Greater wing of sphenoid, the home for aneurysmal bone cysts: a case report

Background Finding an aneurysmal bone cyst in the skull is rare and for a neurosurgeon to come across such lesions in the sphenoid bone with orbital extension is even rarer. Case presentation We report a case of a 16-year female who presented with a three-month history of headache, proptosis, and deterioration of vision. Pre-operative imaging studies which included NCCT head and MRI brain, suggested the lesion to be an aneurysmal bone cyst of the greater wing of the sphenoid, with extension into the orbit. Intraoperative findings did corroborate with the preoperative imaging findings and were again confirmed later from the histopathology report. Conclusion Aneurysmal bone cysts of sphenoid bone with orbital extension, though rare, can be excised completely, without hampering the cosmesis. Being benign, patients can have a prolonged recurrence-free period if the lesion is completely excised.

Development of the cartilaginous connecting apparatuses in the fetal sphenoid, with a focus on the alar process

The human fetal sphenoid is reported to have a cartilaginous connecting apparatus known as the alar process (AP), which connects the ala temporalis (AT) (angle of the greater wing of the sphenoid) to the basisphenoid (anlage of the sphenoid body). However, how the AP develops in humans is unclear. In addition, although the AP is a common structure of the mammalian chondrocranium, little is known about whether it is really a fundamental feature in mammals. This study examined the histological sections of 20 human embryos and fetuses from 6 to 14 weeks of development, of 20 mouse embryos from embryonic days 12–18, and of 4 rats embryos form embryonic days 17 and 20. In addition, we reconsidered the definition of the AP by comparing humans and rats with mice. In humans, the AP was continuous with the basisphenoid but was separated from the AT by a thick perichondrium. Then, the AP–AT connection had a key-and-keyhole structure. Unlike a joint, no cavitation developed in this connection. In mice, there was no boundary between the AT and the basisphenoid, indicating the absence of the AP in the mouse chondrocranium. In rats, the AP was, however, separated from the AT by a thick perichondrium. Therefore, the AP can be defined as follows: the AP is temporally separated from the AT by a thick perichondrium or a key-and-keyhole structure during the fetal period. This is the first study that confirms the absence of the alar process in the mice skull, and its presence in other mammals skull should be further investigated.

Wormian bones: shape, location and relation to each other

The material of the study was the skull of an 8-year-old girl. In the cranioscopy, the following were identified: on the right side, the bone of the sphenoid fontanel or epipteric bone; bones of lambdoid suture - on the right side in the amount of 5, on the left side -1 bone; preinterparietal bone, ospreinterparietale.By the craniometric method, the height and width of the bones were determined. The bone of the sphenoid fontanelle or epipteric bone is located between the frontal, parietal bones, the greater wing of the sphenoid bone, and the squama of the temporal bone. The width of the epipteric bone is 16.5 mm, height 9.5 mm. The bones of the lambdoid suture in the amount of 5 on the right and the 1st on the left were located in an elongated state.The largest bone was located in the middle of the right lambdoid suture; apparently, it was formed by the union of at least two Wormian bones. Preinterparietal bone has a triangular shape, the base of the triangle facing the sagittal suture, the tip, slightly rounded - in the direction of the occipital bone. The lateral angles of the preinterparietal bone are serrated, which, in principle, clearly distinguishes it from the parietal bones. The bone was single, no sutures or grooves dividing the preinterparietal bone into parts were observed. The width of the bone is 18.5 mm, height 13.8 mm.

Reconstruction of the Sphenoid Wing in A Patient with Sphenoid Wing Dysplasia in NF1 – A Case Report

Spheno-orbital dysplasia is almost pathognomic for Neurofibromatosis type 1. Thereis proptosis and deviation of the eye ball medially. We present a case of a young girlwith neurofibromatosis type 1, who had pulsating exophthalmos of the right eye withdiplopia and severe dysplasia of the sphenoid boneand consecutive herniation of theright temporal lobe. She presented with pulsatile proptosis and deviation of the righteye ball to the right. Her x-ray skull showed widening of the orbit. Her MRI scanshowed an arachnoid cyst behind her right eye ball. We had operated on her andreconstructed the right sphenoid greater wing with titanium mesh and duroplastywith G-patch. This had improved her proptosis and deviation of the eye ball. Bang. J Neurosurgery 2020; 9(2): 156-161

Variations in the Anatomy of Sphenoid Sinus: A Computed Tomography Investigation

Aims: The sphenoid sinus is surrounded by many neurovascular structures which are very vulnerable to intrasphenoid sinus surgeries. The purpose of this study is to investigate the variation of sphenoid sinus structure by CT scan imaging. Methodology: This is a retrospective study of 3D images of a paranasal sinus in 129 cases. In this study, three-way metering of the sphenoid sinus, additional septum, pneumatization of the period process (PP), anterior clinoid process (ACP) and greater wing of sphenoid and protrusion and dehiscence of adjacent structures will be assessed. Results: Protrusion of internal carotid artery (ICA), a vidian nerve, maxillary nerve (V2) and optical canal were seen respectively 50.4%, 57.36%, 62.5% and 54.3% but dehiscence of this structure was seen 8.5%, 7%, 3.9% and 6.2%. penumtazition of PP, ACP and greater wing of sphenoid were seen 96.87%, 43.9% and 41.1%. Additional septum also is seen in 76% of the population. Conclusion: This study demonstrates numerous variations in sphenoid sinus structure. Some of the variations cause many problems during intrasphenoidal surgery. Therefore, physicians should evaluate patients completely before surgery.