The sphenoidal emissary foramina prevalence: a meta-analysis of 6,369 subjects

Abstract

Purpose To estimate the prevalence of the sphenoidal emissary foramina (SEF), and the effect of possible moderators on it. Methods A systematic online literature search was conducted. The pooled prevalence with 95% confidence intervals was estimated. Outlier and influential analyses were performed. The presence of small-study effect and publication bias were evaluated. Moderator analyses were executed to investigate the effect of the specimens’ continent of origin, type of study (dried skull or imaging), probing for the evaluation of SEF patency (conduction and instruments used), side dominance (bilateral or unilateral), morphometric data [SEF diameter, distances SEF–Foramen ovale (FO) and SEF–Foramen spinosum (FS)], and the methodology used for the morphometric measurements (caliper, DICOM Viewer, and image analysis software) on the estimated prevalence. Results In total, 6,460 subjects from 26 studies were included in the meta-analysis. The overall SEF prevalence was estimated as 38.1%. The heterogeneity was high and statistically significant. No indications of publication bias and small-study effect were identified. The conducted subgroup analyses did not yield statistically significant differences in the SEF prevalence between groups, except of the type of side dominance. Both results of the univariable and multivariable regression analyses showed the association of the unilateral dominance with a decrease in the reported SEF prevalence. Conclusion The identification of more unilateral than bilateral foramina in a given cohort is associated with a decrease in the reported crude SEF prevalence. Laterality-specific estimates should be established for a precisive estimation of the emissary foramina prevalence.

Bone anatomic variations of the parasellar region and its technical implications in para clinoid and posterior communicating segment aneurysms microsurgical clipping – Technical note

“…[6] e preoperative imaging protocol for aneurysms in this region should include fine-cut CT angiography with 3-D reconstructions, emphasizing axial cuts at the level of the upper paraclinoid region. [8] e studies pay special attention to the presence of the CCF and/or ICB, as each of these variants may limit the complete resection of the ACP by the extradural approach. However, removing the ACP entails considerable technical complexity due to its vicinity to the ICA and the second and third cranial nerves, potentially leading to catastrophic complications.…”

Clinical anatomy of the sphenoid bone and its terminology

“…The sphenoid emissary foramen (of Vesalius) is a small and inconstant opening that is located medially to the foramen ovale in the roof of the infratemporal fossa [24][25][26][27]. A small emissary vein passes through this foramen.…”