Foramen rotundum

PURPOSE: Dilatation of the trigeminal cavum, or Meckel's cave (MC), is usually considered a radiological sign of idiopathic intracranial hypertension. However, the normal size of the trigeminal cavum is poorly characterized. In this study, we describe the anatomy of this meningeal structure. METHODS: We dissected 18 MCs and measured the length and width of the arachnoid web and its extension along the trigeminal nerve. RESULTS: Arachnoid cysts were clearly attached to the ophthalmic (V1) and maxillary (V2) branches until they entered the cavernous sinus and foramen rotundum, respectively, without extension to the skull base...

Trigeminal neuralgia (TN) refers to sudden shooting pain in areas innervated by trigeminal nerves originating from the Gasserian ganglion. Physicians initially manage it by prescribing drugs, such as carbamazepine. Surgical intervention is the next best option if patients do not respond to drug treatments. These procedures include microvascular decompression, rhizotomy, balloon compression, and gamma knife surgery. However, less optimal patient outcomes, recurrences, adverse effects, and high costs have necessitated alternative surgical interventions to treat such patients...

BACKGROUND: Advantages and limitations of different craniotomy positions and approach trajectories to the Gasserian ganglion (GG) and related structures using an anterior subtemporal approach have not been studied systematically. The knowledge of these features is of importance when intending keyhole anterior subtemporal approaches (kAST) to GG, optimizing access and minimizing risks. METHODS: 8 formalin-fixed heads were used bilaterally to assess temporal lobe retraction (TLR), trigeminal exposure and relevant anatomical aspects of extra- and transdural classical anterior subtemporal approaches (CLAST) in comparison to slightly dorsally- (DAST) and ventrally- (VAST) allocated corridors...

UNLABELLED: There is limited literature of objective assessments of foramina of skull base using computed tomography (CT) scan. This study was carried out to analyze the dimensions of foramen ovale (FO), foramen spinosum (FS), and foramen rotundum (FR) using CT scan imaging of the human skull and their associations with sex, age, and laterality of the body. MATERIALS AND METHODS: A cross-sectional study was carried out in the Department of Radiodiagnosis and Imaging at BP Koirala Institute of Health Sciences (BPKIHS), Nepal using a purposive sampling method...

UNLABELLED: Background : A spontaneous cerebrospinal leak from Sternberg's canal with meningoencephalocele is a very rare clinical entity. Endoscopic repair of the defect is challenging and crucial in identifying the defect. The aim of this case report is to highlight the presence and management with endoscopic surgery in repairing Sternberg canal. Case : 40-year-old woman presents with spontaneous CSF rhinorrhea with no predisposing factors. CT imaging and MRI showed osteodural defect in the lateral recess of sphenoid with meningoencephalocoele lateral to the foramen rotundum...

BACKGROUND SMARCB1-deficient sinonasal carcinoma is a rare neoplasm with inactivation of the SWI/SNF complex, with an aggressive clinical course as most of the lesions present as advanced in pT3/T4 stages with frequent recurrence, and many patients succumb to the disease. Reported initially in 2014, the lesion has male predominance, with an age range of 19 to 89 years and predilection for the ethmoid sinus and nasal cavity. Histopathological findings show a proliferation of small- to medium-sized monomorphic basaloid cells with indistinctive cytoplasmic borders and round variably prominent nuclei with scattered cells that show rhabdoid morphology...

BACKGROUND: The repair of lateral sphenoid sinus cerebrospinal fluid leaks is routinely accomplished through the use of the endonasal endoscopic approach (EEA) with a transpterygoidal extension. This approach can incur sinus morbidity, damage to the vidian, palatine and trigeminal nerves, and the contents of the pterygopalatine fossa, particularly if the encephalocele is lateral to the foramen rotundum (FR) and V2. OBJECTIVE: To investigate the use of the lateral transorbital approach (LTOA) as an alternative approach for repair of lateral sphenoid sinus encephaloceles that avoids the potential morbidity of EEA...

PURPOSE: To report a novel case of central retinal artery occlusion in a 44-year-old male caused by emboli from a non-traumatic maxillary artery pseudoaneurysm. OBSERVATIONS: A 44-year-old male with history of hypertension presented to clinic with painless vision loss in his left eye. He was found to have a central retinal artery occlusion. Ocular massage and intraocular pressure lowering agents were administered and the patient was transferred to the emergency department for cerebrovascular work-up...

OBJECTIVE: The current study aimed to establish a new method for the fast exposure of the internal maxillary artery (IMA) during extracranial-intracranial (EC-IC) bypass surgery. METHODS: 11 formalin-fixed cadaveric specimens were dissected to explore the positional relationship between the IMA and the maxillary nerve and pterygomaxillary fissure (PMF). Three bone windows of the middle fossa were stated for further analysis. Then the length of IMA that could be pulled up above the middle fossa was measured after different degrees of bony structure removal...

