Morphometric and anatomic variations of foramen ovale in human skull and its clinical importance

Kuppasad Prakash; Kundadukkam Saniya; Thittamaranahalli Honnegowda; Haradi Ramkishore; Amit Nautiyal

doi:10.4103/ajns.AJNS_243_19

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(04): 1134-1137
DOI: 10.4103/ajns.AJNS_243_19

Original Article

Morphometric and anatomic variations of foramen ovale in human skull and its clinical importance

Authors

Kuppasad Prakash

⁰Department of Anatomy, Azeezia Institute of Medical Sciences and Research, Kollam, Kerala
Kundadukkam Saniya

⁰Department of Anatomy, Azeezia Institute of Medical Sciences and Research, Kollam, Kerala
Thittamaranahalli Honnegowda

¹Department of Anatomy, Kannur Medical College, Kannur, Kerala
Haradi Ramkishore

²Department of Anatomy, Karwar Institute of Medical Sciences, Karwar, Karnataka
Amit Nautiyal

³Department of Nuclear Medicine, Tata Memorial Hospital, Pune, Maharashtra

Abstract

Objective: There is a paucity of information regarding the specific anatomy and clinical significance of variations of foramen ovale (FO). The present study was undertaken to define this anatomy in more detail and to review the literature regarding these anatomic variations. Materials and Methods: A total of 124 adult human dry skulls were analyzed for the variations in appearance and number of FO being noted. The length and width of the FO of both sides were determined using digital vernier calipers and area (A) was also calculated and analyzed. Results: Of 82 adult skulls, the values for the right side was 7.64 ± 1.194 mm, 5.128 ± 0.827 mm, and 30.808 ± 7.545 mm² and for the left side the values was 7.561 ± 1.123 mm, 5.244 ± 0.950 mm, and 31.310 ± 8.262 mm², respectively, for the mean length, width, and area of the FO. The shape of foramen was typically ovale in most of the skulls (56.70%) with some bony variations such as spine, tubercles, bony bridge/bar, and confluence. Conclusion: Such variants in the FO could interfere with transcutaneous needle placement into the FO or distort anatomic relationships during approaches to the cranial base.

Key-words:

Anatomic landmarks - foramen ovale - greater wing of the sphenoid - middle cranial fossa - skull base

Full Text

References

References
1 Reymond J, Charuta A, Wysocki J. The morphology and morphometry of the foramina of the greater wing of the human sphenoid bone. Folia Morphol (Warsz) 2005;64:188-93.
2 Emril DR, Ho KY. Treatment of trigeminal neuralgia: Role of radiofrequency ablation. J Pain Res 2010;3:249-54.
3 Tubbs RS, May WR Jr., Apaydin N, Shoja MM, Shokouhi G, Loukas M, et al. Ossification of ligaments near the foramen ovale: An anatomic study with potential clinical significance regarding transcutaneous approaches to the skull base. Neurosurgery 2009;65:60-4.
4 Freire AR, Rossi AC, Souza de Oliveria VC, Prado FB, Ferreira Caria PH, Botacin PR. Emissary foramens of the human skull: Anatomical characteristics and its relations with clinical neurosurgery. Int J Morphol 2013;31:287-92.
5 Gerber AM. Improved visualization of the foramen ovale for percutaneous approaches to the gasserian ganglion: Technical note. J Neurosurg 1994;80:156-9.
6 Osunwoke EA, Mbadugha CC, Orish CN, Oghenemavwe EL, Ukah CJ. A morphometric study of foramen ovale and foramen spinosum of the human sphenoid bone in the Southern Nigerian population. J Appl Biosci 2010;26:1631-5.
7 Di Ieva A, Bruner E, Haider T, Rodella LF, Lee JM, Cusimano MD, et al. Skull base embryology: A multidisciplinary review. Childs Nerv Syst 2014;30:991-1000.
8 Nemzek WR, Brodie HA, Hecht ST, Chong BW, Babcook CJ, Seibert JA. MR, CT, and plain film imaging of the developing skull base in fetal specimens. AJNR Am J Neuroradiol 2000;21:1699-706.
9 Padget DH. The development of the cranial venous system in man, from the viewpoint of comparative anatomy. Contrib Embryol 1957;36:79-140.
10 Wieser HG, Siegel AM. Analysis of foramen ovale electrode-recorded seizures and correlation with outcome following amygdalohippocampectomy. Epilepsia 1991;32:838-50.
11 Gözil R, Keskil S, Calgüner E, Tunç E, Kadioǧlu D, Sevim A, et al. Neurocranial morphology as determined by asymmetries of the skull base. J Anat 1996;189:673-5.
12 Sindou M, Chavez JM, Saint Pierre G, Jouvet A. Percutaneous biopsy of cavernous sinus tumors through the foramen ovale. Neurosurgery 1997;40:106-10.
13 Barakos JA, Dillon WP. Lesions of the foramen ovale: CT-guided fine-needle aspiration. Radiology 1992;182:573-5.
14 Kantola VE, McGarry GW, Rea PM. Endonasal, transmaxillary, transpterygoid approach to the foramen ovale: Radio-anatomical study of surgical feasibility. J Laryngol Otol 2013;127:1093-102.
15 Chimmalgi M, Kulkarni Y, Sant SM. Sexing of skull by new metrical parameters in west India. J Anat Soc India 2007;56:28-32.
16 Wadhwa A, Sharma M, Kaur P. Anatomic variations of foramen ovale – Clinical implications. Int J Basic Appl Med Sci 2012;2:21-4.
17 Lang J, Maier R, Schafhauser O. Postnatal enlargement of the foramina rotundum, ovale et spinosum and their topographical changes. Anat Anz 1984;156:351-87.
18 Arun SK. Some observations of the foramina ovale and spinosum of human sphenoid bone. J Anat Soc India 2006;55:100-1.