scholarly journals Occurrence of the Foramen of Vesalius and Its Morphometry Relevant to Clinical Consideration

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Vipavadee Chaisuksunt ◽  
Lanaprai Kwathai ◽  
Kritsana Namonta ◽  
Thanaporn Rungruang ◽  
Wandee Apinhasmit ◽  
...  
Keyword(s):  
Skull Base ◽  
Surgical Approach ◽  
Middle Cranial Fossa ◽  
Maximum Diameter ◽  
Foramen Ovale ◽  
Clinical Consideration ◽  
Cranial Fossa ◽  
Foramen Of Vesalius

All 377 dry skulls were examined for the occurrence and morphometry of the foramen of Vesalius (FV) both in the middle cranial fossa and at the extracranial view of the skull base. There were 25.9% and 10.9% of FV found at the extracranial view of the skull base and in the middle cranial fossa, respectively. Total patent FV were 16.1% (11.9% unilaterally and 4.2% bilaterally). Most FV were found in male and on the left side. Comparatively, FV at the extracranial view of the skull base had a larger maximum diameter. The distance between FV and the foramen ovale (FO) was as short as2.05±1.09 mm measured at the extracranial view of the skull base. In conclusion, although the existence of FV is inconstant, its occurrence could not be negligible. The proximity of FV to FO should remind neurosurgeons to be cautious when performing the surgical approach through FO.

Outcomes of Transzygomatic Middle Cranial Fossa Approach for Resection of Skull Base Tumors

2019 ◽  
Author(s):  
Nauman Manzoor ◽  
Silky Chotai ◽  
Robert Yawn ◽  
Reid Thompson ◽  
Alejandro Rivas
Keyword(s):  
Skull Base ◽  
Middle Cranial Fossa ◽  
Skull Base Tumors ◽  
Middle Cranial Fossa Approach ◽  
Cranial Fossa

scholarly journals The orbitopterygoid corridor as a deep keyhole for endoscopic access to the paranasal sinuses and clivus

2020 ◽  
pp. 1-10
Author(s):  
Kenichi Oyama ◽  
Kentaro Watanabe ◽  
Shunya Hanakita ◽  
Pierre-Olivier Champagne ◽  
Thibault Passeri ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Skull Base ◽  
Paranasal Sinuses ◽  
Middle Cranial Fossa ◽  
The Body ◽  
Middle Fossa Approach ◽  
Alternative Approach ◽  
Endoscopic Assistance ◽  
Skull Base Lesions ◽  
Cranial Fossa

OBJECTIVEThe anteromedial triangle (AMT) is the triangle formed by the ophthalmic (V1) and maxillary (V2) nerves. Opening of this bony space offers a limited access to the sphenoid sinus (SphS). This study aims to demonstrate the utility of the orbitopterygopalatine corridor (OPC), obtained by enlarging the AMT and transposing the contents of the pterygopalatine fossa (PPF) and V2, as an entrance to the SphS, maxillary sinus (MaxS), and nasal cavity.METHODSFive formalin-injected cadaveric specimens were used for this study (10 approaches). A classic pterional approach was performed. An OPC was created through the inferior orbital fissure, between the orbit and the PPF, by transposing the PPF inferiorly. The extent of the OPC was measured using neuronavigation and manual measurements. Two illustrative cases using the OPC to access skull base tumors are presented in the body of the article.RESULTSVia the OPC, the SphS, MaxS, ethmoid sinus (EthS), and nasal cavity could be accessed. The use of endoscopic assistance through the OPC achieved better visualization of the EthS, SphS, MaxS, clivus, and nasal cavity. A significant gain in the area of exposure could be achieved using the OPC compared to the AMT (22.4 mm2 vs 504.1 mm2).CONCLUSIONSOpening of the AMT and transposition of V2 and the contents of the PPF creates the OPC, a potentially useful deep keyhole to access the paranasal sinuses and clival region through a middle fossa approach. It is a valuable alternative approach to reach deep-seated skull base lesions infiltrating the cavernous sinus and middle cranial fossa and extending into the paranasal sinus.

