">101.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">81.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">89.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">92.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">78.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">94.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">89.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">81.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">105.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">89.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">106.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">99.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ave±SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.1±1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.0±1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87.1±11.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.1±2.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.0±1.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.5±1.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2282308.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Results of the measurements of subchiasmal region." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib0070" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The sellar region" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.L. 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"vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/25298496/0000003100000003/v1_202005010845/S2529849620300137/v1_202005010845/en/main.assets" "Apartado" => array:4 [ "identificador" => "65581" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical research" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/25298496/0000003100000003/v1_202005010845/S2529849620300137/v1_202005010845/en/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529849620300137?idApp=UINPBA00004B"]

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Clinical Research

The anatomic variations and surgical windows among optic chiasm/nerves and carotid arteries in the sellar region play a role in choosing the best surgical approaches: A Cadaveric study

Las variaciones anatómicas y las vías de acceso quirúrgico en el quiasma, los nervios ópticos y las arterias carótidas de la región selar influyen en la elección de los mejores abordajes quirúrgicos: un estudio en cadáveres

Duygu Baykala, Selcuk Yilmazlara,

Corresponding author

yilmazlars@gmail.com

Corresponding author.

, Recep Fedakarb

a Department of Neurosurgery, School of Medicine, Bursa Uludag University, Bursa, Turkey

b Department of Forensic Medicine, School of Medicine, Bursa Uludag University, Bursa, Turkey