The goal of orbital decompression for thyroid orbitopathy is to expand the orbital space for the contents with various techniques described. Deep lateral wall decompression is a procedure that expands the orbit by removing bone from the greater wing of sphenoid however its effectiveness is dependent on the volume of bone removed. Pneumatization of the greater wing of sphenoid is defined as an extension of the sinus beyond the VR line (a straight line crossing the medial edges of the vidian canal and the foramen rotundum) which is a demarcation between the sphenoid body and the lateral parts of the sphenoid bone, including the greater wings and pterygoid process...

Objective: Measuring the important anatomic parameters related to vidian neurectomy to locate the vidian nerve accurately and prevent the surgical complications. Methods: High resolution CT（HRCT） was used to measure the distance parameters between the important anatomic landmarks in 50 patients （100 sides） with chronic rhinosinusitis, sinus cyst or allergic rhinitis et al. The distance from the posterior opening of the palatovaginal canal to the upper edge of the sphenoidal process of palatine bone, the upper edge of the sphenoidal process of palatine bone to the external opening of the vidian canal, the external opening of the vidian canal to the greater palatine canal, and the external opening of the vidian canal to the foramen rotundus were measured...

Variations of the foramina located at the skull base can have direct clinical implications. For example, transcutaneous approaches to the trigeminal nerve using long spinal needles for treatment of trigeminal neuralgia can inadvertently enter such variant foramina and potentially result in hemorrhage. Therefore, knowledge of such variant foramina is important to the clinician treating or diagnosing patients based on imaging of this region. We report an adult male skull found to have unusual foramina located at the skull base...

OBJECTIVES: To assess the demographic and radiographic features of arrested pneumatization of the sphenoid sinus (APS) and their influence on the confidence of oral and maxillofacial radiologists (OMFRs) in diagnosing APS. METHODS: Reports of cone beam computed tomography (CBCT) APS were retrieved, and the demographic and radiographic features were retrospectively analyzed. Five OMFRs assessed the CBCT images and their confidence in diagnosing APS. The OMFRs' experience (years), expertise (skull-base CBCT cases/month) and diagnostic confidence level were analyzed for agreement and associations with demographic or radiographic features...

OBJECT: The pterygopalatine fossa (PPF) is a covert neurovascular pathway in the skull base and connects with numerous intracranial and extracranial spaces. The aim of this study was to explore the magnetic resonance imaging (MRI) features of PPF invasion in patients with nasopharyngeal carcinoma (NPC). MATERIAL AND METHODS: The medical records of 88 patients with stage T3 or T4 NPC were retrospectively analyzed. The 3-Dimensional (3D) volumetric images of MRI were reconstructed for the tiny connecting conduits of the invaded PPFs in the NPC patients...

•The transorbital approach combining eyebrow incision and crescent-shaped craniotomy increases the surgical freedom to access the anterior and middle skull-base.•The technic allows the use of both endoscope and microscope.•The concept is at the crossroad between the supraorbital keyhole and endoscopic trans-orbital approach.

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...

BACKGROUND: The endoscopic superior eyelid transorbital route to the skull base is gaining progressive popularity in the neurosurgical community. OBJECTIVE: To evaluate the anatomy of the middle cranial fossa from this novel ventral perspective to reach the skull base through the transorbital route and to show limits for possible safe middle fossa drilling from the transorbital route. METHODS: Anatomic study was performed; 5 cadaveric specimens (ie, 10 sides) and 2 dry skulls (ie, 4 sides) were dissected...

We present a case of a 37-year-old female, with progressive left eye proptosis and an extensive ipsilateral en plaque spheno-orbital meningioma, with diffuse involvement of the lateral wall of the cavernous sinus and the orbit. A cranio-orbital zygomatic approach was performed to reach all extension of the lesion. We made an extradural clinoidectomy and an extensive bone removal of the orbit, exposition of the superior and lateral walls of the cavernous sinus, unroofing of the optic canal, superior orbital fissure, foramen rotundum, and foramen ovale...

OBJECTIVES: Radiofrequency thermocoagulation (RFT) is a type of Gasserian ganglion-level ablative intervention that is used for the treatment of trigeminal neuralgia. Guidance technologies are used to assist in the cannulation of the foramen ovale (FO) or foramen rotundum (FR) target. We conducted a systematic review to assess the value of different guidance technologies for RFT. METHODS: We searched PubMed, Embase, the Cochrane database, Web of Science, and PROSPERO for studies published from January 2005 until December 2020...

Introduction  Understanding the anatomic features of the zygomatic nerve is critical for performing the endoscopic transmaxillary approach properly. Injury to the zygomatic nerve can result in facial numbness and corneal problems. Objective  To evaluate the surgical anatomy of the zygomatic nerve and its segments from an endoscopic endonasal perspective for clinical implications of performing the endoscopic transmaxillary approach. Methods  The origin, course, length, and segments of the zygomatic nerve were studied in four specimens from an endonasal perspective...