DOCSLIB.ORG

Intrusion of the Mandibular Condyle Into the Middle Cranial Fossa: Report of a Case in an 11-Year-Old Girl Stephen W

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Intrusion of the Mandibular Condyle Into the Middle Cranial Fossa: Report of a Case in an 11-Year-Old Girl Stephen W PEDIATRICDENTISTRY/Copyright © 1989 by The AmericanAcademy of Pediatric Dentistry Volume 11, Number1 Intrusion of the mandibular condyle into the middle cranial fossa: report of a case in an 11-year-old girl Stephen W. Paulette, DDS Raymond Trop, DDS Michael D. Webb, DDS MamounM. Nazif, DDS, MDS Abstract Intrusion of the headof the condyleinto the middlecranial reduction with removal of the condylar head from the fossa is a rare but highly significant result of traumato the middle cranial fossa and re-establishment of the origi- mandible.Various treatment modalities for this type o fin jury nal joint relationship was presented in the cases re- have been reported in the literature. This case report concerns ported by Zecha(1977), Kallal et al. (1977). Iannetti the intrusion of the left mandibularcondyle into the middle Martucci (1980), and Copenhaver et al. (1985). Docu- cra nial fossa in an 11-year-oldgirl. Five daysafter the original mented cases of intrusion of the mandibular condyle injury, severe limitation of opening was noted, as was a into the middle cranial fossa are summarized in the significant overjet and posterior openbite. A CTscan revealed Table. intrusion of the left condyle into the middle cranial fossa. Treatmentconsisted of closed reduction with intermaxillary Case Report fixation. At the l O-monthfollow-up, full range of motion was A white female, 11 years, 2 months old, fell from her possible with only minimal deviation. bicycle striking her chin on the pavement. No loss of consciousness occurred and she was evaluated and Facial fractures are uncommonin young children released from an outlying hospital the same day. Five and infants. This is due primarily to the larger cranial days later she was seen by her pediatrician because of vault and elasticity of developing bones. The most her inability to open her mouth. She was referred to the commonfractures are of the nasal bone followed by Dental Department of Children’s Hospital of Pitts- fractures of the mandible. The majority of the mandibu- burgh. lar fractures in children involve the condyle (Morgan Clinical examination revealed obvious facial asym- 1975). Despite this relatively frequent involvement of metry with deviation of the mandible to the left, a the condyles, penetration of the condylar head into the contusion on the right cheek, and a healing abrasion of middle cranial fossa is rare (Copenhaveret al. 1985). the chin. Routine laboratory tests were within normal The objective of this paper was to review the litera- range. Range of motion of the mandible was severely ture on intrusion of the mandibular condyle into the limited and maximuminterincisal opening was 5 ram. middle cranial fossa and to report a case in a pediatric Manual palpation of the orbits, maxilla, and mandible patient. was negative for fractures. Intraorally, a significant overjet of 15 mmwas noted Literature Review along with a right-side posterior open bite. Routine Various methods of treatment of intrusion of a radiographs were negative for fractures and TMJ to- mandibular condyle into the middle cranial fossa have mograms and a CT scan were requested which revealed been reported in the literature. Condylar osteotomy intrusion of the left mandibular condyle into the middle with the condylar head remaining in the middle cranial cranial fossa (Figs 1, 2 - page 70). Neurosurgical and fossa was the treatment of choice in the cases presented neuroradiological consultations were obtained on by Dingman and Grabb (1963), Peltier and Matthews admission. Utilizing the CT scan, the presence of a (1969), and Seymour and Irby (1976). Condylectomy meningeal perforation was considered unlikely al- either the craniotomy (Doane 1963; Stoltman 1965) though it could not be ruled out totally. standard TMJ approach (Whitacre 1966; Rowe and With the neurosurgical service on standby, the pa- Killey 1968) also has been reported. Closed or open tient was taken to the operating room on the seventh day 68 CONDYLAR INTRUSION INTO THE CRANIUM -- CASE REPORT: Paulette et al. after the accident. Under nasotracheal general anesthe- The patient was placed on a Polymyxin B-Neomy- sia, Erich arch bars were placed on both arches. A towel cin-Hydrocortisone otic suspension (Corisporin ® Otic clip was placed in the angle region of the mandible Suspension -- Burroughs Wellcome Co; Research Tri- extraorally and a second in the anterior region of the angle Park, NC). An audiogram was performed and the. mandibular arch bar. With traction on both towel clips, patient was noted to have a mild conductive hearing the left TMJ and left ramus of the mandible were pulled loss. Postoperative recovery was uneventful, and the inferiorly; and the fracture was reduced. At this point, patient was discharged on the fifth hospital day. the mandible was evaluated and there was full range of At the 10-month follow-up, full range of motion of motion vertically and transversely. Intermaxillary fixa- the mandible was possible in both the vertical and tion was accomplished with stainless steel wires and tranverse directions with only a slight deviation to the elastics. A minimal amount of bleeding from the left ear patient’s left (Fig 3, page 70). due to a small laceration of the anterior portion of the external auditory canal was observed. TABLE. Summary of Cases of Intrusion of Mandibular Condyle into the Middle Fossa Authors Age Sex Signs and Symptoms Diagnosis Method of Diagnosis Treat~nent* Dingman and 28 M Cerebral concussion Immediate Unknown Osteotomy Grabb (1963) Doane (1963) 13 F Amnesia, momentary 18 Days TMJradio- lntercranial unconsciousness graphs after condylectomy two unsuccess- ful attempts Stoltman (1965) 24 M Unconsciousness Several TMJradio- Craniotomy days graphs with condylectomy Stoltman (1965) 25 M Diminished Immediate TMJradio- Craniotomy hearing intrusion graphs with side condylectomy Peltier and 18 F Mild loss of func- 6 weeks Limitation of Osteotomy Matthews (1965) tion of zygomatic movement at and mandibular surgery branch of central nerve VII Whitacre (1966) 15 F Pain and limitation 10 days TMJ radiographs Reduction of mandibular with function condylectomy Pirok and 19 M Nausea 2 Months Limitation of No treatment Merrill (1970) movement Rowe and Killey 50 M Unconsciousness Immediate TMJ radiographs Condylectomy (1968) Seymour and 64 M Unconsciousness 2 days TMJ tomograms Osteotomy, Irby (1976) left side deafness prosthetic glenoid fossa Zecha (1977) 25 F Limitation of Immediate TMJ radiographs Closed mandibular function reduction Kallal, Gans and 15 F Limitation of Immediate TMJ tomograms Closed Lagrotteria (1977) mandibular function reduction Iannetti and 38 M Pain and limitation Immediate TMJ radiographs Open reduc- Martucci (1980) of mandibular function tion menisectomy prosthetic fossa Copenhaver et al. 9 F Pain and 2 days TMJ tomograms Closed (1985) limitation CT scan reduction of mandibular function Paulette, et al. 11 F Limitation of 5 days TMJ tomograms Closed (1988) mandibular CT scan reduction function * For the purpose of this chart the following terms are used: Osteotomy: surgical separation of the condylar neck from the head without removal of the condyle; and Condylectomy: removal of the condyle. Pediatric Dentistry: March, 1989 - Volume 11, Number 1 69 Discussion instead of the typical scroll shape. Due to the regional anatomy of the mandible and the The middle meningeal artery is located in the floor of cranial base, it is extremely rare for the mandible to the middle cranial fossa in close proximity of the area of receive trauma of significant magnitude and proper the penetration. This points out a need for neurosurgical angulation to cause intrusion of the condyle into the evaluation for a possible epidural hematoma and signi- middle cranial fossa. fies the importance of CT scans in early diagnosis. The lateral aspect of the floor of the