ANATOMICAL VARIATIONS OF FORAMEN OVALE AND CLINICAL SIGNIFICANCE

2021 ◽  
pp. 29-31
Author(s):  
Gyan Prakash Mishra ◽  
Ajay Singh Rajput ◽  
Stuti Tandon
Keyword(s):  
Anterior Margin ◽  
Percutaneous Biopsy ◽  
Diagnostic Procedures ◽  
Anatomical Variations ◽  
Middle Cranial Fossa ◽  
Mandibular Nerve ◽  
Foramen Ovale ◽  
Emissary Vein ◽  
Bony Plate ◽  
Cranial Fossa

INTRODUCTION: The foramen ovale is present in sphenoid bone which transmits the mandibular nerve, accessory meningeal artery, emissary vein and the lesser petrosal nerve. This study was conducted on a total 100 si MATERIALS & METHODS: des in 50 dry adult skulls. The shape of foramen will be determined by a visual examination. Margins of foramen were carefully observed for the abnormal bony outgrowths such as sharp bony projections (spine), small blunt bony projection (tubercle), bony plate and bony bar. We obs RESULTS: erved the variations in shape of foramen ovale. We found oval, almond, round, triangular, slit like and irregular shaped in 62%, 20%, 9%, 4%, 3% and 2% foramina ovale respectively. We also observed abnormal bony outgrowths in the foramen ovale like spines, tubercles, bony plate and bony bar. Abnormal bony bar was dividing the foramen ovale in 2 compartments (Anterior and Posterior). The preci CONCLUSIONS: se knowledge of variations of foramen ovale is of valuable contribution for neurosurgeons to development of new and different techniques to approach the middle cranial fossa. In our study we found , 100% tubercles and 80% spines were arising from anterior margin of foramen ovale. These ndings are important for neurosurgeons to approach middle cranial fossa via foramen ovale for neurosurgical and diagnostic procedures like percutaneous biopsy of cavernous sinus tumours, electroencephalographic analysis, microvascular decompression , percutaneous trigeminal rhizotomy and administration of anaesthesia to the mandibular nerve. Surgeons should avoid to go , close to the anterior margin of foramen ovale as spines and tubercles could interrupt the procedures.

Cribriform Adenocarcinoma of the Minor Salivary Gland (CAMSG); A Separate and Malignant Entity

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S24-S24
Author(s):  
H Laharwani ◽  
T Woods ◽  
J Jackson ◽  
V Manucha ◽  
I Velasco
Keyword(s):  
Salivary Gland ◽  
Cell Carcinoma ◽  
Skull Base ◽  
Minor Salivary Gland ◽  
Middle Cranial Fossa ◽  
Salivary Gland Neoplasm ◽  
Left Neck ◽  
S 100 ◽  
The Face ◽  
Cranial Fossa

Abstract Introduction/Objective Cribriform adenocarcinoma of the minor salivary gland (CAMSG) is a recently described salivary gland neoplasm (SGN) that WHO includes under the polymorphous adenocarcinoma (PAC) subheading. CAMSG is reported to occur mostly in the base of the tongue and lingual tonsils. Methods We present a case of CAMSG of buccal mucosa in a 48-year old woman who presented with pain and swelling on the left side of the face that started after tooth extraction. Imaging revealed a large expansile mass (5.8 x 4.3 x 6.1 cm) originating in the left mandibular angle extending into masticator space, maxillary sinus, pterygopalatine fossa, sphenoid, middle cranial fossa, orbit and skull base. Ameloblastoma, primary intraosseous carcinoma, and squamous cell carcinoma were considered. Incisional biopsy revealed a tumor comprised of round to ovoid cells with clear to vesicular nuclei (ground-glass appearance) and occasional mitosis present in irregular solid, cribriform, and microcystic patterns in a hyalinized stroma with the presence of abundant mucin within lobules and stroma. Results Differential diagnosis of secretory carcinoma, hyalinizing clear cell carcinoma, and less likely PAC and mucoepidermoid carcinoma were considered, all inconsistent with the imaging findings. The tumor cells were positive for S100 and negative for CD117, ki67, p63, CD117, and TTF-1. Based on a prominent cribriform pattern, vesicular nuclei, and S-100 expression, a diagnosis of cribriform adenocarcinoma of minor salivary gland origin was rendered. The patient subsequently underwent left partial maxillectomy, left partial mandibulectomy, and resection of the skull base and left neck dissection and was staged as pT4bN0, with negative margins and vascular invasion. The patient underwent radiation therapy and at 6- month follow up was alive and healthy. Clinically and histologically CAMSG overlaps with tumors of both salivary and non-salivary gland origin. Conclusion Recognition of CAMSG as a distinct entity will help in accurate diagnosis and categorization in the WHO classification of SGNs.

