Review of complications due to foramen ovale puncture

Kaplan, Metin; Erol, Fatih Serhat; Özveren, Mehmet Faik; Topsakal, Cahide; Şam, Bülent; Tekdemi̇r, İbrahi̇m

doi:10.1016/j.jocn.2005.11.043

Cited by 70 publications

(62 citation statements)

References 37 publications

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“…According to Boyd (1930), in 65% of cases, the sphenoidal emissary foramen may appear with diameter of 0.5 mm. On the other hand, the mean diameter found by Kaplan et al (2007), was 1 mm.…”

Section: Literature Reviewmentioning

confidence: 78%

“…According to Boyd (1930), in 65% of cases, the sphenoidal emissary foramen may appear with diameter of 0.5 mm. On the other hand, the mean diameter found by Kaplan et al (2007), was 1 mm.The distance from the sphenoidal emissary foramen in relation to the foramen ovale also has been measured. Rossi et al, measured an average distance of 1.853 ± 0.303 mm on the right side and 2.464 ± 0.311 mm on the left from 80 skulls.…”

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confidence: 78%

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Emissary Foramens of the Human Skull: Anatomical Characteristics and its Relations with Clinical Neurosurgery

Freire

Rossi

Oliveira³

et al. 2013

Int. J. Morphol.

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SUMMARY:The recognition of emissary foramens is important not only for understanding the regional neurovascular anatomy, but also to distinguish normal from potentially abnormal structures. Thus, the aim of this study was to review the literature on anatomical and clinical aspects of the mastoid, parietal and sphenoid emissary foramens. It was found that the emissary foramen presents importance in clinical practice because it acts as a route of spread of extracranial infection to the intracranial structures and also possible complications in neurosurgery, due to its influence in the performance of techniques such as radiofrequency rhizotomy for treatment of trigeminal neuralgia. The anatomical knowledge of the emissary foramens is important due to variability in their incidence in the human skull and its relation to the dura mater sinuses. KEYWORDS: Emissary foramens 288less studied by clinical, needs a through approach to avoid interpretation errors during procedures in neurosurgery and clinical dentistry (Sicher & DuBrul, 1977;Gupta et al., 2005;Louis Jr. et al., 2009;Rossi et al., 2010).Considering the importance of knowing the implications of the anatomical variations of the human skull can generate during clinical procedures, the aim of this study was to review the literature on anatomical and clinical aspects of the mastoid, parietal and sphenoid emissary foramens. Literature ReviewMastoid Foramen. The emissary mastoid foramen is located at the mastoid portion of the temporal bone, near to occipitomastoid suture (Fig. 1). This foramen can also appear on the occipitomastoid suture and, if present, transmits an emissary vein to sigmoid sinus. It can occur in single or multiple (Sicher & DuBrul).The mastoid emissary vein may act as another route of spread of infection or tumors originated in the face and infratemporal fossa (Sicher & DuBrul).In addition, the mastoid foramen is considered an anatomical landmark that helps in the differentiation of species and, thus, was verified their importance in forensic anthropology (Reis et al.). It is believed that the adaptation of a bipedal hominid position was associated with anatomical and physiological changes in the venous system of the skull base to adapt to the concomitant changes in intracranial venous blood flow. The pattern of venous drainage of the Australopithecus was based on the occipital vein. In homo sapiens, the volume of this drainage was reduced occurring, thus, the development of new veins. Among these new veins, the emissary mastoid vein led to the emergence of the mastoid foramen in the modern human skull (Falk, 1986).These evolutionary changes have shown that the sigmoid sinus drains into the vertebral venous plexus when is in the upright position and drains into the internal jugular vein when is in the supine position (Goucha et al., 2002). Boyd (1930) found an incidence of 68% of the mastoid foramen in a sample of 1478 skulls of modern human, while Falk obtained a 90% incidence in a sample of 51 skulls of early human. Reis et al., found an inci...

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“…According to Boyd (1930), in 65% of cases, the sphenoidal emissary foramen may appear with diameter of 0.5 mm. On the other hand, the mean diameter found by Kaplan et al (2007), was 1 mm.…”

Section: Literature Reviewmentioning

confidence: 78%

mentioning

confidence: 78%

Emissary Foramens of the Human Skull: Anatomical Characteristics and its Relations with Clinical Neurosurgery

Freire

Rossi

Oliveira³

et al. 2013

Int. J. Morphol.

