scholarly journals MORPHOMETRIC CHARACTERISTICS OF THE LONGITUDINAL PARAMETERS OF THE MIDDLE CRANIAL FOSSA OF ADULTS DEPENDING ON EXTREME TYPE OF SKULLS STRUCTURE

10.23856/4333 ◽  
2021 ◽  
Vol 43 (6) ◽  
pp. 256-262
Author(s):  
Iryna Chekanova
Keyword(s):  
Short Form ◽  
Middle Cranial Fossa ◽  
Anatomical Landmarks ◽  
Detailed Understanding ◽  
Extreme Type ◽  
Complex Anatomy ◽  
Cranial Fossa ◽  
Human Skulls ◽  
The Individual ◽  
Base Of The Skull

Surgical accesses through the middle cranial fossa (MCF) and their variations require the surgeons a detailed understanding of a complex anatomy of this site of the inner base of the skull (IBS) and an individual anatomical variability of the anatomical landmarks often used in their medical practice. The aim of this study is to establish individual anatomical variability of the longitudinal dimensions of MCF of mature age human. The research was carried out by studying 50 craniotomograms and 50 bone preparations of mature age human skulls with their further subdivision to extreme types of skulls groups. The examinations of the main longitudinal parameters were done for detailed MCF craniometry, namely: MCF lateral cranial length, MCF general length, MCF medial areas length. It was determined that all longitudinal dimensions increase from brachicephales to dolichocephales. This is due to the fact that for brachicrans (round-headedness) short form of the skull is inherent, for dolichocrans (narrow-headedness) – long and for mesocrans (moderate-headedness) average head size is inherent. According to the received data, MCF longitudinal parameters of mature age human regardless of the extreme types of the skull structure have the tendency to increase from medial sections of the investigated area to lateral. The results of this study substantially complete the existing information about the individual anatomical variability of MCF of mature age human and also make it possible to deeply use this data in practical medicine and for further research in morphology and in craniology in details.

The So-Called Cavernous Sinus: A Review of the Controversy and Its Implications for Neurosurgeons

Neurosurgery ◽  
1982 ◽  
Vol 11 (5) ◽  
pp. 712-717 ◽  
Author(s):  
John N. Taptas
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Cranial Nerves ◽  
Sella Turcica ◽  
Middle Cranial Fossa ◽  
Cranial Fossa ◽  
Base Of The Skull ◽  
Extradural Space

Abstract The so-called cavernous sinus is a venous pathway, an irregular network of veins that is part of the extradural venous network of the base of the skull, not a trabeculated venous channel. This venous pathway, the internal carotid artery, and the oculomotor cranial nerves cross the medial portion of the middle cranial fossa in an extradural space formed on each side of the sella turcica by the diverging aspects of a dural fold. In this space the venous pathway has only neighborhood relations with the internal carotid artery and the cranial nerves. The space itself must be distinguished from the vascular and nervous elements that it contains. The revision of the anatomy of this region has not only theoretical interest but also important clinical implications.

Endoscopic Transorbital Approaches to Anterior and Middle Cranial Fossa: A Laboratory Investigation on Surgical Anatomy and Potential Routes

2020 ◽  
Author(s):  
Beniamino A. Nannavecchia ◽  
Mario Ganau ◽  
Hélène Cebula ◽  
Antonino Scibilia ◽  
Maria T. Bozzi ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Middle Cranial Fossa ◽  
Surgical Anatomy ◽  
Anatomical Landmarks ◽  
Orbital Cavity ◽  
New Horizons ◽  
Endoscopic Transorbital ◽  
Cranial Fossa ◽  
Alternative Routes ◽  
Anatomy Knowledge

