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Home , Carotid canal, Foramen ovale (skull), Foramen spinosum

Research Article

The morphometric study of occurrence and variations of S. Ajrish George*, M. S. Thenmozhi

ABSTRACT

Background: Foramen vale is one of the important foramina present in the sphenoid . Anatomically it is located in the greater wing of the . The foramen ovale is situated posterolateral to the and anteromedial to the . The foramen spinosum is present posterior to the foramen ovale. The carotid is present posterior and medial to the foramen spinosum and the foramen rotundum is present anterior to the foramen ovale. The structures which pass through the foramen ovale are the , emissary vein, accessory , and lesser petrosal nerve. The sphenoid bone has a body, a pair of greater wing, pair of lesser wing, pair of lateral pterygoid plate, and a pair of medial pterygoid plate. Aim: The study involves the assessment of any additional features in foramen ovale in dry South Indian . Materials and Methods: This study involves examination of dry adult skulls. First, the foramen ovale is located, and then it is carefully examined for presence of alterations and additional features, and is recorded following computing the data and analyzing it. Results: The maximum length of foramen ovale on the right and left was 10.1 mm, 4.3 mm, respectively. The minimum length of the foramen in right and left was 9.1 mm, 3.2 mm, respectively. The maximum width of foramen ovale on the right and left was 4.8 mm and 2.3 mm, respectively. The minimum width of the foramen in the right and the left side was 5.7 mm and 2.9 mm, respectively. Conclusion: Hence, the anatomic variations should be assessed before any process as variation found in the present study. KEY WORDS: Foramen ovale, Morphometrics, Variations

INTRODUCTION mandibular nerve is surrounded by cartilage to form the foramen ovale.[5] The foramen ovale is observed in Foramen ovale is one of the important foramina present the 7th fetal month as a discrete ring-shaped area and in the sphenoid bone. Anatomically it is located in the is prominently visible even 3 years after birth. The infratemporal surface of the greater wing of the sphenoid foramen ovale connects the to the bone. The foramen ovale is situated posterolateral to through the .[6] In this the foramen rotundum and anteromedial to foramen study, the symmetrical variation of the foramen ovale [1] spinosum. The foramen spinosum is present posterior is concentrated. to the foramen ovale. The is present posterior and medial to the foramen spinosum, and the MATERIALS AND METHODS foramen rotundum is present anterior to the foramen ovale. The structures which pass through the foramen This study involves examination of dry adult skulls. ovale are the mandibular nerve, emissary vein, accessory The skulls were obtained from the Department of middle meningeal artery, and lesser petrosal nerve.[2] The Anatomy, Saveetha Dental College and Hospitals, sphenoid bone has a body, a pair of greater wing, pair Chennai, Tamil Nadu, India. Skulls in poor condition of lesser wing, pair of lateral pterygoid plate, and a pair or with partially damaged surroundings were not of medial pterygoid plate.[3] During the development considered. Measurements of the foramina ovale were of the greater wing of sphenoid is associated with the done by placing a pair of dividers on the anteroposterior postsphenoid space.[4] The greater wing of the sphenoid (length) and transverse (width) diameters of the is formed by endochondral ossification in which the foramen, and then carefully transferred to a meter rule for the readings to be taken. In addition to this, the Access this article online symmetry of both foramina present in the right and the left sides was also compared carefully. All the Website: jprsolutions.info ISSN: 0975-7619 measurements were recorded in millimeters.

Department of Anatomy, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India

*Corresponding author: S. Ajrish George, Department of Anatomy, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India. E-mail: [email protected]

Received on: 15-06-2019; Revised on: 20-07-2019; Accepted on: 24-08-2019

98 Drug Invention Today | Vol 12 • Special Issue 1 • 2019 S. Ajrish George and M. S. Thenmozhi

RESULTS in the easy access of the thus helps to anesthetize the mandibular nerve.[8] Foramen ovale The study was conducted on a total of 60 sides in 30 dry plays a vital role in procedures such as percutaneous adult skulls. The maximum length of foramen ovale on biopsy of tumors of the cavernous sinus,[9] percutaneous the right and left was 10.1 mm and 4.3 mm, respectively. trigeminal rhizotomy for trigeminal neuralgia The minimum length of the foramen in the right and left due to easy access of the gasserian ganglion,[10,11] was 9.1 mm and 3.2 mm, respectively. The mean length and electroencephalic analysis of the seizure for of foramen ovale on the right was 6.773 ± 1.652 mm selective amygdalohippocampectomy patients.[10] The and on the left was 5.744 ± 1.791 mm [Chart 1]. The dimensions of the forman ovale are used to assess the maximum width of foramen ovale on the right and left base symmetries.[12] The mean length of foramen was 4.8 mm and 2.3 mm, respectively. The minimum ovale on the right was 6.773 ± 1.652 mm and on the left width of the foramen in the right and the left sides was was 5.744 ± 1.791 mm. The results are in agreement 5.7 mm and 2.9 mm, respectively. The mean width of with a study conducted by Biswabina Ray et al. on 70 foramen ovale on the right was 3.56 ± 0.737 mm and on sides if 35 human dry skulls in their study. The mean the left was 4.28 ± 0.833 mm [Chart 2]. About 13.33% length of foramen ovale was 7.46 ± 1.41 mm on the of symmetry was observed [Chart 3]. right side and 7.01 ± 1.41 mm on the left side.[13] The mean length of foramen ovale was 6.60mm and 6.26 DISCUSSION mm on the right and left sides in a study conducted in Loni, Maharashtra. In the study done in mangalore, The foramen ovale plays a very important role in various 82 skulls were selected and the mean length of the surgical as well as diagnostic procedures. [7] It helps Foramen study the mean length of foramen ovale was 7.46 ± 1.41 mm on right side 7.01 ± 1.41 mm on left side.[14,15] In this study, the maximum and minimum lengths of foramen ovale on the right and left was 10.1 mm, 4.3 mm and 9.1 mm, 3.2 mm, respectively. This value falls in agreement with the values obtained by the research carried out by Arun (2006) in Nepal, in which the maximal length of foramina ovale of 25 unknown adult human skulls was 9.8 mm, and the minimal length was 2.9 mm.[16] In a developmental Chart 1: Length study conducted in Japan, an average maximal length of foramen ovale was 7.48 mm, and average minimal length was 4.17 mm. In Lang study, the length was 7.2 mm.[17] Landl study reported 6.9 mm on right side and 6.8 mm on left side.[18] The mean width of foramen ovale on the right was 3.56 0.737 mm and on the left was 4.28 ± 0.833 mm. Average width on the right side was 3.4 mm and 3.8 mm on the left side was reported in a study conducted by fluoroscopically assisted laser targeting of foramen ovale in New York.[19] The maximum and minimum width of foramen ovale on the right and left was 4.8 mm, 2.3 mm and 5.7 mm, Chart 2: Width 2.9 mm, respectively. In a study conducted by Gupta, the maximum width of foramen ovale was 5.0 mm on both right and left sides, whereas minimum width