Endoscopic Reconstruction of the Middle Cranial Fossa Through a Subtemporal Keyhole Using a Pedicled Deep Temporal Fascial Flap

2011 ◽  
Vol 70 (suppl_1) ◽  
pp. ons157-ons162 ◽  
Author(s):  
Mika Komatsu ◽  
Fuminari Komatsu ◽  
Antonio Di Ieva ◽  
Tooru Inoue ◽  
Manfred Tschabitscher
Keyword(s):  
Skull Base ◽  
Middle Cranial Fossa ◽  
Pedicled Flap ◽  
Temporal Muscle ◽  
Temporal Fascia ◽  
Fresh Cadaver ◽  
Fascial Flap ◽  
Csf Leakage ◽  
Cranial Fossa ◽  
Temporal Fascial Flap

Abstract BACKGROUND: Reconstruction of the skull base is essential to prevent postoperative leakage of cerebrospinal fluid (CSF). However, a reliable method of reconstructing the middle cranial fossa via a subtemporal keyhole is not available. OBJECTIVE: To determine whether less invasive reconstruction of the middle cranial fossa under endoscopic guidance with a pedicled deep temporal fascia approach via a subtemporal keyhole is feasible and useful. METHODS: The middle cranial fossa in 4 fresh cadaver heads was reconstructed with a 4-mm 0° rigid endoscope. RESULTS: A subtemporal skin incision (subtemporal incision) was followed by 2 small skin incisions (temporal line incisions) made on the superior temporal line. The endoscope was inserted through the temporal line incisions, and then the deep temporal fascia was separated from the superficial temporal fascia and temporal muscle under endoscopic view. A pedicled flap was harvested from the subtemporal incision and applied to the middle cranial fossa after subtemporal keyhole craniotomy. The pedicled deep temporal fascial flap was flexible, long, and large enough to overlay skull base defects. CONCLUSION: This purely endoscopic technique using a pedicled deep temporal fascial flap provided reliable reconstruction of the middle cranial fossa through a subtemporal keyhole. This technique would also be applicable in preventing CSF leakage or treating traumatic, acquired nontraumatic, or congenital encephalocele in the middle cranial fossa.

scholarly journals Numerical variations and localization of foramen spinosum in 3D-CT images

2021 ◽  
Vol 15 (1) ◽  
pp. 59-63
Author(s):  
Yadigar Kastamoni ◽  
Ahmet Dursun ◽  
Veysel Atilla Ayyıldız ◽  
Kenan Öztürk
Keyword(s):  
Transverse Section ◽  
Middle Cranial Fossa ◽  
Ct Images ◽  
3D Ct ◽  
Foramen Ovale ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Cranial Fossa ◽  
Neurovascular Structures

Objectives: The structures passing through the foramen spinosum and its neurovascular relationships are of great importance for surgical approches directed to middle cranial fossa. The aim of the present study was to examine the number and location of the foramen spinosum (FS) in 3D-CT images. Methods: The study was retrospectively conducted on 3D-CT images of 177 adults. Firstly, the transverse section passing through the upper edge of the orbit, extending parallel to the Frankfurt plane was chosen. Then, the x and y-axes were determined on that transverse section. The coordinates, number, and location of the FS with respect to the foramen ovale (FO) were identified accordingly on x and y-axes. Results: While 1 FS was present in 90.96% of a total of 354 sides of 177 heads, there were 2 FS and 3 FS in 8.76% and 0.28% of the sides, respectively. The FS was located posterolaterally in 97.68%, posteriorly in 2.06%, and laterally in 0.26% with respect to the FO. In terms of FS coordinates, there was no statistically significant difference between gender and sides in the distance of the FS to the x-axis, but there was a statistically significant difference between gender and sides in the distance of the FS to the y-axis. Conclusion: Evaluation of the number of the FS and its location would help identifying and preserving neighbouring neurovascular structures during surgical interventions directed to the middle cranial fossa.

The Extended Middle Cranial Fossa Approach for the Treatment of Skull Base Lesions

2019 ◽  
Author(s):  
Noga Lipschitz ◽  
Gavriel Kohlberg ◽  
Joseph Breen ◽  
Myles Pensak ◽  
Mario Zuccarello ◽  
...  
Keyword(s):  
Skull Base ◽  
Middle Cranial Fossa ◽  
Middle Cranial Fossa Approach ◽  
Skull Base Lesions ◽  
Cranial Fossa
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