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Sellar and parasellar region is a critical anatomical structure in the middle of skull base&#44; which is limited to optic nerve&#44; chiasm and Willis polygon superiorly&#44; cavernous sinuses and internal carotid artery &#40;ICA&#41; laterally&#44; and brainstem and basilar artery posteriorly&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> In this region&#44; the most easily affected neural structure by the pathologies is optical apparatus&#46; Anterior cerebral arteries and anterior communicating artery are located superiorly to the chiasm&#46; Tuber cinereum and infundibulum are located postero-inferiorly to the optic chiasm&#44; internal carotid arteries are laterally&#44; and diaphragma sellae and pituitary gland are inferiorly&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Most pathologies in sellar and parasellar region are located inferiorly to optic nerve and chiasm&#44; and just posteriorly to chiasmatic sulcus&#46; Chiasm is located centrally &#40;normal location&#41; in 70&#37; of humans&#44; and overlies diaphragma sellae&#46; Optic chiasm might be in 3 different locations as prefix chiasm&#44; central chiasm and postfix chiasm&#44; according to diaphragma sellae&#44; pituitary gland and pituitary stalk&#46; This location variety determines clinical symptomatology and surgical approaches significantly&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Understanding the relation between carotid artery&#44; optic nerve and anterior clinoid process is the basis of surgical approaches performed in subchiasmal&#44; sellar&#8211;presellar regions&#46; Surgical approaches of pathologies located in sellar&#8211;parasellar&#44; subchiasmal region differ according to the region where pathology extends&#44; and to the structures affected by the pathology&#46; Although approaches according to the type of pathology are mostly clear nowadays&#44; it is significant in each case to determine the structures which were affected by the pathology&#44; and to choose the best surgical approach without damaging the surrounding tissues&#46; The location of the optic chiasm&#44; the length of the optic nerves&#44; the distance and angle between the optic nerves determine the morbidity and mortality of surgical approaches&#46; Approach to subchiasmal and parachiasmal region might be challenging due to the critical anatomy of optic nerves&#44; optic chiasm&#44; carotid arteries&#46; Although transnasal endoscopic approaches to this region increased recently&#44; transcranial approach should be considered evidently in resistible lesions&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Albeit some studies on cadavers related to the anatomy of sellar&#8211;parasellar region&#44; cavernous sinus&#44; and diaphragma sellae are present&#44; there are few studies in literature where neural and vascular anatomy of subchiasmal&#8211;parachiasmal region were compared in terms of transcranial and transnasal approaches&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">2&#8211;5</span></a> In the current study&#44; the relationship of anatomic structures with one another was investigated in order to prefer surgical approach to optico-chiasmatic region in such a way that it does not harm anatomic structures&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">The current study was done in 30 adult human autopsy cases performed by Bursa Uludag University School of Medicine Department of Forensic Medicine and the Institute of Forensic Medicine Morgue Department&#44; with the approval by Uludag University School of Medicine Neurosurgery Department &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41;&#46; The study was approved by Uludag University Ethical Committee on 08&#46;07&#46;2014 with an approval number of 2014-14&#47;14&#44; and by Bursa Forensic Institute Education and Scientific Research Commission on 15&#46;12&#46;2015 with an approval number of 21589509&#47;1021&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The technic&#44; which was defined by Y&#305;lmazlar et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">6</span></a> was modified as sellar and parasellar region was removed en bloc with preserving the lower part of mesencephalon including optic nerves&#44; chiasm&#44; Willis polygon&#44; basilar artery&#44; pons and hypothalamic region&#46; Thirty fresh cadaveric blocks were kept and fixed in formaldehyde for 3 days&#46; In the course of dissection of thirty anatomical block samples&#44; sellar and parasellar region was explored in accordance with the microsurgical principles&#44; without doing any harm on brain structures&#46; Subsequent to optic nerves&#44; chiasm&#44; lamina terminalis and tractus opticus region&#44; which constitute the anatomical structure of suprachiasmal region&#44; were observed en bloc&#44; first anatomical photographic imaging of suprasellar and parasellar regions was done &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Subchiasmal region&#44; as a secondary exploration region&#44; was approached in 30 anatomical block samples with a similar way to transnasal approach&#44; and images were obtained &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>b&#41;&#46; In the 30 cadaveric block samples&#44; the following measurements and evaluations were done for anatomical research&#44; without doing any harm on the anatomical structures of suprachiasmal&#44; parachiasmal&#44; and subchiasmal regions&#46; The openability limits of surgical windows were tested