middle cranial Utilizing routine radiographs, it is often difficult to fossa is reinforced by the zygomatic process of the suspect intrusion of a condyle into the middle cranial squama, but the floor overlying the medial aspect of the fossa. This is especially true if additional fractures are condyle is thin. Trauma to the mandible usually comes present to account for the malocclusion. When detailed from a frontal or lateral direction, which most often directs the condyles against the dense posterior slope of the glenoid fossa. This results in fracture of the narrow, relatively weak neck of the condyle. Assuming that the trauma was directed in an upward and more posterior position, at the angle of the mandible, dental occlusion becomes a factor limiting the distance that the mandible can travel in a vertical direction unless the mouth was opened at the time of the accident. Normal anatomical form of the mandibular condyle varies considerably. Yale (1969) and Klein (1970) con- sidered in detail the variable shapes and angulations of the mandibular condyles. Whitacre (1966) pointed out that the infrequency of this type of dislocation may point toward a structural variance. Examination of the condyle in this case reveals it to be small and oval FIG 2. CT scan illustrating intrusion of the left condyle into the middle cranial fossa. FIG 1. Tomogram of left condyle revealing intrusion into FIG 3. The patient at 10-month follow-up with slight the middle cranial fossa. deviation to the left on opening. 70 CONDYLAR INTRUSION INTO THE CRANIUM — CASE REPORT: Paulette et al. TMJ radiographs, tomograms, and CT scans are util- Copenhaver RH, Dennis MJ, Kloppedal E, Edwards DB, Scheffer RB: Fracture of the glenoid fossa and dislocation of the mandibular ized, intrusion of the condyle into the middle cranial condyle into the middle cranial fossa. I Oral Maxillofac Surg fossa can be diagnosed with greater efficiency. CTscans 43:974-77, 1985. are recognized as the modality of choice for evaluation of head trauma (Tsai 1978). It offers direct and accurate Dingman RO, Grabb WC:Mandibular laterognathism. Plast Recon- soft tissue imaging of the brain which facilitates evalu- str Surg 31:563-75, 1963.
Load more

Recommended publications
  • The Normal Dimensions of the Sella Turcica in North Karnataka Region- a Computed Tomographic Study Lohit V Shaha*, Babasaheb G Patil**, Sanjeev I Kolagi***
    Original Article Pravara Med Rev 2018;10(3) The normal dimensions of the Sella Turcica in North Karnataka region- A Computed tomographic study Lohit V Shaha*, Babasaheb G Patil**, Sanjeev I Kolagi*** Abstract Aim of the study: Sella turcica is an important structure in middle cranial fossa. It is a saddle shaped concavity in the body of sphenoid bone. It is bounded by dura of cavernous sinuses bilaterally, the lamina dura and dorsum sellae posteriorly and the tuberculum sellae and planum sphenoidale anteriorly. The present study was undertaken to study the normal dimensions of sella turcica morphometry. Material and methods: This observational study was conducted in S Nijalingappa medical college and HSK hospital, Bagalkot. 1650 computed tomographic images of healthy Indians aged 21-70 years were collected. Radiant Dicom viewer software was used to determine the linear dimensions of sella turcica. Data was analysed using t test and ANOVA with Epi Info software. Results: The mean values (in millimeter) of length, width and height of sella turcica in different age groups was 8.80 ± 1.65, 10.83 ± 1.35 and 8.52 ± 1.50. Conclusion: The dimensions of sella turcica vary in different populations and these findings could form an initial database for Indian population which may provide a good anatomical knowledge during objective evaluation and detection of pathological conditions of sella turcica and hypophysis cerebri. Key words: Sphenoid bone, Linear dimensions, Hypophysis cerebri Introduction Sella turcica is an important structure in middle cranial fossa. It is safe treatment of various pituitary disorders such as a saddle shaped concavity in the body of sphenoid bone.
