Cavernous sinus and abducens nerve in human fetuses near term

Sato, Minako; Cho, Kwang Ho; Yamamoto, Masahito; Hirouchi, Hidetomo; Murakami, Gen; Abé, Hiroshi; Abe, Shinichi

doi:10.1007/s00276-020-02443-5

Cited by 10 publications

(5 citation statements)

References 21 publications

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“…Actually, in late‐term fetuses, we found a bony plate originating from the AP along the internal carotid artery. The intracavernous course of the internal carotid artery is almost straight in newborns and late‐term fetuses (Sato et al, 2020; Weninger & Müller, 1999). The lingula might be a membranous bone formed by a mechanical stress to “bend” the parasellar artery after birth.…”

Section: Discussionmentioning

confidence: 99%

“…Paraffin‐embedded sagittal sections were obtained from 25 embryos and fetuses of approximate GA 6–34 weeks and CRL 12–295 mm. Because sagittal sections show topographical anatomy better than horizontal sections, sagittal sections of the sphenoid have been used to assess the anatomy of the developing cavernous sinus (Sato et al, 2020) and extraocular rectus muscles (Kim et al, 2020; Naito et al, 2019). The specimens were categorized into four groups by age and size, with Group 1 consisting of four embryos of GA 6 weeks and CRL 12–15 mm, Group 2 of six early fetuses of GA 7–8 weeks and CRL 24–35 mm, Group 3 of eight midterm fetuses of GA 12–15 weeks and CRL 71–115 mm, and Group 4 of seven late‐term fetuses of GA 25–34 weeks and CRL 200–295 mm.…”

Section: Methodsmentioning

confidence: 99%

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Association between the developing sphenoid and adult morphology: A study using sagittal sections of the skull base from human embryos and fetuses

et al. 2021

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The developing sphenoid is regarded as a median cartilage mass (basisphenoid [BS]) with three cartilaginous processes (orbitosphenoid [OS], ala temporalis [AT], and alar process [AP]). The relationships of this initial configuration with the adult morphology are difficult to determine because of extensive membranous ossification along the cartilaginous elements. The purpose of this study was therefore to evaluate the anatomical connections between each element of the fetal sphenoid and adult morphology. Sagittal sections from 25 embryos and fetuses of gestational age 6–34 weeks and crown‐rump length 12–295 mm were therefore examined and compared with horizontal and frontal sections from the other 25 late‐term fetuses (217–340 mm). The OS was identified as a set of three mutually attached cartilage bars in early fetuses. At all stages, the OS‐post was continuous with the anterolateral part of the BS. The BS included the notochord and Rathke's pouch remnant in embryos and early fetuses. The dorsum sellae was absent from embryos, but it protruded from the BS in early fetuses before a fossa for the hypophysis became evident. Although not higher than the hypophysis at midterm, the dorsum sellae elongated superiorly after gestational age 25 weeks. In early fetuses, the AP was located on the side immediately anterior to the otic capsule. The AT developed on the side immediately posterior to the extraocular rectus muscles. At late term, the greater wing was formed by membranous bones from the AT and AP. The AT and AP formed a complex bridge between the BS and the greater wing. A small cartilage, future medial pterygoid process (PTmed) was located inferior to the AT in early fetuses. At midterm, one endochondral bone and multiple membranous bones formed the PTmed. The lateral pterygoid process (PTlat) was formed by a single membranous bone plate. Therefore, we connected fetal elements and the adult morphology as follows. (1) Derivative of the OS makes not only the lesser wing but also the anterior margin of the body of the sphenoid. (2) Derivatives of the BS are the body of the sphenoid including the sella turcica and the dorsum sellae. (3) Most of the greater wing including the foramen rotundum and the foramen oval originate from the AT and AP and multiple membranous bones. (4) The PTmed originate from endochondral bones and multiple membranous bones, while the PTlat derive from a single membranous bone.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Association between the developing sphenoid and adult morphology: A study using sagittal sections of the skull base from human embryos and fetuses

et al. 2021

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“…Newman [41] concludes that CS surgery results in transient worsening of cranial nerves III-VI function. Consequently, the ability to conduct successful surgeries within this area is based mainly on an improved understanding of the anatomy and pathology in the parasellar and petroclival regions combined with modern neuroimaging [10,14,42,43].…”