during dissections&#46; Each stage of the anatomical dissection was recorded by operation microscope &#40;Carl Zeiss OPMI Pentero&#8482;&#44; Jena&#44; Germany&#41;&#44; and the measurements were done by ImageJ program&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Qualitative and quantitative measurements</span><p id="par0040" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">A&#46;</span><p id="par0045" class="elsevierStylePara elsevierViewall">Qualitative measurementsThe location of optic chiasm according to sellae was noted in 30 cases&#46; Chiasm was designated as central type if it was located on sellae&#44; as prefix type if it was located anteriorly to sellae&#44; and as postfix if it was located on dorsum sellae posteriorly to sellae&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">B&#46;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Quantitative measurementsThe measurements on the cases were performed with digital caliper&#46; Classifying of photographs obtained&#44; detecting the anatomical variations and performing quantitative measurements were done on the computer&#46;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0015"><p id="par0065" class="elsevierStylePara elsevierViewall">B1&#58; Measurements of suprachiasmal region<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0020"><p id="par0070" class="elsevierStylePara elsevierViewall">B1&#46;1&#58; The angle between both optic nerves was measured medially&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><p id="par0075" class="elsevierStylePara elsevierViewall">B1&#46;2&#58; The length of the distance between both optic nerves was measured in the plane of the nerve entering the optical channel&#46;</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0030"><p id="par0080" class="elsevierStylePara elsevierViewall">B2&#58; Measurements of anterior subchiasmal region<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0035"><p id="par0085" class="elsevierStylePara elsevierViewall">B2&#46;1&#58; The midline length between tuberculum sellae and the posterior part of the pituitary stalk was measured &#40;this is the endoscopic operating distance&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><p id="par0090" class="elsevierStylePara elsevierViewall">B2&#46;2&#58; The distance between the anterior clinoids was measured medially&#46;</p></li></ul></p></li></ul></p></li></ul></p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0095" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">A&#46;</span><p id="par0100" class="elsevierStylePara elsevierViewall">Results of the qualitative measurementsIn the 30 cadaveric samples where the location of the optic chiasm according to sellae was noted&#44; central type chiasm where chiasm is seen directly on the sellae was detected in 20 cases &#40;67&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>a&#41;&#44; postfix type chiasm where chiasm is seen anteriorly to sellae was detected in 6 cases &#40;20&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>c&#41;&#44; and prefix type chiasm where chiasm is seen on dorsum sellae posteriorly to sellae was detected in 4 cases &#40;13&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>b&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">B&#46;</span><p id="par0110" class="elsevierStylePara elsevierViewall">Results of the quantitative measurements<ul class="elsevierStyleList" id="lis0030"><li class="elsevierStyleListItem" id="lsti0055"><p id="par0115" class="elsevierStylePara elsevierViewall">B1&#58; Results of the measurements of subchiasmal region<ul class="elsevierStyleList" id="lis0035"><li class="elsevierStyleListItem" id="lsti0060"><p id="par0120" class="elsevierStylePara elsevierViewall">B1&#46;1&#58; The angle between the optic nerves was defined&#46; The biggest one was 106&#46;1&#176;&#44; and the smallest one was 65&#46;9&#176; &#40;mean value 87&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;6&#176;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0065"><p id="par0125" class="elsevierStylePara elsevierViewall">B1&#46;2&#58; The distance between the optic nerves was measured medially&#44; in the plane where the nerve enters the optical channel&#46; The biggest one was 16&#46;1<span class="elsevierStyleHsp" style=""></span>mm&#44; and the shortest one was 6&#46;6<span class="elsevierStyleHsp" style=""></span>mm &#40;mean value 12&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;6<span class="elsevierStyleHsp" style=""></span>mm&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#41;&#46;</p></li></ul></p></li><li class="elsevierStyleListItem" id="lsti0070"><p id="par0130" class="elsevierStylePara elsevierViewall">B2&#58; Results of the measurements of anterior subchiasmal region<ul class="elsevierStyleList" id="lis0040"><li class="elsevierStyleListItem" id="lsti0075"><p id="par0135" class="elsevierStylePara elsevierViewall">B2&#46;1&#58; The midline length between the anterior part of tuberculum sellae and the posterior part of the pituitary stalk was measured&#46; The longest value was 11&#46;9<span class="elsevierStyleHsp" style=""></span>mm&#44; and the shortest one was 4&#46;9<span class="elsevierStyleHsp" style=""></span>mm &#40;mean value 9&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;7<span class="elsevierStyleHsp" style=""></span>mm&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0080"><p id="par0140" class="elsevierStylePara elsevierViewall">B2&#46;2&#58; The distance between the anterior clinoids was measured medially&#46; The