    [Show full text]
  • Perinate and Eggs of a Giant Caenagnathid Dinosaur from the Late Cretaceous of Central China
    ARTICLE Received 29 Jul 2016 | Accepted 15 Feb 2017 | Published 9 May 2017 DOI: 10.1038/ncomms14952 OPEN Perinate and eggs of a giant caenagnathid dinosaur from the Late Cretaceous of central China Hanyong Pu1, Darla K. Zelenitsky2, Junchang Lu¨3, Philip J. Currie4, Kenneth Carpenter5,LiXu1, Eva B. Koppelhus4, Songhai Jia1, Le Xiao1, Huali Chuang1, Tianran Li1, Martin Kundra´t6 & Caizhi Shen3 The abundance of dinosaur eggs in Upper Cretaceous strata of Henan Province, China led to the collection and export of countless such fossils. One of these specimens, recently repatriated to China, is a partial clutch of large dinosaur eggs (Macroelongatoolithus) with a closely associated small theropod skeleton. Here we identify the specimen as an embryo and eggs of a new, large caenagnathid oviraptorosaur, Beibeilong sinensis. This specimen is the first known association between skeletal remains and eggs of caenagnathids. Caenagnathids and oviraptorids share similarities in their eggs and clutches, although the eggs of Beibeilong are significantly larger than those of oviraptorids and indicate an adult body size comparable to a gigantic caenagnathid. An abundance of Macroelongatoolithus eggs reported from Asia and North America contrasts with the dearth of giant caenagnathid skeletal remains. Regardless, the large caenagnathid-Macroelongatoolithus association revealed here suggests these dinosaurs were relatively common during the early Late Cretaceous. 1 Henan Geological Museum, Zhengzhou 450016, China. 2 Department of Geoscience, University of Calgary, Calgary, Alberta, Canada T2N 1N4. 3 Institute of Geology, Chinese Academy of Geological Sciences, Beijing 100037, China. 4 Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada T6G 2E9. 5 Prehistoric Museum, Utah State University, 155 East Main Street, Price, Utah 84501, USA.
    [Show full text]
  • GLOSSARY of MEDICAL and ANATOMICAL TERMS
    GLOSSARY of MEDICAL and ANATOMICAL TERMS Abbreviations: • A. Arabic • abb. = abbreviation • c. circa = about • F. French • adj. adjective • G. Greek • Ge. German • cf. compare • L. Latin • dim. = diminutive • OF. Old French • ( ) plural form in brackets A-band abb. of anisotropic band G. anisos = unequal + tropos = turning; meaning having not equal properties in every direction; transverse bands in living skeletal muscle which rotate the plane of polarised light, cf. I-band. Abbé, Ernst. 1840-1905. German physicist; mathematical analysis of optics as a basis for constructing better microscopes; devised oil immersion lens; Abbé condenser. absorption L. absorbere = to suck up. acervulus L. = sand, gritty; brain sand (cf. psammoma body). acetylcholine an ester of choline found in many tissue, synapses & neuromuscular junctions, where it is a neural transmitter. acetylcholinesterase enzyme at motor end-plate responsible for rapid destruction of acetylcholine, a neurotransmitter. acidophilic adj. L. acidus = sour + G. philein = to love; affinity for an acidic dye, such as eosin staining cytoplasmic proteins. acinus (-i) L. = a juicy berry, a grape; applied to small, rounded terminal secretory units of compound exocrine glands that have a small lumen (adj. acinar). acrosome G. akron = extremity + soma = body; head of spermatozoon. actin polymer protein filament found in the intracellular cytoskeleton, particularly in the thin (I-) bands of striated muscle. adenohypophysis G. ade = an acorn + hypophyses = an undergrowth; anterior lobe of hypophysis (cf. pituitary). adenoid G. " + -oeides = in form of; in the form of a gland, glandular; the pharyngeal tonsil. adipocyte L. adeps = fat (of an animal) + G. kytos = a container; cells responsible for storage and metabolism of lipids, found in white fat and brown fat.
    [Show full text]
  • Median Occipital Fossa: Is It Really a Sign of Crime Or Simply an Anatomical Variant?
