Anatomy of the petrosphenoidal and petrolingual ligaments at the petrous apex

Abstract

The petrous apex is a complex area surrounded by the cavernous sinus, Dorello's canal and Meckel's cave. The petrosphenoidal ligament (PSL) and the petrolingual ligament (PLL) are important structures located in the region. These two ligaments were examined under a surgical microscope in 10 specimens of five adult cadaveric heads fixed in formalin. They were found to span from the petrous apex to the posterior clinoid process, and the lingula of the sphenoid bone, respectively. The dural sleeve of the abducens nerve, the dorsal meningeal artery or its medial branch, and the venous blood space were located below the PSL in all specimens, and the petrous or sphenoidal insertion of the PSL varied in five specimens. The PLL invariably surrounded part of the dorsal and lateral walls of the lacerum segment of the internal carotid artery (ICA), just under the anteroinferior portion of the anteromedial wall of Meckel's cave in all specimens. The PSL and PLL are valuable anatomical landmarks for identifying the ICA and the nerves in this region. A thorough understanding of the relationship of the two ligaments with neurovascular structures is a prerequisite for surgery in and around the petrous apex.

Micro-computed tomography study of the abnormal osseous extensions of sella turcica

“…Morphological appearance and shape of the sellar formation suggests that these are ossified dural bands, that were originally stretched between the posterior clinoid processes and the petrous apex of the temporal bones. Their position corresponds with the course of the petrosphenoid ligament, connecting the lateral margin of the dorsum sellae to the border of the petrous bone [9]. Another ossified entity arising from the posterior clinoid processes towards the petrous apex seems to be the ossified petroclinoid ligament, which is normally composed of the dens fibrous connective tissue [13].…”

The anatomical relationship between the eustachian tube and petrous internal carotid artery

“…The anatomy of the skull base in the coronal plane of the ICA is very complex, with close proximity of important structures such as the ICA, sixth cranial nerve, trigeminal nerve, vidian nerve, middle meningeal artery, and greater petrosal nerve 10, 12. Numerous anatomical studies employing cadaveric dissections and radiological examinations of the petrous bone have described the relationship between these critical structures.…”

“…The vidian artery is not consistently present but is also a useful landmark. EES of the nasopharynx and infrapetrous approaches to the skull base often result in transgression or resection of the medial aspect of the eustachian tube (ET) 9, 10. In the current literature, there is limited knowledge that evaluates the relationship between the ET and petrous segment of the ICA.…”

Dorello's Canal and Gruber's Ligament: Historical Perspective

“…The length of the ligament has been reported to be between 13.2 and 13.9 mm in various studies. 12,[15][16][17] Destrieux et al 14 and Icke et al 16 described the ligament as either butterfly shaped or triangular, with the base inserting on the posterior clinoid process. However, Iaconetta et al 15 and Liu et al 17 found the base attached to the petrous apex.…”