biggest one was 26&#46;3<span class="elsevierStyleHsp" style=""></span>mm&#44; and the shortest one was 15&#46;6<span class="elsevierStyleHsp" style=""></span>mm &#40;mean value 21&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;4<span class="elsevierStyleHsp" style=""></span>mm&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#41;&#46;</p></li></ul></p></li></ul></p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0145" class="elsevierStylePara elsevierViewall">In determining the surgical approach to the region&#44; the types of optic chiasm and openability of the approach windows must be into consideration&#46; Optic chiasm is designated as prefix chiasm if it is located anterior to diaphragm sellae&#44; pituitary stalk and pituitary gland&#59; as central chiasm if it is located in the middle&#59; and as postfix chiasm if it is located behind&#46; Chiasm is located in 70&#37; of humans centrally&#44; and overlies diaphragma sellae&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">The variations of optic chiasm&#44; and the prefix and postfix terms were suggested for the first time by Schaeffer in 1924&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> Recently&#44; Griessenauer et al&#46; emphasized that the relationship between the location of chiasm and the pituitary gland is significant to determinate the surgical approach&#44; and concluded that cases with postfix chiasm type have the lowest risk for the injuries of optic chiasm and pituitary stalk during a surgical operation&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a> In various anatomical and radiological studies&#44; prefix type chiasm was reported with a rate of 4&#8211;24&#37;&#44; central type chiasm with a rate of 65&#8211;88&#37;&#44; and postfix type chiasm with a rate of 4&#8211;17&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">9&#8211;12</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">In the current study&#44; 4 prefix types &#40;13&#37;&#41;&#44; 6 postfix types &#40;20&#37;&#41;&#44; and 20 central types &#40;67&#37;&#41; of chiasm were defined&#46; These proportions are concordant with the optic chiasm type results of the anatomical study&#44; which was performed by Yohannan et al&#46; on 100 cases autopsy series&#46; Gulsen et al&#46; discussed in human cadaver samples the anatomical location of pituitary gland associated with tuberculum sellae and dorsum sellae&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">13</span></a> In that study&#44; the team evaluated the location of the pituitary gland according to diaphragma sellae and dorsum sellae in 60 cadaveric brains where pituitary stalks were preserved&#46; The chiasm located as normal in forty-seven &#40;78&#37;&#41; cadaveric brains&#44; while prefix types were defined in 3 &#40;5&#37;&#41;&#44; and postfix types were defined in 10 &#40;17&#37;&#41; cases&#46; The distance between the tuberculum sellae and the posterior part of the pituitary stalk was measured as 1&#8211;8<span class="elsevierStyleHsp" style=""></span>mm&#46; In this study&#44; it was emphasized that exploring the relationship between pituitary stalk and the surrounding structures during the opening of the chiasmatic cistern and removing of the tumor is significant to prevent the injuries of pituitary stalk&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">13</span></a> In the current study&#44; the length of the midline between tuberculum sellae and the posterior part of pituitary gland was measured as 4&#46;9&#8211;11&#46;9<span class="elsevierStyleHsp" style=""></span>mm &#40;mean value 9&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;7<span class="elsevierStyleHsp" style=""></span>mm&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall">A further parameter indicates the location of optic chiasm according to sella turcica is the angle between optic nerves&#46; The angle between the intracranial segments of optic nerves in median sagittal plane was first measured by Won et al&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">12</span></a> Yohannan et al&#46; suggested that the measurement of the angle between two optical nerves in preoperative imaging might be indicative to choose the subfrontal interoptical approach to pituitary adenomas&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> The mean angle between optic nerves was measured as 69&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;2&#176; in 100 autopsy cases performed by Yohannan et al&#46; The authors defined this angle as 79&#46;61&#176; in cases with prefix chiasm&#44; as 68&#46;1&#176; in cases with normofix chiasm&#44; and as 59&#46;48&#176; in cases with postfix chiasm&#46; The &#8220;limit&#8221; value was identified as &#8805;71&#46;4&#176; to designate a chiasm as prefix&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> In our study&#44; we first measured this angle between two optic nerves&#44; which indirectly shows the location of chiasm according to diaphragma sellae&#44; and then detected the mean value of this angle as 87&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;6&#176;&#46; The &#8220;limit&#8221; value to designate a chiasm as prefix was measured in the current study as &#8805;101&#46;1&#176;&#46; The angle between optic nerves ranged between 65&#46;9&#176; and 75&#46;0&#176; in 6 cases with postfix chiasm &#40;mean value 69&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;7&#176;&#41;&#44; between 101&#46;1&#176; and 106&#46;1&#176; in 4 cases with prefix chiasm &#40;mean value 