    IJAE Vol. 124, n. 1: 104-106, 2019 ITALIAN JOURNAL OF ANATOMY AND EMBRYOLOGY Letter - Basic and Applied Anatomy Median occipital fossa: is it really a sign of crime or simply an anatomical variant? Domenico Chirchiglia1,*, Pasquale Chirchiglia1, Rosa Marotta2 Departments of 1Neurosurgery and 2Health Sciences, University Of Catanzaro, Italy Abstract Anatomical variants are alterations of the form, thickness, length, width, position of organs and anatomic structures that can cause problems of a functional nature. They can be vascular, bony, muscular and more. They represent anomalies that may cause disturbances or do not cause changes in functions. The criminologist Cesare Lombroso had correlated the anatomical varia- tions to the criminal tendency. The most emblematic case was that related to the alleged brig- and Villella, on which Lombroso, performing the autopsy, found in the skull the so-called medi- al occipital fossa or a third dimple. He stated that the median occipital dimple was considered a sign of atavism, the expression of the criminal. In fact all the anatomical variants described by Lombroso are variations of normality. No one ever said that anatomical variants were a sign of crime. In conclusion, anatomical variants cannot be related to crime tendency, therefore the debated median occipital fossa is only and simply an anatomical variant. Key words Anatomy, anatomical variants, median occipital fossa, Cesare Lombroso. Dear Editor, The occipital bone is the main bone of the occiput, lower part of the skull. It is trapezoidal in shape and overlies the occipital lobes of the cerebrum. The base of the skull in the occipital bone contains the foramen magnum, which allows the passage of the spinal cord.
    [Show full text]
  • Morphological (Length, Depth, and Diameter) Study of Sella Turcica In
    Original Article Morphological (Length, Depth, and Diameter) Study of Sella Turcica in Different Mandibular Growth Patterns in Indians Siddhartha Kaustav Konwar1, Anshul Singhla1, Rimlee Bayan2 Department of Orthodontics, I.T.S. Dental College Hospital and Research Centre, Greater Noida, Uttar Pradesh, India ABSTRACT Aim: This study aims to analyze the morphological dimensions of sella turcica to determine if differences exist due to gender, age or in subjects with different skeletal patterns. Methods: A total of 100 (43 males and 57 females) sella turcica cephalometric radiograph was traced. Linear dimensions of sella turcica (length, depth, and diameter [in mm]) were measured and skeletal shape/type (normal, bridging, double contour, oblique, irregular, and pyramidal) was assessed. A Student’s t-test was used to calculate the mean differences in linear dimensions of sella turcica between males and females and between different age groups, skeletal types. A Chi-square test was used to test the interrelationship of gender, age and skeletal types with the shape of sella turcica. Results: In low angle group subjects, 80% of the subjects had normal sella and 20% of the subjects had variations in morphology and in high angle group subjects, 76% of the subjects had a normal sella, and 24% of the subjects had variations in the morphology. Conclusions: The shape of the sella turcica was normal in 78% of the subjects, and there was a significant difference in length between high and low angle subjects, where the length of sella was larger in the low angle subjects and the distribution of shape of sella turcica was found to be significantly different among both high and low angle types.
    [Show full text]
  • A New Morphometric Method for the Sella Turcica and the Hypophyseal Fossa and Its Clinical Relevance
    Folia Morphol. Vol. 64, No. 4, pp. 240–247 Copyright © 2005 Via Medica O R I G I N A L A R T I C L E ISSN 0015–5659 www.fm.viamedica.pl A new morphometric method for the sella turcica and the hypophyseal fossa and its clinical relevance Dionyssios Venieratos1, Sophia Anagnostopoulou1, Anna Garidou2 1Department of Anatomy, Medical School, University of Athens, Greece 2Endocrinology Unit, Leof. Pentelis 13, 152 33 Halandri, Greece [Received 22 June 2005; Revised 27 September 2005, Accepted 27 September] The sella turcica and the hypophyseal fossa should be considered different enti- ties, the latter being part of the former. Their morphology and dimensions cor- relate to some extent with those of the contained pituitary gland and have, for this reason, attracted the interest of anatomists and radiologists. With the appli- cation of MRI, however, these data are of limited use in the diagnosis of pitu- itary disorders, although they remain valuable with regard to a microsurgical approach to the hypophysis. The proposed morphometric method was applied to 20 dry skulls. We first made casts of the corresponding sellae. Their volumes were then measured by immersion. The frontal section of each hypophyseal fossa was obtained through its deepest point and magnified. The Cartesian co-ordinates of the contour of the section were used to evaluate the corresponding area and centroid. The volume of each fossa was finally obtained by the use of Pappus’ theorem applied to solids of rotation. The volumes of the sellae obtained as above ranged from 460 mm3 to 1570 mm3 with a mean value of 835 mm3.
