Bilateral Extensive Ossification of the Posterior Petroclinoid Ligament: An Anatomical Case Report and Literature Review

Wysiadecki, Grzegorz; Haładaj, Robert; Polguj, Michał; Żytkowski, Andrzej; Topol, Mirosław

doi:10.1055/s-0038-1666782

Cited by 13 publications

(6 citation statements)

References 32 publications

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“…Such variation was observed in our material in two cases in which the presence of ossification within the dura covering inferomedial triangle was confirmed histologically. Similar findings have also been described in anatomical and radiographic reports [ 14 , 15 , 16 , 17 , 18 , 19 ]. Touska et al [ 18 ] concluded that ligamentous skull base mineralizations are relatively common findings on CT scans.…”

Section: Discussionsupporting

confidence: 90%

“…Touska et al [ 18 ] concluded that ligamentous skull base mineralizations are relatively common findings on CT scans. In the majority of cases, intracranial calcifications or ossifications are not accompanied by any detectable pathology [ 14 , 19 ]. However, mineralization of skull base ligaments can occur as a result of an interplay between a broad range of factors, including genetics, metabolic abnormalities and mechanical stress [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Calcification of the posterior petroclinoid dural fold may also be qualified as age-related degeneration, showing a laminar or nodular pattern [ 19 ]. Such variants are clinically relevant and can result in barriers to minimally invasive surgical approaches [ 1 , 14 , 15 , 16 , 17 , 18 , 19 ]. Posterior petroclinoid fold ossifications or calcifications can affect surgical dissection of the entry corridor through the inferomedial and inferolateral triangles and can be especially important when access involving the inferomedial triangle is enlarged by opening the oculomotor trigone [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

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Microsurgical Anatomy of the Inferomedial Paraclival Triangle: Contents, Topographical Relationships and Anatomical Variations

et al. 2021

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The inferomedial triangle is one of the two surgical triangles in the paraclival subregion of the skull base. It is delineated by the posterior clinoid process, the dural entrance of the trochlear nerve and the dural entrance of the abducens nerve. The aim of the present article is to describe the anatomical variations within the inferomedial triangle. Measurements of the triangle’s borders and area were supplemented by detailed observations of the topographical anatomy and various arrangements of its contents. Nine adult cadaveric heads (18 sides) and 28 sagittal head sections were studied. The mean area of the inferomedial triangle was estimated to be 60.7 mm2. The mean lengths of its medial, lateral and superior borders were 16.1 mm, 11.9 mm and 10.4 mm, respectively. The dorsal meningeal artery was identified within the inferomedial triangle in 37 out of 46 sides (80.4%). A well-developed petrosphenoidal ligament of Grüber was identified within the triangle on 36 sides (78.3%). Although some structures were variable, the constant contents of the inferomedial triangle were the posterior petroclinoid dural fold, the upper end of the petroclival suture, the gulfar segment of the abducens nerve and the posterior genu of the intracavernous internal carotid artery.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Microsurgical Anatomy of the Inferomedial Paraclival Triangle: Contents, Topographical Relationships and Anatomical Variations

et al. 2021

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“…The dissecting procedure was designed and performed according to previously described protocols [6,18–20]. The orbit was carefully opened through removal of its entire superior wall (the orbital roof) using bone chisel and Luer bone rongeur.…”

Section: Methodsmentioning

confidence: 99%

Anatomical Variations of the Supraorbital and Supratrochlear Nerves: Their Intraorbital Course and Relation to the Supraorbital Margin

2019

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Background This study aimed to describe the topographical anatomy of the supraorbital and supratrochlear nerves. Anatomical variations of both the intraorbital course of the 2 nerves and their relation to the supraorbital margin were analyzed. Material/Methods The research material involved 50 isolated adult cadaveric hemi-heads and 25 macerated adult skulls. All studied specimens were of Caucasian origin. Results Taking into account the location of the frontal nerve division, 2 main variants of the intraorbital course of the supraorbital and supratrochlear nerves were distinguished. The first variant (variant I, 42%) involved cases in which the supraorbital and supratrochlear nerves branched off from the frontal nerve in the distal half of the length of the orbit. In the second variant (variant II, 58%), the frontal nerve branched into the supraorbital and supratrochlear nerves in the proximal half of the orbit. Variant II was characterized by the presence of a thick supraorbital nerve and a long, tiny supratrochlear nerve. For variant I, 27.8% of the supraorbital nerves were divided into the medial and lateral branch within the orbit, whereas, for variant II, 75% of nerves were divided into the medial and lateral branch within the orbit (before crossing the supraorbital margin). Single passage was observed on the supraorbital margin in 80% of wet specimens and in 78% of orbits examined on the macerated skulls. Conclusions Both the intraorbital and extraorbital course of the branches of the supraorbital and supratrochlear nerves were highly diverse. These variations should be taken into account during medical procedures performed within the orbital and frontal regions.

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“…This procedure was based on the additional removal of the wedge-shaped part of the occipital squama. This access not only protects the cranial nerves, which allows obtaining a good quality of specimens [21,59,61] but also prevents accidental damage to the brainstem, which is crucial especially when using the Klingler's method. The access may be extended by removal of the vertebral arches (vertebral pedicles must be carefully chiseled), which allows obtaining a complete specimen of the brain and spinal cord.…”

Section: Researchers Demonstrated Structuresmentioning

confidence: 99%

Klingler’s method of brain dissection: review of the technique including its usefulness in practical neuroanatomy teaching, neurosurgery and neuroimaging

et al. 2019

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Klingler's technique was discovered in the 1930s. It is a modified method of brain fixation and dissection, based on freezing and thawing of the brain tissue, subsequent peeling away of white matter fibres and the gradual exposure of white matter tracts. The added value of this technique is that it is carried out in a stratigraphic manner. This fact makes it an invaluable tool for an in-depth understanding of the complex anatomical organisation of the cerebral hemispheres. The purpose of this paper is to provide a review of Klingler's method while taking into account the original description of the technique and its value for medical training. The historical background, the concise outline of white matter organisation, as well as our own experience in using this procedure for research and teaching activities were also included. The fibre dissection technique may still be considered an excellent complementary research tool for neuroanatomical studies. Numerous detailed observations about the white matter topography and spatial organisation have been recently made by applying this method. Using this technique may also improve understanding of the three-dimensional intrinsic structure of the brain, which is particularly important both in under-and postgraduate training in the field of neuroanatomy. (Folia Morphol 2019; 78, 3: 455-466)

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Bilateral Extensive Ossification of the Posterior Petroclinoid Ligament: An Anatomical Case Report and Literature Review

Cited by 13 publications

References 32 publications

Microsurgical Anatomy of the Inferomedial Paraclival Triangle: Contents, Topographical Relationships and Anatomical Variations

Microsurgical Anatomy of the Inferomedial Paraclival Triangle: Contents, Topographical Relationships and Anatomical Variations

Anatomical Variations of the Supraorbital and Supratrochlear Nerves: Their Intraorbital Course and Relation to the Supraorbital Margin

Klingler’s method of brain dissection: review of the technique including its usefulness in practical neuroanatomy teaching, neurosurgery and neuroimaging

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