104&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;1&#176;&#41;&#44; and between 79&#46;9&#176; and 99&#46;1&#176; in 20 cases with central chiasm &#40;mean value 88&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;7&#176;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Preoperative determining the angle radiologically might be a guiding light to surgeon&#44; with suggesting the location of chiasm&#46; In the current study&#44; the angle between optic nerves in each 3 types of chiasm was measured bigger than those ones in the study of Yohannan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> In particular&#44; a prefix chiasm in subfrontal approach might complicate the approach to subchiasmal region&#44; by reducing the range of surgical manipulation&#46; Thus&#44; defining this variation would definitely change the planning of the operation&#46; Apart from the location and extent of the pathology&#44; preoperative anatomical and radiological knowledge of the location of the optic nerves and chiasm might be useful in choosing a transsphenoidal or transcranial surgeries&#46; During the surgery&#44; the position and the boundaries of the optic nerves&#44; optic chiasm&#44; carotid and oculomotor nerves determine the corridor of the surgical approach &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; Another factor is the ability to pull without damaging the nerve and vascular structures of surgical approach windows&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0165" class="elsevierStylePara elsevierViewall">A further factor challenge the surgery to this region is the length between two optic nerves in the plane where the nerve enters to the optical channel&#46; In the current study&#44; the mean length between optical nerves was 12&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;6<span class="elsevierStyleHsp" style=""></span>mm &#40;ranging between 6&#46;1<span class="elsevierStyleHsp" style=""></span>mm and 16<span class="elsevierStyleHsp" style=""></span>mm&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; In addition&#44; the relationship of this length with the types of optic chiasm was evaluated&#46; The length between optic nerves ranged between 9&#46;4 and 13&#46;7<span class="elsevierStyleHsp" style=""></span>mm &#40;mean value 11&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;4<span class="elsevierStyleHsp" style=""></span>mm&#41; in the samples with postfix chiasm&#44; between 8&#46;3 and 14&#46;6<span class="elsevierStyleHsp" style=""></span>mm &#40;mean value 11&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;1<span class="elsevierStyleHsp" style=""></span>mm&#41; in the samples with prefix chiasm&#44; and between 6&#46;6 and 16<span class="elsevierStyleHsp" style=""></span>mm &#40;mean value 12&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;8<span class="elsevierStyleHsp" style=""></span>mm&#41; in the samples with central chiasm &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; As a conclusion&#44; no relation between the type of chiasm and the distance between optic nerves was seen &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;0875&#41;&#46; Concurrently&#44; it was seen in the measurements we performed that the distance between optic nerves are naturally concordant with the distance between anterior clinoid processes&#46; In our study&#44; the mean distance between two optic nerves in the plane that nerve enters to the optic channel was 12&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;6<span class="elsevierStyleHsp" style=""></span>mm &#40;ranged between 16&#46;1<span class="elsevierStyleHsp" style=""></span>mm and 6&#46;6<span class="elsevierStyleHsp" style=""></span>mm&#41;&#44; as well as the mean distance between anterior clinoid processes was 21&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;4<span class="elsevierStyleHsp" style=""></span>mm &#40;ranged between 26&#46;3<span class="elsevierStyleHsp" style=""></span>mm and 15&#46;6<span class="elsevierStyleHsp" style=""></span>mm&#41;&#46; As the distance between optic nerves decreases&#44; the risk of postoperative deficit development increases as the optic nerve retraction might be increased &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusion</span><p id="par0170" class="elsevierStylePara elsevierViewall">In this study&#44; we showed the importance of the types of chiasm in surgical approaches to sellar&#8211;parasellar and subchiasmal region by showing optic chiasm types&#46; In the dissections we performed on 30 cadaveric samples&#44; we showed 67&#37; central type chiasm&#46; Further&#44; this study shows that the relationship among the chiasma&#44; optic nerves&#44; and bony structures is important in determining the surgical approach in the surgery of the sellar&#8211;parasellar and subchiasmal region&#46; We have seen that the angle and length of the optic nerves distance between anterior clinoid processes is important as well as optical chiasm types to select the appropriate approach from transsphenoidal or transcranial surgical approaches&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Author contributions</span><p id="par0175" class="elsevierStylePara elsevierViewall">Duygu Baykal and Selcuk Yilmazlar contributed to the design and effective implementation of the cadaveric-anatomic study&#44; to the analysis of the results and to the writing of the manuscript&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Duygu Baykal carried out the dissection of the materials and performed the measurements and wrote the manuscript with support from Selcuk Yilmazlar&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Recep Fedakar was involved in obtaining materials and supervised the study&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">All authors provided critical feedback and discussed the results and contributed to the final manuscript&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interest</span><p id="par0195" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest&#46;</p></span></span>"
