Topographic and microscopic anatomical description of the emissary sinus of foramen ovale in adult humans

Leonel, Luciano; Sousa, Severino Denicio Gonçalves de; Liberti, Édson Aparecido

doi:10.1016/j.clineuro.2018.03.018

Cited by 8 publications

(7 citation statements)

References 38 publications

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“…8 This mobilization maneuver can cause occasional venous bleeding because of a constant peri-ICA venous plexus within the Meckel's cave (the emissary vein-Vesalius vein), which communicates the cavernous sinus to the pterygoid plexus. 4,8,10 This anatomy can be studied with a preoperative CTA scan before the surgical case.…”

Section: Discussionmentioning

confidence: 99%

The Lingual Process of the Sphenoid Bone and the Petrolingual Ligament: Surgical Anatomy, Landmarks, and Clinical Relevance

Leonel

Rezende

Alexander

et al. 2022

Operative Neurosurgery

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BACKGROUND:The lingual process of the sphenoid bone (LP) and the petrolingual ligament (PLL) surround laterally the internal carotid artery within the middle cranial fossa (MCF). OBJECTIVE: To study the LP and the PLL and anatomical variations considering their relationships with different structures and landmarks within the MCF, especially oriented toward the endoscopic endonasal approaches. METHODS: Seventy-two sides of dry skulls and 20 sides of embalmed specimens were studied. The measurements of the LP and the PLL were obtained, considering important landmarks in the MCF. RESULTS: The LP had a mean length and height of 5 mm and 3 mm, respectively. Its distance from the foramen lacerum was 6 mm, from the foramen ovale 10 mm, foramen rotundum 15 mm, and petrous apex 9 mm. In 44 sides (61.11%), the LP partially closed the lateral aspect of the carotid sulcus; in 17 sides (23.61%), it was found as a near-ring; and in 11 sides (15.2%), it was considered rudimentary. Considering the PLL, its length and height were, respectively, 9 mm, and 4 mm. CONCLUSION: The LP and PLL separate the carotid artery at the inferior aspect of Meckel's cave and constitute important landmarks for endoscopic endonasal approaches to Meckel's cave and MCF, and their identification and removal is essential for internal carotid artery mobilization in this area.

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Section: Discussionmentioning

confidence: 99%

The Lingual Process of the Sphenoid Bone and the Petrolingual Ligament: Surgical Anatomy, Landmarks, and Clinical Relevance

Leonel

Rezende

Alexander

et al. 2022

Operative Neurosurgery

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“…However, lesions arising from the superior portion of the ITF, especially those with intracranial extension through the foramen ovale, often require opening and enlargement of the foramen ovale; therefore, copious venous bleeding should be anticipated, and strategies for hemostasis should be adequately prepared prior to the surgery. 22 The presence of the IMA running on the surface or deep to the lateral pterygoid muscle impacts any surgery in the ITF; 11 however, the incidence of this anatomical variation has not been described well. This study found that the IMA travelled on the surface of the lateral pterygoid muscle in 75% of the specimens.…”

Section: Discussionmentioning

confidence: 99%

“…5 ). 22 A subperiosteal elevation with preservation of an intact periosteum can avoid injury of the pterygoid venous plexus within the superior head of the lateral pterygoid muscle. For lesions arising from V 3 located deep to the lateral pterygoid muscle, the combination of displacement of the LPP technique and a subperiosteal elevation of the superior head of lateral pterygoid muscle facilitates exposure of the region from the foramen ovale to the distal segment of the V 3 while avoiding injury of the pterygoid plexus.…”

Section: Discussionmentioning

confidence: 99%

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Anatomical Variations and Relationships of the Infratemporal Fossa: Foundation of a Novel Endonasal Approach to the Foramen Ovale