Abstract Background Transorbital neuroendoscopic (TONES) approaches promise to open up new horizons for skull base surgery, offering alternative routes to reach the anterior and middle cranial fossa (ACF and MCF, respectively). Objective The aim of this anatomical study is to acquire new surgical anatomy knowledge and exploit it for the refinement of TONES approaches, as an alternative to open surgery, to reduce the distance to the target, and the risk of neurovascular lesions in pathological conditions extending beyond the orbital cavity. Materials and Methods Six head specimens (12 orbits) were studied/dissected. The orbit was approached and divided in a four clockwise quadrants manner to simulate three transconjunctival routes: the precaruncular (PC), preseptal (PS), and lateral retrocanthal (LRC), and one transpalpebral route—the superior eyelid crease (SLC). The boundaries and the most important anatomical landmarks were identified and are herein duly detailed with particular attention to the neurovascular structures encountered in each of those routes. Results The dissections showed that the PC approach facilitates the treatment of optic nerve and frontal sinus pathologies, whereas LRC appears safer to reach ACF and MCF allowing for a free multiplanar working channel (up to 180 degrees) to the floor, roof, and lateral-to-medial walls. Conclusion The plane of tendon lateral canthal's insertion and the sphenofrontal suture (SFS) were identified as the key anatomical landmarks for TONES approaches. Further studies are warranted to establish a practical clinical algorithm based on the anatomical four clockwise quadrants herein implemented/proposed, and the key surgical landmarks identified.

Acquired Middle Cranial Fossa Fistulas

Neurosurgery ◽  
1979 ◽  
Vol 5 (4) ◽  
pp. 466-472 ◽  
Author(s):  
Benjamin Kaufman ◽  
Howard Yonas ◽  
Robert J. White ◽  
Clinton F. Miller
Keyword(s):  
Cerebrospinal Fluid ◽  
Normal Population ◽  
Normal Pressure ◽  
Middle Cranial Fossa ◽  
Csf Leak ◽  
Middle Fossa ◽  
Middle Fossa Approach ◽  
Cranial Fossa ◽  
Definition Of ◽  
Base Of The Skull

Abstract To the accepted classification of three types of normal pressure, nontraumatic cerebrospinal fluid (CSF) fistulas, we would add “acquired.” This type of CSF fistula tends to occur from the middle cranial fossa because of the enlargement of “pitholes” that are normally present in its anterior medial aspect. The enlargement of these bony defects is due to normal intracranial pressure variations that, not uncommonly, create meningoceles and meningoencephaloceles. A portion of the floor of this area is aerated in up to 10% of the normal population by the lateral recess of the sphenoid sinus, the pterygoid recess. Thus, this area has the potential to act as a pathway between the middle fossa and the paranasal sinuses, allowing cerebrospinal fluid to pass into the sinuses. Isotope and computerized tomographic studies are helpful in the localization of such a CSF leak. Tomography of the base of the skull, however, is essential for the ideal definition of possible routes of fistulization. If there is any question of the presence of a middle fossa fistula, these studies can show whether the floor of this area is pneumatized and whether there are any defects in the floor. The treatment of such a fistula should include generalized reinforcement of the floor of the anterior middle fossa by a middle fossa approach. If any doubt exists as to the site of leakage (anterior or middle fossa), the minimal surgical procedure should include exploration of both areas via a frontotemporal craniotomy.

scholarly journals Morphometry relevant to Anterior Petrosectomy with special reference to Kawase’s Triangle

2017 ◽  
Vol 06 (04) ◽  
pp. 280-285
Author(s):  
Abu Ubaida Siddiqui ◽  
Bikash Chandra Satapathy ◽  
Sukhjeet Singh Gill
Keyword(s):  
Holistic Approach ◽  
Middle Cranial Fossa ◽  
Petrous Apex ◽  
Morphometric Study ◽  
Physiological Status ◽  
Anatomical Landmarks ◽  
Safe Procedure ◽  
Methodical Approach ◽  
Anterior Petrosectomy ◽  
The Individual

Abstract Background and aims :The petrous apex and the middle cranial fossa is a commonly explored area in neurosurgeries and hence require a holistic approach which should include the possibility of anatomical variants and morphometric dissimilarities. Material and Methods:This morphometric study was undertaken on 91 dry adult skulls [182 petrosal apices] to analyze a number of parameters relevant to Anterior Petrosectomy [AP] via the Kawase’s Triangle [KT]. The anatomical landmarks most pertinent to Anterior Petrosectomy [Kawase's approach] were defined, recorded and validated. The findings of the study were compared with earlier workers who have employed other means of investigation viz. dry bones/CT scans or cadaveric studies . Results : The parameters undertaken for the study presented with variable values and moresoever for the surface area of the KT. This can be very logically attributed to the variant anatomy amongst races and also to the physiological status of the individual Conclusions : AP has evolved as a preferred method for approaching petroclival region and thus requires an in depth understanding. The present analysis throws significant light on certain parameters that would be helpful in making anterior petrosectomy safer. Surgeries of the skull base demand for high end precision and proficiency and thus our findings provide enhanced alertness for a better and safe procedure. A methodical approach to the area with the background knowledge of these parameters shall culminate in desired neurosurgical outcomes.

