Topography, syntopy and morphology of the human otic ganglion: A cadaver study

Senger, Miriam; Stoffels, Hans-Jürgen; Angelov, Doychin N.

doi:10.1016/j.aanat.2014.05.039

Cited by 10 publications

(23 citation statements)

References 19 publications

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“…In consideration of the risk of tethering and screw placement, it is important to include advanced imaging when the arcuate foramen is found on x-ray, especially in trauma cases. In 2014, Todd et al reported on adverse events related to chiropractic care for children and infants but did not include arcuate foramen as an underlying pathology or increased risk for performing manual cervical manipulations [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

An anatomical study of arcuate foramen and its clinical implications: a case report

et al. 2016

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BackgroundThe objective of this paper is to describe the relationship of the vertebral artery (VA) to the Atlas (C1) in the sub-occipital region in the presence of arcuate foramen; and discuss the clinical implications related to manual therapies and surgical implications related to screw placement. This study is an anatomical cadaveric case report of symmetrical bilateral lateral and dorsal arcuate foramina on the C1 dorsal arch. Case PresentationOut of 40 cadavers that were available for use in teaching anatomy in the university setting, three presented with anomalies of the C1 dorsal arch. The sub-occipital regions were skillfully prosected to preserve related structures, especially VAs, sub-occipital and greater occipital nerves. Visual observations, photographs, measurements, and radiographic examinations were performed between January 15, 2014 and August 25, 2014. One cadaver (Specimen A) presented with complete bilateral ossified arcuate foramina, and two presented with partial ossification of the atlanto-occipital membrane. Specimen A presented the bilateral anomaly which is almost symmetrical. The VAs were found passing through double foramina (lateral and dorsal) on each side.ConclusionsArcuate foramina have been shown to be commonly found anomalies with highly variable shapes and sizes, even in the same individual with a bilateral condition. This study found a rare type of the anomaly associated with the C1 dorsal arch, which protected the VA against manual pressure. However, VA, in this case, would be more susceptible to dissection. The presence of the arcuate foramen would also complicate screw placement during surgery. Clinical pre-screening for signs of vertebrobasilar insufficiency is important for chiropractic and manual therapies.

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Section: Discussionmentioning

confidence: 99%

An anatomical study of arcuate foramen and its clinical implications: a case report

et al. 2016

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“…It has been described that approximately 50% of the cranial vasomotor response is mediated by the OG and the other 50% by the SPG in an animal model 18 . Parasympathetic fibers synapse in the OG 8 . Histological analysis of the human OG is positive for choline acetyltransferase (unpublished work of Prof. Angelov at the Anatomical Institute of the University of Cologne, Germany).…”

Section: Introductionmentioning

confidence: 98%

“…1). Its location and relationship to adjacent structures appear to be constant 8 . It is situated directly medial to and in contact with the mandibular nerve 8 .…”

Section: Introductionmentioning

confidence: 99%

“…Its location and relationship to adjacent structures appear to be constant 8 . It is situated directly medial to and in contact with the mandibular nerve 8 . The mean distance from the OG to the foramen ovale (a structure localizable on head computed tomography (CT) scans) is 4.5 mm (SD 1.7) 1 .…”

Section: Introductionmentioning

confidence: 99%

“…Some postganglionic fibers exit the ganglion toward the auriculotemporal nerve and reach the parotid gland. Other fibers leave the ganglion via the external sphenoidal nerve (also referred to as dorsal rami, ganglionic cord, internal sphenoidal nerve or rami communicantes cum sinus cavernosus) 8 . These fibers reach the trigeminal ganglion and ganglia of the cavernous sinus.…”

Section: Introductionmentioning

confidence: 99%

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Open‐Label, Multi‐Dose, Pilot Safety Study of Injection of OnabotulinumtoxinA Toward the Otic Ganglion for the Treatment of Intractable Chronic Cluster Headache

et al. 2020

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Background The otic ganglion (OG) provides parasympathetic innervation to the cerebral circulation and cranial structures and may be involved in the pathophysiology of trigeminal autonomic headaches. This structure has never been targeted in any headache disorder. Objective To investigate the safety of injecting onabotulinumtoxin A (BTA) toward the OG in 10 patients with intractable chronic cluster headache and to collect efficacy data. Methods A total of 10 patients with chronic cluster headache were enrolled in this open‐label, multi‐dose pilot safety study. All patients were recruited and treated on an out‐patient basis at St Olav's University Hospital (Norway). In 5 patients each, the OG was the injection target with 12.5 IU of BTA or 25 IU, respectively. The primary outcome measure was adverse events (AEs) and the main secondary outcome was the number of attacks per week measured at baseline and in the second month following injection. Results For the primary endpoint, we analyzed data for all 10 patients. There were a total of 17 AEs in 6 of the 10 patients. All AEs were considered mild and disappeared by the end of follow‐up. The median number of attacks per week at baseline was 17.0 [7.8 to 25.8] vs 14.0 [7.3 to 20.0] in the second month following injection; difference: 3 (95%CI: −0.3 to 7.9), P = .063. Conclusions Injection with BTA toward the OG appears to be safe. We did not find a statistically significant reduction in the number of attacks per week at month 2 after injection compared to the baseline. This study suggests that the OG is not an important target for the treatment of chronic cluster headache. A future study employing more precise targeting of the OG may be indicated.

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