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VOLUME 3 , ISSUE 3 ( September-December, 2011 ) > List of Articles

REVIEW ARTICLE

Sternberg's Canal and the Controversies Surrounding It

Keywords : Cerebrospinal fluid,Sphenoid sinus,Lateral recess,Sternberg's canal,Benign intracranial hypertension,Lateral craniopharyngeal canal

Citation Information : Sternberg's Canal and the Controversies Surrounding It. Int J Otorhinolaryngol Clin 2011; 3 (3):184-187.

DOI: 10.5005/jp-journals-10003-1079

Published Online: 01-12-2011

Copyright Statement:  Copyright © 2011; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

Although Maxmillan Sternberg described this anatomical entity (the lateral craniopharyngeal canal or the Sternberg's canal) as far back as in 1888, it has only recently stirred much controversy in world medical literature.

Materials and methods

A review of contemporary world literature on this subject has been made and applied to the authors’ personal surgical experience of managing 21 spontaneous cerebrospinal fluid (CSF) leaks over a period of 6 years, with special focus on lateral sphenoid CSF leaks, in an attempt to understand their philosophy and clinical course.

Results

Due to the rarity of such spontaneous CSF leaks (in all the published world series as well as the authors’ personal experience), it is difficult to comment on the exact site of congenital ‘weakness’, i.e. Sternberg's canal. Similar body profiles of all the patients in most series further complicates the scenario.

Conclusion

While one school of thought based on clinical and cadaveric studies hypothesizes, the Sternberg's canal to be present lateral to the foramen rotundum, the other based entirely on radiological analysis of 1000 CT scans of the paranasal sinuses proposes it to be medial to the foramen rotundum. Most patients with lateral sphenoid sinus CSF leaks (in world literature as well as the authors’ personal experience), are obese middle-aged women irrespective of whether the leak arises medial or lateral to the foramen rotundum. Thus, two strong and valid theories as regards the origin and existence (in adult life) of the Sternberg's canal are present and a multicentric, combined clinicoradiological, meta-analytical approach may probably serve as a solution to this controversy.


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  1. Ein bisher noch nicht beschriebener Kanal im Keilben des Menschen. Anat Anz 1888;3:225–53.
  2. Sternberg's canal: Fact or fiction? Am J Rhinol All 2009;23(2):167–71.
  3. Endonasal endoscopic repair of Sternberg's canal cerebrospinal fluid leaks. Laryngoscope 2007;117:345–49.
  4. Congenital transsphenoidal meningocele: Case report and review of the literature. Am J Otolaryngol 2006;27:422–44.
  5. Sternberg's canal—cause of congenital sphenoidal meningocele. Eur Arch Otorhinolaryngol 2000;257:430–32.
  6. Spontaneous CSF-leaks and meningoencephaloceles in sphenoid sinus by persisting Sternberg's canal. Rhinology 2009;47:369–74.
  7. The Sinuses. New York: Raven Press 1995.
  8. A Le Fort I osteotomy approach to lateral sphenoid sinus encephalocoeles. J Laryngol Otol 1998;112:779–81.
  9. Sphenoid encephalocoeles: Disease management and identification of lesions within the lateral recess of the sphenoid sinus. Laryngoscope 2002;112: 1800–05.
  10. Volume of the ventricles in benign intracranial hypertension. Lancet 1980;2:7–8.
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