Endoscopic anterior transmaxillary “transalisphenoid” approach to Meckel’s cave and the middle cranial fossa: an anatomical study and clinical application

2018 ◽  
Vol 130 (1) ◽  
pp. 227-237 ◽  
Author(s):  
Huy Q. Truong ◽  
Xicai Sun ◽  
Emrah Celtikci ◽  
Hamid Borghei-Razavi ◽  
Eric W. Wang ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Cavernous Sinus ◽  
Infratemporal Fossa ◽  
Middle Cranial Fossa ◽  
Anatomical Landmarks ◽  
Middle Fossa ◽  
Meckel’S Cave ◽  
Meckel's Cave ◽  
Cranial Fossa ◽  
Greater Wing

OBJECTIVEMultiple approaches have been designed to reach the medial middle fossa (for lesions in Meckel’s cave, in particular), but an anterior approach through the greater wing of the sphenoid (transalisphenoid) has not been explored. In this study, the authors sought to assess the feasibility of and define the anatomical landmarks for an endoscopic anterior transmaxillary transalisphenoid (EATT) approach to Meckel’s cave and the middle cranial fossa.METHODSEndoscopic dissection was performed on 5 cadaver heads injected intravascularly with colored silicone bilaterally to develop the approach and define surgical landmarks. The authors then used this approach in 2 patients with tumors that involved Meckel’s cave and provide their illustrative clinical case reports.RESULTSThe EATT approach is divided into the following 4 stages: 1) entry into the maxillary sinus, 2) exposure of the greater wing of the sphenoid, 3) exposure of the medial middle fossa, and 4) exposure of Meckel’s cave and lateral wall of the cavernous sinus. The approach provided excellent surgical access to the anterior and lateral portions of Meckel’s cave and offered the possibility of expanding into the infratemporal fossa and lateral middle fossa and, in combination with an endonasal transpterygoid approach, accessing the anteromedial aspect of Meckel’s cave.CONCLUSIONSThe EATT approach to Meckel’s cave and the middle cranial fossa is technically feasible and confers certain advantages in specific clinical situations. The approach might complement current surgical approaches for lesions of Meckel’s cave and could be ideal for lesions that are lateral to the trigeminal ganglion in Meckel’s cave or extend from the maxillary sinus, infratemporal fossa, or pterygopalatine fossa into the middle cranial fossa, Meckel’s cave, and cavernous sinus, such as schwannomas, meningiomas, and sinonasal tumors and perineural spread of cutaneous malignancy.

scholarly journals General craniometric characteristics of linear parameters of the middle cranial fossa of a mature person

2020 ◽  
Vol 26 (4) ◽  
pp. 55-61
Author(s):  
I.V. Chekanova ◽  
O.Yu. Vovk ◽  
V.B. Ikramov ◽  
S.O. Dubina
Keyword(s):  
Rapid Development ◽  
Middle Cranial Fossa ◽  
Bone Architecture ◽  
Morphological Data ◽  
Longitudinal Size ◽  
Length Width ◽  
Cranial Fossa ◽  
Base Of The Skull ◽  
Neurovascular Structures ◽  
Mature Person