Chart 3: Symmetry

Drug Invention Today | Vol 12 • Special Issue 1 • 2019 99 S. Ajrish George and M. S. Thenmozhi was 1.0 mm on right side and 2.2 mm on left side.[19] Krishnamurthy A, Murlimanju BV, et al. A morphometric study Symmetry was observed 13.33% of the skulls. of foramen ovale. Turk Neurosurg 2011;21:378-83. 9. Sindou M, Chavez JM, Saint Pierre G, Jouvet A. Percutaneous biopsy of cavernous sinus tumors through the foramen ovale. CONCLUSION Neurosurgery 1997;40:106-10. 10. Wieser HG, Siegel AM. Analysis of foramen ovale electrode- Hence, foramen ovale has differing dimensions and recorded seizures and correlation with outcome following symmetry which has various clinical, surgical, and amygdalohippocampectomy. Epilepsia 1991;32:838-50. 11. Gusmão S, Oliveira M, Tazinaffo U, Honey CR. Percutaneous anatomical importance. This study is of significance trigeminal nerve radiofrequency rhizotomy guided by for the medical practitioners in cases of trigeminal computerized tomography fluoroscopy. Technical note. neuralgia, diagnostic detection of tumors, and J Neurosurg 2003;99:785-6. 12. Gözil R, Keskil S, Calgüner E, Tunç E, Kadioğlu D, Sevim A, abnormal bony outgrowths causing ischemia and et al. Neurocranial morphology as determined by asymmetries necrosis. of the skull base. J Anat 1996;189 (Pt 3):673-5. 13. Ray B, Gupta N, Ghose S. Anatomic variations of foramen ovale. Kathmandu Univ Med J (KUMJ) 2005;3:64-8. REFERENCES 14. Shaw JP. Pterygospinous and pterygoalar foramen: A role in the 1. Osunwoke EA, Mbadugha CC, Orish CN, Oghenemavwe EL, etiology of Trigeminal Neuralgia? Clin Anat 1993;6:173-8. Ukah CJ. A morphometric study of foramen ovale and foramen 15. Daimi SR, Siddiqui AU, Gill SS. Analysis of foramen ovale spinosum of the human sphenoid bone in the Southern Nigerian with special emphasis on pterygoalar bar and pterygoalar foramen. Folia Morphol (Warsz) 2011;70:149-53. population. J Appl Biosci 2010;26:1631-5. 16. Wadhwa A, Sharma M, Kaur P. Anatomic variations of 2. Lang J. Skull Base and Related Structures. Atlas of Clinical foramen ovale – clinical implications. Int J Basic Appl Med Sci Anatomy. Stutgart, New York: Shattauer; 1995. 2012;2:21-4. 3. Richard LD, Wayne V, Tibbitts RM, Mitchell AW, Paul RR. 17. Lang J, Maier R, Schafhauser O. Postnatal enlargement of the Gray’s Anatomy for Students. Philadelphia, PA: Elsevier/ foramina rotundum, ovale et spinosum and their topographical Churchill Livingstone; 2005. changes. Anat Anz 1984;156:351-87. Daimi SR, Siddiqui AU, 4. Bekov DB. Atlas Venoznoi Sistemy Golovnogo Mozga Gill SS. Analysis of foramen ovale with special emphasis Tscheloveka. Moskwa: Medicina; 1965. on pterygoalar bar and pterygoalar foramen. Folia Morphol 5. Williams PL, Bannister LH, Berry MM, Collin P, Dyson M, (Warsz) 2011;70:149-53. th Dussek JE, et al. Gray’s Anatomy. 38 ed. New York: Churchill 18. Patel R, Mehta CD. Morphometry of foramen ovale at base of Livingstone. skull in Gujarat. IOSR J Dent Med Sci 2014;13:26-30. 6. Murugan M, Saheb SH. Morphometric and morphological 19. Bochenek A, Reicher M. Anatomia Człowieka. 6th ed., Vol. 3. study on foramen ovale. Int J Anat Res 2014;2:664-7. Warszawa: PZWL; 1993. 7. Yanagi S. Developmental studies on the foramen rotundum, foramen ovale and foramen spinosum of the human sphenoid bone. Hokkaido Igaku Zasshi 1987;62:485-96. Source of support: Nil; Conflict of interest: None Declared 8. Somesh MS, Sridevi HB, Prabhu LV, Swamy MS,

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