The pterygoalar bar: A meta-analysis of its prevalence, morphology and morphometry

Pękala, Przemysław A.; Henry, Brandon Michael; Pękala, Jakub R.; Frączek, Paulina; Taterra, Dominik; Natsis, Konstantinos; Piagkou, Maria; Skrzat, Janusz; Tomaszewska, Iwona M.

doi:10.1016/j.jcms.2017.06.019

Cited by 10 publications

(12 citation statements)

References 13 publications

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“…In the current study, these structures were found to be mineralised in 17.1% and 6.3% (pterygospinous and pterygoalar ligaments, respectively) of patients. The published rate of ligamentous mineralisation is variable (1–27.97% for the pterygospinous ligament [ 7 , 8 , 20 , 21 , 51 – 58 , 60 – 65 ] and 1.3–62.35% for the pterygoalar ligament [ 8 , 20 – 22 , 56 , 57 , 62 – 66 ]), but the latter was comparable to a recent meta-analysis [ 67 ].…”

Section: Discussionsupporting

confidence: 59%

“… Natsis et al [ 66 ] 145 skulls Greece 18–91 years 27.60% 4.10% 31.70% Implications for neural impingement. Pękala et al [ 67 ] Meta-analysis 25 studies – – 8.4% (overall pooled prevalence) 4.4% (overall pooled prevalence) – Meta-analysis. *Includes elongation of the middle clinoid process **Complete includes contact type …”

Section: Resultsmentioning

confidence: 99%

“…Others have described further variations, such as division of the lingual nerve into an anterior and posterior division by a mineralised ligament, which can increase the risk of entrapment [ 77 ]. Entrapment may also arise when the lingual nerve passes between an ossified pterygospinous ligament and the medial pterygoid muscle [ 9 , 67 , 78 ]. In addition, Krmpotić-Nemanić et al noted that various types of lateral pterygoid plate enlargement (including complete ossification of the pterygospinous ligament) resulted in the displacement of the lingual and inferior alveolar branches resulting in fixation and increased risk of compression [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Skull base ligamentous mineralisation: evaluation using computed tomography and a review of the clinical relevance

et al. 2019

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Objectives To determine the frequency, morphologic and demographic characteristics, and clinical relevance of the mineralisation of six skull base ligaments (interclinoid, caroticoclinoid, petrosphenoid, posterior petroclinoid, pterygospinous, and pterygoalar). Methods This is a retrospective review of 240 CT scans of the paranasal sinuses (ages 6–80 years). A limited systematic review was performed primarily using Embase and Medline databases. Results Ligamentous mineralisation was well delineated on CT and occurred at ≥ 1 location in 58.3% of patients. There was a nonsignificant trend towards a greater incidence with advancing age. The interclinoid and posterior petroclinoid ligaments were most commonly mineralised (22.1% and 18.3%, respectively); the petrosphenoid and pterygoalar ligaments were least frequently mineralised (10.8% and 6.3%, respectively). The mean age of patients with posterior petroclinoid mineralisation was significantly greater than those with interclinoid and petrosphenoid mineralisation and was not seen in patients aged 6–20 years. The literature review highlighted the clinically relevant potential for mineralised ligaments to cause barriers to surgical access (e.g. to the foramen ovale), increase the risk of neurovascular injury during surgery at the skull base (e.g. during anterior clinoidectomy), and predispose to neural impingement. Conclusions Skull base ligamentous mineralisation is commonly encountered on CT imaging. Given the potentially significant clinical implications, an understanding of the morphological appearances is of importance to those planning interventions at the skull base. To the authors’ knowledge, this study is the first to comprehensively evaluate such a wide range of skull base ligaments using CT. For some ligaments, the incidence on CT has not been previously described.

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Section: Discussionsupporting

confidence: 59%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Skull base ligamentous mineralisation: evaluation using computed tomography and a review of the clinical relevance

et al. 2019

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“…According to our study, complete PaB in Bulgarians occurs in 1.4% of the cases (1.6% in males and 1.2% in females). The combined data of 25 articles (n = 16,168 subjects) have been assessed in a meta-analysis considering the complete PaB frequency, which is found to be 4.4% [ 47 ]. The geographical distribution has shown that complete PaB is most commonly found in Asia (7.0%) followed by South and North Americas (5.0%), and Europe (2.6%), but these differences are statistically insignificant.…”

Section: Discussionmentioning

confidence: 99%

“…Complete PaB has been most frequently recorded unilaterally (36.6%), on the left side (53.2%). Bilateral PaB has been statistically less common, with a pooled frequency of 5.0% [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Osseous Bridges of the Sphenoid Bone: Frequency, Bilateral and Sex Distribution

Nikolova

Toneva

Zlatareva

et al. 2023

Biology

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Sellar (caroticoclinoid and interclinoid), pterygospinous and pterygoalar bridges are osseous bars of the sphenoid bone, which enclose additional foramina in the skull base and could cause entrapment of nerves, occlusion of vessels and obstruction of surgical corridors. This study aimed to investigate the frequency of sphenoid bone bridges in Bulgarians and to assess the bilateral and sex differences in their distribution. This study was performed on head CT scans of 315 Bulgarians, 148 males and 167 females. The sellar bridges were the most common type of sphenoid bridging; particularly the caroticoclinoid bridge. The pterygospinous bridge was a relatively common finding and the pterygoalar bridge was the most infrequent type of bridging. The total frequency of sellar bridges did not differ significantly between both sides and sexes. The pterygospinous bridge did not indicate significant bilateral differences but showed considerable sex differences concerning the left-side occurrence, which was significantly higher in the male series. There were no considerable bilateral and sex differences in the distribution of the pterygoalar bridging. There were no significant correlations between the different types of sphenoid bone bridges, but each type of bridging showed significant positive correlations between the right and left side co-occurrence in males and females.

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