Given the rapid development of neurology, neurosurgery, otolaryngology and forensic medicine, there is a need for new, updated morphological data of internal base of the skull, in particular middle cranial fossa. This is due to the complex bone architecture of the middle cranial fossa and the location of important neurovascular structures in this area, which are important for surgeons not to damage during the operation. In this regard, it is necessary to detail the features of the structure, shape, position and size of the middle cranial fossa. The aim of the work is a detailed morphological and craniometric study of the linear parameters of the middle cranial fossa of a mature person depending on gender. The study was performed by studying 50 CT scans of the head and 50 bone preparations of the skulls of men and women of mature age. In our study, a detailed morphometry of longitudinal and latitudinal parameters at different levels of the middle cranial fossa, as well as determining its depth and area. Morphometry of linear parameters of the studied area of the skull showed the presence of a range of variability in length, width and depth depending on the sex of a mature person. The study showed an increase in the longitudinal size of the middle cranial fossa from the lateral to the medial; the transverse dimensions of the middle cranial fossa take on smaller values in its anterior parts and gradually increase to the posterior ones, which in our opinion is due to the characteristic shape of this part of the skull. The performed morphometry of longitudinal and latitudinal parameters, depth and area of the middle cranial fossa showed that these parameters are predominant in males in contrast to females, which is due to the slightly increased head size in this group of adult’s people. Depth of the middle cranial fossa has the smallest range of variability depending on sex. It is established that right-handed asymmetry is more often observed in mature people of both sexes. Rarely, left-sided asymmetry is determined due to an increase in the length of the lateral sections in mature men. The data obtained make it possible to expand knowledge about the structure of the middle cranial fossa and can serve as a basis for further research.

scholarly journals Three-dimensional assessment of the middle cranial fossa and central skull base following Herbst appliance treatment

2018 ◽  
Vol 88 (6) ◽  
pp. 757-764
Author(s):  
Karine Sayure Okano ◽  
Lucia Helena Soares Cevidanes ◽  
Paula Loureiro Cheib ◽  
Antonio Carlos de Oliveira Ruellas ◽  
Marília Yatabe ◽  
...  
Keyword(s):  
Skull Base ◽  
Visual Analysis ◽  
Three Dimensional ◽  
Middle Cranial Fossa ◽  
Spatial Behavior ◽  
Anterior Cranial Fossa ◽  
Control Group ◽  
Anatomical Landmarks ◽  
Herbst Appliance ◽  
Cranial Fossa

ABSTRACT Objectives: The purpose of this three-dimensional (3D) study was to assess retrospectively the middle cranial fossa and central skull base of patients treated with the Herbst appliance (HA). Materials and Methods: 3D surface virtual models of 40 Class II, division 1 malocclusion patients were generated from cone-beam computed tomography (CBCT) acquired before treatment (T0) and after 8 months of HA treatment (T1). T0 and T1 3D models were superimposed volumetrically at the anterior cranial fossa. Twenty subjects who had been treated with the Herbst appliance (HAG) were compared to 20 subjects who were not treated orthopedically. The latter group served as a comparison control group (CG). Quantitative assessments of the location and directional changes were made with linear and angular measurements between anatomical landmarks. Qualitative assessments of the spatial behavior of the middle cranial fossa and central skull base relative to the anterior cranial fossa were displayed graphically for visualization with color maps and semitransparent overlays. Non-parametric tests were performed to compare the between the HAG and CG. Results: Point-to-point linear measurements and skeletal rotation (pitch, roll, and yaw) changes were very small along the observational period and were not significantly different between HAG and CG. Visual analysis of color maps and overlays confirmed that no changes in the cranial base were associated with HA. Conclusions: HA therapy did not produce clinically significant changes in the middle cranial fossa and central skull base.

Chondrosarcoma of the nasal septum

1982 ◽  
Vol 96 (5) ◽  
pp. 459-467 ◽  
Author(s):  
C. M. Bailey
Keyword(s):  
Case History ◽  
Nasal Septum ◽  
Posterior Part ◽  
Surgical Excision ◽  
Middle Cranial Fossa ◽  
Rare Tumour ◽  
Effective Form ◽  
Cranial Fossa ◽  
The Right ◽  
Base Of The Skull

SummaryThe case history is presented of a patient with a massive chondrosarcoma arising from the posterior part of the nasal septum, extending into the base of the skull to involve the right middle cranial fossa. Removal of the main bulk of the tumour was accomplished by means of a cranio-facial resection, and it is hoped that useful palliation has thus been achieved.The literature relating to this rare tumour is reviewed: only seven cases have been previously described in which the tumour is believed to have arisen from the nasal septum. It is generally accepted that chondrosarcomas are radio-insensitive, and that surgical excision is the only effective form of treatment.

