The petroclinoid ligament: a meta-analysis of its morphometry and prevalence of mineralization with a review of the literature

Plutecki, Dawid; Ostrowski, Patryk; Bonczar, Michał; Iwanaga, Joe; Walocha, J; Pękala, A; Szczepanek, Elżbieta; Tubbs, R. Shane; Loukas, Marious; Wysiadecki, Grzegorz; Koziej, Mateusz

doi:10.5603/fm.a2022.0082

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…Our working hypothesis is that the abducens nerve pathway in humans is unique and that its vulnerability may result from two possible factors. First, the increased vulnerability of the abducens nerve may be caused by its anatomical relations within the Dorello canal ( Ekanem et al, 2023 ; Plutecki et al, 2023 ). A second possible factor is that the abducens nerve pathway is exceptionally close to the midline compared to other cranial nerves.…”

Section: Introduction and Aimsmentioning

confidence: 99%

Unveiling the vulnerability of the human abducens nerve: insights from comparative cranial base anatomy in mammals and primates

Rotenstreich,

Eran,

Siegler

et al. 2024

Front. Neuroanat.

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The topographic anatomy of the abducens nerve has been the subject of research for more than 150 years. Although its vulnerability was initially attributed to its length, this hypothesis has largely lost prominence. Instead, attention has shifted toward its intricate anatomical relations along the cranial base. Contrary to the extensive anatomical and neurosurgical literature on abducens nerve anatomy in humans, its complex anatomy in other species has received less emphasis. The main question addressed here is why the human abducens nerve is predisposed to injury. Specifically, we aim to perform a comparative analysis of the basicranial pathway of the abducens nerve in mammals and primates. Our hypothesis links its vulnerability to cranial base flexion, particularly around the sphenooccipital synchondrosis. We examined the abducens nerve pathway in various mammals, including primates, humans (N = 40; 60% males; 40% females), and human fetuses (N = 5; 60% males; 40% females). The findings are presented at both the macroscopic and histological levels. To associate our findings with basicranial flexion, we measured the cranial base angles in the species included in this study and compared them to data in the available literature. Our findings show that the primitive state of the abducens nerve pathway follows a nearly flat (unflexed) cranial base from the pontomedullary sulcus to the superior orbital fissure. Only the gulfar segment, where the nerve passes through Dorello’s canal, demonstrates some degree of variation. We present evidence indicating that the derived state of the abducens pathway, which is most pronounced in humans from an early stage of development, is characterized by following the significantly more flexed basicranium. Overall, the present study elucidates the evolutionary basis for the vulnerability of the abducens nerve, especially within its gulfar and cavernous segments, which are situated at the main synchondroses between the anterior, middle, and posterior cranial fossae—a unique anatomical relation exclusive to the abducens nerve. The principal differences between the pathways of this nerve and those of other cranial nerves are discussed. The findings suggest that the highly flexed human cranial base plays a pivotal role in the intricate anatomical relations and resulting vulnerability of the abducens nerve.

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Section: Introduction and Aimsmentioning

confidence: 99%

Unveiling the vulnerability of the human abducens nerve: insights from comparative cranial base anatomy in mammals and primates

Rotenstreich,

Eran,

Siegler

et al. 2024

Front. Neuroanat.

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An atypical anatomical variation of the petrosphenoidal ligament in a newborn cadaver

et al. 2023

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Purpose:To report an atypical anatomical variation of the petrosphenoidal ligament in a newborn cadaver and to discuss its clinical signi cance.Methods: During a study of 10 newborn cadavers, the skull base was dissected to reveal the anatomy of the petrosphenoidal ligament and its relationship with the abducens nerve. An atypical anatomical variation was observed, and this is described. The length of the right and left ligaments to the point where it splits into two arms, the joint length of the two ligaments at the junction of the clivus, the length of the ligament proceeding to the posterior clinoid process, and the abducens nerve's diameter as it passes below the ligament were measured on ImageJ software.Results: The petrosphenoidal ligaments were y-shaped, and the attachment of the proximal ligaments was bi d. In the midline above the clivus, some ligament bundles joined the contralateral petrosphenoidal ligament, whilst another group of bundles originated at the posterior clinoid process. At the entry to Dorello's canal, the abducens nerve had a diameter of 0.59 mm on the left and 0.65 mm on the right. The part of the ligaments converging on the clivus in the midline after dividing into two arms was 10.68 mm.Conclusions: We think that this case report will provide useful information for surgical procedures to the petroclival region, transnasal surgical anpproaches, and surgical interventions involving the carotid artery.

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The petroclinoid ligament: a meta-analysis of its morphometry and prevalence of mineralization with a review of the literature

Abstract: This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Folia Morphologica" are listed in PubMed.

Cited by 2 publications

References 17 publications

Unveiling the vulnerability of the human abducens nerve: insights from comparative cranial base anatomy in mammals and primates

Unveiling the vulnerability of the human abducens nerve: insights from comparative cranial base anatomy in mammals and primates

An atypical anatomical variation of the petrosphenoidal ligament in a newborn cadaver

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