    [Show full text]
  • Manual Lymph Drainage (MLD) (Vodder Technique)
    MLD Worksheet 1 Manual Lymph Drainage (MLD) (Vodder Technique) Worksheets for Klose Training & Consulting, LLC Lymphedema Certification Course Objective: To provide a step by step, easy to follow guide for learning MLD techniques and sequences required to treat unilateral, medically uncomplicated lymphedema of the upper and lower extremities. © Klose Training & Consulting, LLC 2015 MLD Worksheet 2 © Klose Training & Consulting, LLC 2015 MLD Worksheet 3 Overview MLD Treatment Sequence for Unilateral, Secondary Lymphedema of the Upper Extremity (UE) This example describes a patient with left UE lymphedema caused by modified radical mastectomy with removal and/or radiation of the axillary lymph nodes. Objective: To provide an introduction of the steps needed to treat unilateral, secondary, medically uncomplicated lymphedema of the upper extremity. Each step will be described in detail on the following pages. Neck and abdominal treatment 1. Perform neck sequence 2. Perform abdominal and deep abdominal sequences Trunk preparation with patient in supine 3. Treat axillary lymph nodes with stationary circles on unaffected side 4. Perform chest sequence on unaffected side 5. Open‐up sagittal watershed area across sternum 6. Establish anastomoses pathways by moving lymph fluid from affected to unaffected side (anterior axillo‐axillary anastomoses) 7. Prepare inguinal lymph nodes on affected side 8. Open‐up transverse watershed and lateral trunk with stationary circles 9. Establish anastomoses by moving lymph fluid from affected axilla region (lateral chest) to inguinal lymph nodes (axillo‐inguinal anastomoses) 10. If indicated: treat intercostal and parasternal pathways on affected side 11. Alternate steps 6 and 9 ‐ following “L” pattern (re‐working axillo‐axillary and axillo‐inguinal anastomoses) Continue trunk preparation with patient in prone (if not possible, in sidelying) 12.
    [Show full text]
  • Skull – Communication
    Multimedial Unit of Dept. of Anatomy JU Anterior cranial fossa The floor: ● Cribriform plate of ethmoid ● Orbital parts of frontal ● Lesser wings of sphenoid ● Body of sphenoid – anterior to prechiasmatic sulcus Contents: ● Frontal lobes of brain ● Olfactory bulbs ● Olfactory tracts ● Anterior meningeal vessels (from anterior ethmoid) Communication: 1. Through cribriform plate of ethmoid with the nasal cavity Contents: ● Olfactory fila ● Anterior athmoidal vessels and nerves 2. Through foramen cecum with the nasal cavity ● Extension of dura mater ● Small vein connecting veins of nasal cavity and superior sagittal sinus Middle cranial fossa It consists of the central (body of sphenoid) and two lateral parts. Lateral parts consist of: ● Greater wing of sphenoid ● Squamous parts of temporal ● Anterior surfaces of pyramids of temporal The border between the anterior and middle cranial fossa ● Posterior margins of lesser wings of sphenoid ● Sphenoidal limbus The border between the middle and posterior cranial fossae: ● Superior margins of the petrous parts of temporal ● Dorsum sellae Contents: Central part ● Interbrain ● Intercavernous sinuses Lateral part ● Temporal lobes of brain ● Cavernous sinus ● Cranial nerves II – VI ● Internal carotid arteries ● Middle meningeal vessels ● Greater and lesser petrosal nerves Cavernous sinus Contents: ● Internal carotid artery ● Cavernous plexus ● Abducens nerve ● Lateral wall of cavernous sinus contains: ● Oculomotor nerve ● Trochlear nerve ● Ophthalmic nerve ● Maxillary nerve Communication of middle cranial fossa: 1. Through superior orbital fissure with the orbit Contents: ● Oculomotor nerve ● Trochlear nerve ● Ophthalmic nerve ● Abducens nerve ● Sympathetic postganglionic axons of the cavernous plexus ● Superior ophthalmic vein ● Superior branch of the inferior ophthalmic vein ● Ramus of middle meningeal artery 2. Optic canal – with orbit ● Optic nerve ● Ophthalmic artery 3.