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“…Overall, 13.5% of abducens nerves show a duplicate pattern with different relationships to the petrosphenoidal ligament, thereby making it easier to damage. 22,31,34,35 In addition, there are vascular anastomoses between the TN and abducens nerve that can impair vascular supply to the abducens nerve when the TN is lesioned. 35 Oculomotor paresis occurs infrequently 21 because it is difficult for the needle to reach the oculomotor nerve from the FO.…”

Section: Injury To Intracranial Structures Due To Incorrectmentioning

confidence: 99%

“…Therefore, the trochlear nerve is more frequently injured after V1 lesioning than after V2 or V3 lesioning. 22,32 The trochlear nerve crosses the clivus 12 mm from the tip of the dorsum. 19 Deeper and more medial punctures can contribute to this palsy.…”

Section: Injury To Intracranial Structures Due To Incorrectmentioning

confidence: 99%

Foramen ovale puncture, lesioning accuracy, and avoiding complications: microsurgical anatomy study with clinical implications

Peris-Celda

Graziano

Russo

et al. 2013

JNS

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F oramen ovale puncture was first described by Här-tel in 1914 18 as a percutaneous route to the Meckel cave to treat trigeminal neuralgia. Microvascular decompression induces little or no hypesthesia and is usually the treatment of choice for young patients without comorbidities.3 However, less invasive techniques, including FO puncture, are preferred Object. Foramen ovale (FO) puncture allows for trigeminal neuralgia treatment, FO electrode placement, and selected biopsy studies. The goals of this study were to demonstrate the anatomical basis of complications related to FO puncture, and provide anatomical landmarks for improvement of safety, selective lesioning of the trigeminal nerve (TN), and optimal placement of electrodes.Methods. Both sides of 50 dry skulls were studied to obtain the distances from the FO to relevant cranial base references. A total of 36 sides from 18 formalin-fixed specimens were dissected for Meckel cave and TN measurements. The best radiographic projection for FO visualization was assessed in 40 skulls, and the optimal trajectory angles, insertion depths, and topographies of the lesions were evaluated in 17 specimens. In addition, the differences in postoperative pain relief after the radiofrequency procedure among different branches of the TN were statistically assessed in 49 patients to determine if there was any TN branch less efficiently targeted.Results. Most severe complications during FO puncture are related to incorrect needle placement intracranially or extracranially. The needle should be inserted 25 mm lateral to the oral commissure, forming an approximately 45° angle with the hard palate in the lateral radiographic view, directed 20° medially in the anteroposterior view. Once the needle reaches the FO, it can be advanced by 20 mm, on average, up to the petrous ridge. If the needle/radiofrequency electrode tip remains more than 18 mm away from the midline, injury to the cavernous carotid artery is minimized. Anatomically there is less potential for complications when the needle/radiofrequency electrode is advanced no more than 2 mm away from the clival line in the lateral view, when the needle pierces the medial part of the FO toward the medial part of the trigeminal impression in the petrous ridge, and no more than 4 mm in the lateral part. The 40°/45° inferior transfacial-20° oblique radiographic projection visualized 96.2% of the FOs in dry skulls, and the remainder were not visualized in any other projection of the radiograph. Patients with V1 involvement experienced postoperative pain more frequently than did patients with V2 or V3 involvement. Anatomical targeting of V1 in specimens was more efficiently achieved by inserting the needle in the medial third of the FO; for V2 targeting, in the middle of the FO; and for V3 targeting, in the lateral third of the FO.Conclusions. Knowledge of the extracranial and intracranial anatomical relationships of the FO is essential to understanding and avoiding complications during FO puncture. These data suggest that better rad...

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“…A variety of neoplastic processes and trigeminal neuralgia have been documented to involve the FO and FR (Lanzieri et al;Kanpolat et al, 2001, Kaplan et al, 2007. However, wide review of the literature shows only very few studies on the anatomical variations of FO, FR, FS and FV.…”

Section: Introductionmentioning

confidence: 99%

Anatomical Examination of the Foramens of the Middle Cranial Fossa

et al. 2014

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SUMMARY:Three foramina can be identified in the greater wing of the sphenoid bone: The foramen rotundum (FR), foramen ovale (FO) and foramen spinosum (FS). In addition, there may be another foramen called foramen ovale accessorium or foramen vesalius (FV) which connects the middle cranial fossa to the fossa pterygoidea (pterygoid fossa). It is described as an opening with smooth walls in front and medial to foramen ovale which leads to an oblique channel directed towards the fossa pterygoidea. FV was present between FO and FR in 14 (31.8%) of 44 dry and 6 (33.3%) of 18 cadaver skullbase sides (total 20 (32.3%) of 62). The diameter values of foramens on both the right and the left side were observed to be almost symmetrical. FR's distance from the midline on the left side was greater than the right side. Also, the distance between FO and the petrous apex and the distance between FS and the petrous apex were greater on the left side. On the right side the distance between FO and FR, and the distance between FO and FS were greater. Also, the distance between FR and the petrous apex was greater on the right side. Anatomical variations in appearance size and distance of FR, FO, FS and FV are of great surgical importance. In conclusion, we can infer that the information provided with this study can help the neurosurgeon and anatomist to increase the knowledge about anatomy of middle cranial fossa.KEY WORDS: Foramen rotundum; Foramen ovale; Foramen spinosum; Foramen Vesalius.

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Review of complications due to foramen ovale puncture

Cited by 70 publications

References 37 publications

Emissary Foramens of the Human Skull: Anatomical Characteristics and its Relations with Clinical Neurosurgery

Emissary Foramens of the Human Skull: Anatomical Characteristics and its Relations with Clinical Neurosurgery

Foramen ovale puncture, lesioning accuracy, and avoiding complications: microsurgical anatomy study with clinical implications

Anatomical Examination of the Foramens of the Middle Cranial Fossa

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