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          "titulo" => "Introduction"
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    "fechaRecibido" => "2019-07-21"
    "fechaAceptado" => "2019-10-08"
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          "palabras" => array:5 [
            0 => "Cadaveric study"
            1 => "Optic chiasm"
            2 => "Optic nerve"
            3 => "Internal carotid artery"
            4 => "Surgical approach"
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          "palabras" => array:5 [
            0 => "Estudio en cad&#225;veres"
            1 => "Quiasma &#243;ptico"
            2 => "Nervio &#243;ptico"
            3 => "Arteria car&#243;tida interna"
            4 => "Acceso quir&#250;rgico"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Understanding the relationship between the carotid artery&#44; optic nerve and the anterior clinoid process is the basis of surgical approaches performed in the subchiasmal region&#46; The location of the optic chiasm&#44; the length of the optic nerves&#44; and the distance and angle between the optic nerves determine the route of surgical approaches&#46; We have determined the types of optic chiasm to study the relationship between vascular and neural structures in this region&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Thirty autopsy specimens were investigated at the Bursa Forensic Medicine Institute for optic chiasm types and the relationship between the neural and vascular anatomical structures of the sellar&#8211;parasellar and subchiasmal region was examined between June 2016 and November 2016&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">In this study&#44; 4 prefix types &#40;13&#37;&#41;&#44; 6 postfix types &#40;20&#37;&#41;&#44; and 20 central types &#40;67&#37;&#41; of chiasm were defined&#46; Furthermore&#44; we measured this angle between two optic nerves&#44; which indirectly shows the location of chiasm according to the diaphragma sellae&#44; and then detected the mean value of this angle as 87&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;6&#176;&#46; The &#8220;limit&#8221; value to designate a chiasm as prefix was measured in the current study as &#8805;101&#46;1&#176;&#46; The angle between optic nerves ranged from a mean value of 69&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;7&#176; in 6 cases with postfix chiasm&#44; to a mean value of 104&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;1&#176; in 4 cases with prefix chiasm and a mean value of 88&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;7&#176; in 20 cases with central chiasm&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In this study&#44; we showed that the relationship among optic chiasma types&#44; optic nerves and bony and vascular structures around the sellar area was effective at determining the surgical approach to this region&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Comprender la relaci&#243;n entre la arteria car&#243;tida&#44; el nervio &#243;ptico y la ap&#243;fisis clinoides anterior es la base de los tratamientos quir&#250;rgicos realizados en la regi&#243;n subquiasm&#225;tica&#46; La ubicaci&#243;n del quiasma &#243;ptico&#44; la longitud de los nervios &#243;pticos&#44; y la distancia y el &#225;ngulo entre dichos nervios determinan la v&#237;a de acceso quir&#250;rgico&#46; Hemos determinado los tipos de quiasma &#243;ptico para estudiar la relaci&#243;n entre las estructuras vasculares y neurales en esta regi&#243;n&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Entre junio y noviembre de 2016&#44; se analizaron 30 muestras de autopsia en el Instituto de Medicina Legal de Bursa &#40;Turqu&#237;a&#41; para determinar los tipos de quiasma &#243;ptico&#44; y examinar la relaci&#243;n entre las estructuras anat&#243;micas neurales y vasculares de las regiones selar-paraselar y subquiasm&#225;tica&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">En este estudio&#44; se definieron 4 casos de quiasma prefijado &#40;13&#37;&#41;&#44; 6 de quiasma posfijado &#40;20&#37;&#41; y 20 de quiasma central &#40;67&#37;&#41;&#46; Adem&#225;s&#44; medimos el &#225;ngulo entre 2 nervios &#243;pticos que muestra indirectamente la ubicaci&#243;n del quiasma seg&#250;n el diafragma selar&#44; y luego detectamos el valor medio de este &#225;ngulo &#40;87&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;6&#176;&#41;&#46; El valor &#171;l&#237;mite&#187; para designar un quiasma como &#171;prefijado&#187; se midi&#243; en el estudio actual como &#8805;<span class="elsevierStyleHsp" style=""></span>101&#44;1&#176;&#46; El valor medio del &#225;ngulo entre los nervios &#243;pticos oscil&#243; entre 69&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;7&#176; en los 6 casos de quiasma posfijado&#44; 104&#44;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;1&#176; en los 4 casos de quiasma prefijado y 88&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;7&#176; en los 20 casos de quiasma central&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En este estudio&#44; pusimos de manifiesto que la relaci&#243;n entre los tipos de quiasma &#243;ptico&#44; los nervios &#243;pticos y las estructuras &#243;seas y vasculares alrededor del &#225;rea selar fue eficaz para determinar el acceso quir&#250;rgico en esta regi&#243;n&#46;</p></span>"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Superior view of sellar and parasellar region&#46; &#40;b&#41; Inferior view of sellar and parasellar region&#46; ON&#58; optic nerve&#44; OC&#58; optic chiasm&#44; Acomm&#58; anterior communicating artery&#44; HS&#58; hypophysis stalk&#44; OcN&#58; oculomotor nerve&#44; BA&#58; basilar artery&#44; Cl&#58; clivus&#44; TS&#58; tuberculum sella&#44; Tc&#58; tuber cinereum&#46;</p>"