Section: Discussionmentioning

confidence: 99%

“…The cavernous segment of the AN can be involved in numerous pathologies of neoplastic, vascular, and inflammatory origin. Due to its unique spatial relationships, the cavernous segment of the AN is susceptible to iatrogenic injury during endovascular interventions within the ICA and skull base surgery for CS lesions [ 14 ]. The AN also intersects with the bundles of sympathetic fibers derived from the ICP, some of which run toward the nerve or join the cranial nerves located in the lateral wall of the CS [ 8 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Gross and Micro-Anatomical Study of the Cavernous Segment of the Abducens Nerve and Its Relationships to Internal Carotid Plexus: Application to Skull Base Surgery

et al. 2021

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The present study aims to provide detailed observations on the cavernous segment of the abducens nerve (AN), emphasizing anatomical variations and the relationships between the nerve and the internal carotid plexus. A total of 60 sides underwent gross-anatomical study. Five specimens of the AN were stained using Sihler’s method. An additional five specimens were subjected to histological examination. Four types of AN course were observed: a single nerve along its entire course, duplication of the nerve, division into separate rootlets at the point of contact with the cavernous part of the internal carotid artery (ICA), and early-branching before entering the orbit. Due to the relationships between the ICA and internal carotid plexus, the cavernous segment of the AN can be subdivided into a carotid portion located at the point of contact with the posterior vertical segment of the cavernous ICA and a prefissural portion. The carotid portion of the cavernous AN segment is a place of angulation, where the nerve always directly adheres to the ICA. The prefissural portion of the AN, in turn, is the primary site of fiber exchange between the internal carotid plexus and either the AN or the lateral wall of the cavernous sinus.

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“…However, Weninger and Müller [ 23 , 24 ] demonstrated that, in infants, the intracavernous ICA shows an individual and age-dependent variations from the almost straight course (25%) to an adult-like siphon. Our group recently ensured the straight course in near-term fetuses [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Fetal development of the carotid canal with special reference to a contribution of the sphenoid bone and pharyngotympanic tube

et al. 2021

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The bony carotid canal is a tube-like bone with a rough surface in contrast to smooth surfaces of the other parts of the temporal bone petrosal portion (petrosa): it takes an impression of the additional, out-sourcing product. No study had been conducted to evaluate a contribution of the adjacent sphenoid and pharyngotympanic tube (PTT) to the carotid canal. We examined sagittal and horizontal histological sections of hemi-heads from 37 human fetuses at 10 to 37 weeks. At 10 to 18 weeks, the future carotid canal was identified as a wide loose space between the cartilaginous cochlea and the ossified or cartilaginous sphenoid elements (ala temporalis and pterygoid). A linear mesenchymal condensation extending between the cochlear wall and ala temporalis suggested the future antero-inferior margin of the carotid canal. This delineation was more clearly identified in later stages. After 25 weeks, 1) the growing pterygoid pushed the PTT upward and, in turn, the PTT pushed the internal carotid artery (ICA) upward toward the petrosa: 2) a membranous ossification occurs in the dense mesenchymal tissue, the latter of which took an appearance of an anterior process of the petrosa; 3) the bony process of the petrosa involved the ICA inside or posteriorly. The bony carotid canal was made with membranous ossification in the dense mesenchymal tissue between the petrosa and sphenoid. The mother tissue was detached from the sphenoid by the PTT. The ossification of the septum between the ICA and tympanic cavity seemed to continue after birth.

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Cavernous sinus and abducens nerve in human fetuses near term

Cited by 10 publications

References 21 publications

Association between the developing sphenoid and adult morphology: A study using sagittal sections of the skull base from human embryos and fetuses

Association between the developing sphenoid and adult morphology: A study using sagittal sections of the skull base from human embryos and fetuses

Gross and Micro-Anatomical Study of the Cavernous Segment of the Abducens Nerve and Its Relationships to Internal Carotid Plexus: Application to Skull Base Surgery

Fetal development of the carotid canal with special reference to a contribution of the sphenoid bone and pharyngotympanic tube

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