Middle Cranial Fossa Approach: Anatomical Study on Skull Base Triangles as a Landmark for a Safe Anterior Petrosectomy

2019 ◽  
Author(s):  
Pasquale Anania ◽  
Rosa Mirapeix-Lucas ◽  
Gianluigi Zona ◽  
Alessandro Prior ◽  
Carlos Asencio Cortes ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Middle Cranial Fossa ◽  
Gasserian Ganglion ◽  
Anatomical Landmarks ◽  
Basal Turn ◽  
Caucasian Race ◽  
Iatrogenic Damage ◽  
Anterior Petrosectomy ◽  
Cranial Fossa ◽  
Hearing Damage

Abstract Objective The Kawase approach provides access to the petroclival and posterior cavernous sinus regions, cerebellopontine angle, and upper basilar artery territory. Nevertheless, it remains one of the most challenging approach for neurosurgeons, due to the considerable related morbidity and mortality. The goal of this study was to evaluate the relationship between anatomical landmarks and their possible variations, and to measure the extension of the Kawase space, to define the reliability of these landmarks while performing an anterior petrosectomy. Design Using eight cadaveric specimens (15 sides), an anatomical dissections and extradural exposure of the Kawase area were performed. Settings A two-step analysis of the distances between the mandibular branch of the trigeminal nerve (V3) and the structures at risk of iatrogenic damage was performed. Main outcome measures We measured the distance between V3 and the basal turn of the cochlea, and between V3 and the internal acoustic canal (IAC), analyzing the limits of bone resection without causing hearing damage. Results We analyzed eight cadaveric (15 sides) formalin-fixed heads injected with colored silicone: four males and four females of Caucasian race (mean age: 73.83 years). We found a mean distance of 10.46 ± 1.13 mm between the great superficial petrous nerve (GSPN) intersection with V3 and the basal turn of the cochlea, and of 11.92 ± 1.71 mm between the origin point of V3 from the Gasserian ganglion and the fundus of the IAC. Conclusion The knowledge of the safe distance between the most applicable anatomic landmarks and the hearing structures is a practical and useful method to perform this approach reducing related comorbidity.

scholarly journals Morphometric and morphologic study of Foramen Ovale in In Indian population

2019 ◽  
Vol 10 (6) ◽  
pp. 71-74
Author(s):  
Mumal Nagwani Mishra ◽  
Kaveri Dande ◽  
Dewanshi Mishra ◽  
Archana Rani ◽  
Madhuresh Kumar
Keyword(s):  
Middle Cranial Fossa ◽  
Base Line ◽  
Foramen Ovale ◽  
Observer Error ◽  
Morphologic Characteristics ◽  
Bony Plate ◽  
Cranial Fossa ◽  
Vascular Structures ◽  
Human Skulls ◽  
Safe Approach

Background:The floor of middle cranial fossa shows several foramina through which vital neural and vascular structures pass. Thus, the knowledge of normal and variant anatomy of these foramina is important. One such foramen is Foramen ovale which allows the passage of certain important structures. Aims and Objective:This study also aimed to provide a base line data to neurosurgeons for easy and safe approach to middle cranial fossa. Thus, to fulfill the above, the morphometric and morphologic characteristics of the foramenovalewere studied and the observed metric and non-metric parameters were compared with those of previous studies. Materials and Methods:The study has been conducted on 160 adult non-pathological dry human skulls of unknown age and sex. Those parts of broken skulls were included in the study in which the area of Foramen ovale was intact. All the parameters were obtained by one observer only to avoid inter-observer error. The foramen ovale was identified and different metric and non-metric parameters were observed and measured. Results:The most common shape on both sides was noted to be transversely oval. Out of 160 skulls, 2 skulls (1.25%) showed accessory FO bilaterally. 4 skulls showed divided FO on left side. Out of 4, 2 skulls( 1.25%) were noted to have bony bar and in 2 skulls (1.25%) the main FO were divided by bony plate. Conclusion: The morphologic variations of Foramen Ovale in the form of accessory foramen and presence of bony bar / bony plate are common. This study will provide a baseline data as well as frequency of related variations in our population for a safer approach by the surgeons. 

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