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Central type chiasm&#46; ON&#58; optic nerve&#44; OC&#58; optic chiasm&#44; ICA&#58; internal carotid artery&#44; A1&#58; A1 segment of anterior cerebral artery&#44; A2&#58; A2 segment of anterior cerebral artery&#44; Acomm&#58; anterior communicating artery&#44; TS&#58; tuberculum sellae&#44; DS&#58; diaphragma sellae&#46; &#40;Superior view of sellar&#8211;parasellar region&#46;&#41; &#40;b&#41; Prefixed type chiasm&#46; ON&#58; optic nerve&#44; OC&#58; optic chiasm&#44; TS&#58; tuberculum sellae&#44; ICA&#58; internal carotid artery&#44; A1&#58; A1 segment of anterior cerebral artery&#44; A2&#58; A2 segment of anterior cerebral artery&#46; &#40;Superior view of sellar&#8211;parasellar region&#46;&#41; &#40;c&#41; Postfixed type chiasm&#46; ON&#58; optic nerve&#44; OC&#58; optic chiasm&#44; HS&#58; hypophysis stalk&#44; ICA&#58; internal carotid artery&#44; A1&#58; A1 segment of anterior cerebral artery&#46; &#40;Superior view of sellar&#8211;parasellar region&#46;&#41;</p>"
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      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Fig&#46; 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 935
            "Ancho" => 2167
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        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; ON&#58; optic nerve&#44; OcN&#58; oculomotor nerve&#44; OC&#58; optic chiasm&#44; ICA&#58; internal carotid artery&#44; A1&#58; A1 segment of anterior cerebral artery&#44; A2&#58; A2 segment of anterior cerebral artery&#44; Acomm&#58; anterior communicating artery&#44; BA&#58; basilar artery&#44; Pcom&#58; posterior communicating artery&#44; V&#58; vein&#44; Cp&#58; posterior clinoid process&#44; TS&#58; tuberculum sellae&#44; LT&#58; lamina terminalis&#46; &#40;Right anterolateral view of sellar&#8211;parasellar and subchiasmal region&#46;&#41; &#40;b&#41; ON&#58; optic nerve&#44; Ocn&#58; oculomotor nerve&#44; OC&#58; optic chiasm&#44; S&#58; hypophysis stalk&#44; ICA&#58; internal carotid artery&#44; A1&#58; A1 segment of anterior cerebral artery&#44; A2&#58; A2 segment of anterior cerebral artery&#44; Acomm&#58; anterior communicating artery&#44; MCA&#58; middle cerebral artery&#44; BT&#58; basilar tip&#46; &#40;Right anterolateral view of sellar&#8211;parasellar region&#46;&#41;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Fig&#46; 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
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            "Alto" => 720
            "Ancho" => 2917
            "Tamanyo" => 357189
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        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Selection of surgical approaches and surgical corridors according to position of optic nerves and optic chiasm&#46; &#40;a&#41; Usage of interoptic &#40;io&#41;&#44; lamina terminalis &#40;lt&#41; and opticocarotid &#40;oc&#41; corridors in superior approach with a transcranial technique&#46; &#40;b&#41; Usage of interoptic &#40;io&#41;&#44; opticocarotid &#40;oc&#41;&#44; caroticooculomotor &#40;co&#41; and inferior oculomotor nerve &#40;iocn&#41; corridors in superior-lateral approach with a transcranial skull base technique&#46; &#40;c&#41; Usage of interoculomotor nerves &#40;interocn&#41; corridors in inferior approach with a transsphenoidal endoscopic technique&#46; ON&#58; optic nerve&#44; ICA&#58; internal carotid artery&#44; A1&#58; A1 segment of anterior cerebral artery&#44; M1&#58; M1 segment of middle cerebral artery&#44; Acomm&#58; anterior communicating artery&#44; OcN&#58; oculomotor nerve&#44; HS&#58; hypophysis stalk&#44; DS&#58; dorsum sella&#44; MB&#58; mamillary body&#44; BA&#58; basilar artery&#44; SCA&#58; superior cerebellar artery&#44; P1&#58; P1 segment of posterior cerebral artery&#46;</p>"
        ]
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      4 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
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            0 => array:2 [
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Distance between tuberculum sellae and pituitary stalk &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
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        "texto" => "<p id="par0200" class="elsevierStylePara elsevierViewall">The authors thank the deceased individuals and their families whose donation of bodies made this study possible&#46; We thank the Forensic Medicine&#44; Bursa&#44; Turkey for coordinating this work&#46;</p>"
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Article information

ISSN: 25298496
Original language: English

DOI:10.1016/j.neucie.2019.10.001

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