London

Prevedello

et al. 2020

J Neurol Surg B Skull Base

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Objective Access to the infratemporal fossa (ITF) is complicated by its complex neurovascular relationships. In addition, copious bleeding from the pterygoid plexus adds to surgical challenge. This study aims to detail the anatomical relationships among the internal maxillary artery (IMA), pterygoid plexus, V3, and pterygoid muscles in ITF. Furthermore, it introduces a novel approach that displaces the lateral pterygoid plate (LPP) to access the foramen ovale. Design and Main Outcome Measures Six cadaveric specimens (12 sides) were dissected using an endonasal approach to the ITF modified by releasing and displacing the LPP and lateral pterygoid muscle (LPTM) as a unit. Subperiosteal elevation of the superior head of LPTM revealed the foramen ovale. The anatomic relationships among the V3, pterygoid muscles, pterygoid plexus, and IMA were surveyed. Results In 9/12 sides (75%), the proximal IMA ran between the temporalis and the LPTM, whereas in 3/12 sides (25%), the IMA pierced the LPTM. The deep temporal nerve was a consistent landmark to separate the superior and inferior heads of LPTM. An endonasal approach displacing the LPP in combination with a subperiosteal elevation of the superior head of LPTM provided access to the posterior trunk of V3 and foramen ovale while sparing injury of the LPTM and exposing the pterygoid plexus. The anterior trunk of V3 traveled anterolaterally along the greater wing of sphenoid in all specimens. Conclusion Displacement of the LPP and LPTM provided direct exposure of foramen ovale and V3 avoiding dissection of the muscle and pterygoid plexus; thus, this maneuver may prevent intraoperative bleeding and postoperative trismus.

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“…3,4 The emissary vein of the foramen ovale (EVFO), a major emissary vein at the middle cranial fossa, connects medially to the cavernous sinus and laterally to the middle meningeal vein. 5,6 It runs inferiorly through the foramen ovale and joins into the pterygoid plexus and/or the pharyngeal plexus. It also receives the superficial middle cerebral vein in individuals with a type of variant termination, the so-called sphenobasal vein.…”

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confidence: 99%

Petrobasal Vein: A Previously Unrecognized Vein Directly Connecting the Superior Petrosal Sinus with the Emissary Vein of the Foramen Ovale

Ide

Kiyosue

Shimada

et al. 2021

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The superior petrosal sinus terminates anteriorly at the cavernous sinus and posteriorly at the transverse sinus. Venous variations directly connecting the superior petrosal sinus and the emissary veins of the foramen ovale are not well-recognized. We present a connecting vein, provisionally named the petrobasal vein.MATERIALS AND METHODS: Biplane cerebral angiography of the bilateral internal carotid arteries and the vertebral artery acquired in 267 patients was retrospectively reviewed by 2 neuroradiologists with special interest in the existence and course of the petrobasal vein. RESULTS:The petrobasal vein was observed to lie anterior-posteriorly on the superior surface of the petrosal bone and connected to the midportion of the superior petrosal sinus and the emissary veins of the foramen ovale in 41 patients (15%) and sides (7.9%); it drained into the pterygoid plexus. The petrobasal vein was observed on VAG in 21 patients, on ICAG alone in 8 patients (9 sides), on both VAG and ICAG in 12 patients, and on ICAG in 1 patient. In the patients in whom the petrobasal vein was visualized on the ICAs, the superficial middle cerebral vein drained into a combination of the pterygoid plexus via the emissary veins of the foramen ovale and the superior petrosal sinus. CONCLUSIONS:The petrobasal vein, an unknown vein directly connecting the superior petrosal sinus and the emissary veins of the foramen ovale and draining into the pterygoid plexus, can occasionally be identified on cerebral angiography as a variant drainage route from the cerebellum and brainstem veins and/or from the superficial middle cerebral vein. The petrobasal vein is thought to be a remnant of the primitive tentorial sinus. ABBREVIATIONS: dAVF ¼ dural AVF; EVFO ¼ emissary vein of the foramen ovale; ICAG ¼ internal carotid angiography; PBV ¼ petrobasal vein; PTS ¼ primitive tentorial sinus; SMCV ¼ superior middle cerebral vein; SPS ¼ superior petrosal sinus; VA ¼ vertebral artery; VAG ¼ vertebral angiography

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Topographic and microscopic anatomical description of the emissary sinus of foramen ovale in adult humans

Cited by 8 publications

References 38 publications

The Lingual Process of the Sphenoid Bone and the Petrolingual Ligament: Surgical Anatomy, Landmarks, and Clinical Relevance

The Lingual Process of the Sphenoid Bone and the Petrolingual Ligament: Surgical Anatomy, Landmarks, and Clinical Relevance

Anatomical Variations and Relationships of the Infratemporal Fossa: Foundation of a Novel Endonasal Approach to the Foramen Ovale

Petrobasal Vein: A Previously Unrecognized Vein Directly Connecting the Superior Petrosal Sinus with the Emissary Vein of the Foramen Ovale

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