Dorello's Canal for Laymen: A Lego-Like Presentation

Abstract

Objective Dorello's canal was first described by Gruber in 1859, and later by Dorello. Vail also described the anatomy of Dorello's canal. In the preceding century, Dorello's canal was clinically important, in understanding sixth nerve palsy and nowadays it is mostly important for skull base surgery. The understanding of the three dimensional anatomy, of this canal is very difficult to understand, and there is no simple explanation for its anatomy and its relationship with adjacent structures. We present a simple, Lego-like, presentation of Dorello's canal, in a stepwise manner.

Materials and Methods Dorello's canal was dissected in five formalin-fixed cadaver specimens (10 sides). The craniotomy was performed, while preserving the neural and vascular structures associated with the canal. A 3D model was created, to explain the canal's anatomy.

Results Using the petrous pyramid, the sixth nerve, the cavernous sinus, the trigeminal ganglion, the petorclival ligament and the posterior clinoid, the three-dimensional structure of Dorello's canal was defined. This simple representation aids in understanding the three dimensional relationship of Dorello's canal to its neighboring structures.

Conclusion Dorello's canal with its three dimensional structure and relationship to its neighboring anatomical structures could be reconstructed using a few anatomical building blocks. This method simplifies the understanding of this complex anatomical structure, and could be used for teaching purposes for aspiring neurosurgeons, and anatomy students.

Keywords

Dorello's canal - anatomy - 3D - skull base

• References

• 1 Gruber W. Anatomie des Keilbeins und Schlafenbeins. In: Richter HE, Winter A. eds. Schmidt's Jahrbucher der Und Auslandischen. Gesammten Medicin, II, Anatomie und Physiologie; 1859: 40
• 2 Tsitsopoulos PD, Tsonidis CA, Petsas GP, Hadjiioannou PN, Njau SN, Anagnostopoulos IV. Microsurgical Study of the Dorello's Canal. Skull Base Surg 1996; 6 (3) 181-185
• 3 Dorello P. Considerazioni sopra la causa della paralisi transitoria dell' abducente nelle flogosi dell' orecchio medio. In: Ferreri G, ed. Atti della Clinica Oto-Rino-Laringoiatrica. Roma; 1905: 209-217
• 4 Vail RL. Anatomical studies of Dorello's canal. Laryngoscope 1922; 32: 569-575
• 5 Umansky F, Elidan J, Valarezo A. Dorello's canal: a microanatomical study. J Neurosurg 1991; 75 (2) 294-298
• 6 Destrieux C, Velut S, Kakou MK, Lefrancq T, Arbeille B, Santini JJ. A new concept in Dorello's canal microanatomy: the petroclival venous confluence. J Neurosurg 1997; 87 (1) 67-72
• 7 Liu XD, Xu QW, Che XM, Mao RL. Anatomy of the petrosphenoidal and petrolingual ligaments at the petrous apex. Clin Anat 2009; 22 (3) 302-306
• 8 Yousry I, Camelio S, Wiesmann M , et al. Detailed magnetic resonance imaging anatomy of the cisternal segment of the abducent nerve: Dorello's canal and neurovascular relationships and landmarks. J Neurosurg 1999; 91 (2) 276-283
• 9 Ozveren MF, Erol FS, Alkan A, Kocak A, Onal C, Türe U. Microanatomical architecture of Dorello's canal and its clinical implications. Neurosurgery 2007; 60 (2, Suppl 1) ONS1-ONS7 , discussion ONS7–ONS8
• 10 Sanan A, Abdel Aziz KM, Janjua RM, van Loveren HR, Keller JT. Colored silicone injection for use in neurosurgical dissections: anatomic technical note. Neurosurgery 1999; 45 (5) 1267-1271 , discussion 1271–1274
• 11 Tekdemir I, Deda H, Karahan ST, Arinci K. The Intracranial Course of the Abducens Nerve. Turk Neurosurg 1996; 6: 96-102