DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20161978

Sphenoidal emissary foramen and its clinical consideration

Surekha D. Jadhav, Manoj P. Ambali, Balbhim R. Zambare

Abstract


Background:Sphenoidal emissary foramen is a small, variable and an inconstant foramen in middle cranial fossa which is located antero-medial to the foramen ovale. Emissary vein passing through it connects the pterygoid venous plexus with the cavernous sinus which has clinical significance because through an extra-cranial infection may reach to cavernous sinus. Aim of present study was to investigate the incidence and shape of sphenoidal emissary foramen, the number of present on one side and the presence of bony septum in it.

Methods: Two hundred and fifty (right 250; left-250) dry Indian adult skulls of unknown age and sex were used for this study. Middle cranial fossa of each skull was macroscopically observed for the presence, absence of sphenoidal emissary foramen. Patency was confirmed by inserting a bristle through each probable foramen and only patent foramen were calculated.

Results: We observed that sphenoidal emissary foramen was present in 72 (28.8%) skulls. Unilaterally it was present in 17.6% and bilaterally in 11.2% skulls.

Conclusions: Incidence of this foramen is variable and therefore recognition of this anatomical structure is important. Knowledge of their variations will be helpful for neurosurgeons and radiologist.

 


Keywords


Sphenoidal emissary foramen, Middle cranial fossa, Sphenoid bone, Emissary vein, Foramen ovale, Cavernous sinus

Full Text:

PDF

References


Standring S. Gray’s anatomy: the anatomical basis of clinical practice. Churchill Livingstone Elsevier; New York, NY; USA. 40th ed. 2008:424.

Kodama K, Inoue K, Nagashima M, Matsumura G, Watanabe S, Kodama G. The foramen Vesalius in the Japanese juvenile and adult skulls. Hokkaido Igaku Zasshi. 1997;72(6):667-74.

Kale A, Aksu F, Ozturk A. Foramen of vesalius. Saudi Med J. 2009;30(1):56-9.

Avci E, Kocaogullar Y, Fossett D, Caputy A. Middle fossa surgical anatomy related to the subtemporal preauricular infratemporal approach: an anatomic study. Turkish Neurosurgery. 2001;11:38-43.

Bergman RA, Afifi AK, Miyauchi R. Illustrated encyclopedia of human anatomic variation: Opus V: skeletal systems- cranium. Sphenoid Bone. Available at:http://www.anatomyatlases.org/AnatomicVariants/SkeletalSystem/Text/SphenoidBone.shtml. Accessed on 19/4/2016.

Lang J. Clinical Anatomy of the Head, Neurocranium. Orbit and Craniocervical Region. Berlin, Springer-Verlag. 1983.

Gupta N, Ray B, Ghosh S. Anatomic characteristics of foramen vesalis. Kathmandu Univ Med J. 2005;3:155-58.

Ginsberg LE, Pruett SW, Chen MY, Elster AD. Skull base foramina of the middle cranial fossa: reassessment of normal variation with high resolution CT. Am J Neuroradiol. 1994;15:283-91.

Wood JF. The non-metrical morphological characteristic of the skull as criteria for racial diagnosis, Part 1. General discussion of the morphological characters employed in racial diagnosis. ‎J Anat. 1931;65(1):179-95.

Berry AC, Berry RJ. Epigenetic variation in the human cranium. J Anat. 1967;101:361-79.

Richardson ML, Helms CA, Voglar JB, Genant HK. Skeletal changes in neuromuscular disorders mimicking juvenile rheumatoid arthritis and hemophilia. Am J Roentgenol. 1984;143:893-97.

Boyd GI. Emissary foramina of cranium in man and anthropoids. J Anat. 1930;65(1):108-21.

Lanzieri CF, Duchesneau PM, Rosenbloom SA, Smith AS, Rosenbaum AE. The significance of asymmetry of the foramen of vesalius. Am J Neuroradiol. 1988;9(6):1201-204.

Reymond J, Charuta A, Wysocki J. The morphology and morphometry of the foramina of the greater wing of the human sphenoid bone. Folia Morphologica. 2005;64(3):188-93.

Rosi AC, Freire AR, Prado FB, Caria PHF, Botacin PR. Morphological characteristic of foramen of Vesalius and its relationship with clinical implications. J Morphol Sci. 2010;27(1):26-9.

Murlimanju BV, Reddy GR, Latha VP, Vasudha VS, Rao CP, Mangala MP, Ashwin Rajanigandha KV. Foramen vesalius: prevalence, morphology, embryological basis and clinical implications. Journal of Surgical Academia. 2015;5(1):24-8.

Zdila MJ, Cyrus LM, Laslo JM, Lambert HW. Bilateral duplication of the sphenoidal emissary foramen: a case report with implications for surgeries using transovale cannulation. Anatomy Physiology journal. 2014;4(4):157-58.

Sindou M, Keravel Y, Abdennebi B, Szapiro JN. Neurosurgical treatment of trigeminal neuralgia. Direct apporoach or percutaneous method? Neurochirurgic. 1987;33(22):89-111.

Nemzek WR, Brodie HA, Hecht ST, Chong BW, Babcook CJ, Seibert JA. MR, CT and plain film imaging of the developing skull base in fetal specimens. American J Neuroradiol. 2000;21(9):1699-706.

James TM, Persley R, Steel FL. The foramen ovale and sphenoidal angle in man. Anatomy and Embryol. 1980;160:93-104.