Foramen of Civinini: A New Anatomical Guide for Maxillofacial Surgeons

Abstract

Introduction: Study on Morphometric and radiological aspect on existence of foramen of civinini. Sphenoid bone comprises of some rare ossified ligaments, may encounter difficulty in surgical procedures. Incidence of Pterygospinous bars various with different racial groups and they are genetically controlled. Complete ossification of pterygospinous ligament form foramen of civinini. Entrapments of vessels or nerves may occur due to existence of pterygospinous bar. The bar may locate medially or inferiorly to formen ovale as seen in Hawaiian and lemurs. Co-existence of bar with the wide lateral pterygoid plate exhibits development of the bar from herbivore, carnivore and old world monkeys. Comparatively absence or small spine of civinini noted in new world monkeys, rodents and platyrrhines. Pterygospinousbar represents the phylogenetic remnant of Human beings. Material and Methods:By using digital vernier caliper, the measurements of length, width of the pterygospinous bar and area of foramen of civinini including the length and breadth of lateral pterygoid plate were measured. Using X-rays the radiological view was determined.Results: In this study from 160 cases of skull and sphenoid bones revealed that complete and incomplete foramen of civinini in 1.25% and 7.5% of cases respectively. Peculiarly accessory foramen of civinini noticed in 1.25% of cases. Maximum area of foramen of civinini was 94.2mm 2

Anatomical Study of Pterygospinous and Pterygoalar Bar in Human Skulls with their Phylogeny and Clinical Significance

“…According to previous studies, the position of pterygospinous bar was medial or inferior to foramen ovale and the pterygoalar bar was medial, lateral or inferior to the foramen ovale [6,8,14]. In the present study, the pterygospinous bar was most commonly seen to cross the foramen inferiorly and in few cases was medial to the foramen ovale.…”

“…When it is present in varying degrees, it gives rise to ptergoalar and pterygospinous foramen [6,18]. A wide pterygospinous bar exists in skulls of herbivores, rodents, carnivores and mature monkeys and small pterygospinous bar is seen in rodents but not seen in new world monkeys [3,4,6]. Therefore the presence of pterygospinous bar in man is considered to be a phylogenic remnant [4,19].…”

“…Therefore the presence of pterygospinous bar in man is considered to be a phylogenic remnant [4,19]. There were reports that ossification of pterygospinous ligament was genetically controlled and showed racial variation in frequency [6]. The pterygoalar bar and foramen are normally seen in lower animals and persist in variable percentage of human population of different races [18].…”

“…The foramen formed by this bar was called as foramen of Civinini or pterygospinous foramen through which passes the medial pterygoid vessels and nerves as well as branches of mandibular nerve to the muscles of mastication [3][4][5]. So ossification of this ligament may entrap the neurovascular structures and this may be an obstacle for mandibular nerve block [6].…”

Skull

“…Tubbs et al (2009) analyzed 154 adult dry human skulls and reported one pterygospinous foramen (foramen of Civinini) and one pterygoalar foramen (foramen of Hyrtl). A study of 160 skulls revealed complete and incomplete pterygospinous foramina in 1.25% and 7.5%, respectively (Saran et al 2013).…”