    [Show full text]
  • Skull. Sphenoid and Ethmoid Bones
    Skull. Sphenoid and Ethmoid bones PhD., Dr. David Lendvai Department of Anatomy, Histology and Embriology Semmelweis University, Faculty of Medicine 2018. Skeletal system Structure of the skull Border between viscerocrainum and neurocranium Calvaria Main parts of the skull •Constitute by 22 bones: •neurocranium (8) – UNPAIRED: frontal, occipital, sphenoid, ethmoid bones PAIRED: temporal, parietal bones •viscerocranium (14) -UNPAIRED: mandibule, vomer. PAIRED: nasal, maxilla, zygomatic, lacrimal, palatine, inferior nasal concha Their role – formation of cavities, protect viscera, voice formation, initial portions of the gastrointerstinal and respiratory systems, insertion of muscles (mascication, head movements) Cavities: - Cranial cavity, - Nasal cavity, - Paranasal sinuses - Oral cavity, - Orbit, - (Tympanic cavity, Inner ear) Connections between cranial bones • Synchondrosis, synostosis (cartilagineal and bony connections) • Sutures – Coronal – Sagittal – Lambdoid Calvaria and the base of the skull Calvaria External aspect of the calvaria Base of the skull Internal aspect of the calvaria Fossae cranii Anterior cranial fossa MIddle cranial fossa Posterior cranial fossa • Posterior cranial fossa: • Anterior cranial fossa: • Occipital, temporal bones, frontal, ethmoid, lesser wings parietal bones of sphenoid • Middle cranial fossa: sphenoid, temporal bones, parietal bones Bones of the neurocranium Parietal bone Frontal bone Temporal bone Ethmoid Sphenoid Sphenoid bone Braus Part of the external skull base (- body (Corpus), pterygoid process,
    [Show full text]
  • Anatomic Moment: Osseous Anatomy of the Pterygopalatine Fossa
    Anatomic Moment Osseous Anatomy of the Pterygopalatine Fossa David L. Daniels, Leighton P. Mark, John L. Ulmer, Mahmood F. Mafee, Jim McDaniel, Nirav C. Shah, Scott Erickson, Lowell A. Sether, and Safwan S. Jaradeh The pterygopalatine fossa (PPF) represents a major dicular plate is variably contoured and fuses with the pathway of spread of malignancy and infection from medial surface of the medial pterygoid plate (Fig 3). the head and neck into the skull base. The ability to At the upper part of the perpendicular plate, pro- precisely locate tumor and infection on CT and MR cesses are present that fuse with the maxillary and imaging studies is crucial for performing biopsies and sphenoid bones. The orbital process extends supero- planning treatment. laterally to attach to the posterior margin of the Determining the exact margins of the PPF is prob- orbital surface of the maxillary bone and partly to the lematic, because they are not strictly defined even in inferior surface of the body of the sphenoid bone the anatomic literature. The obliquely oriented upper (Figs 3A and B, and 5B and C). The sphenoidal part of the perpendicular plate of the palatine bone process extends superomedially to attach to the base and the pterygoid process form a small pyramidal- of the medial pterygoid plate (Figs 3A and B, and 4B shaped fossa that probably was called the PPF be- and E). At the junction of the perpendicular and cause it contains the pterygopalatine ganglion (1) (Fig horizontal plates, the pyramidal process attaches to 1B and C). However, axial CT studies define a larger the maxillary bone and extends posterolaterally to fossa, which incorporates the pyramidal-shaped fossa attach to the angled inferior margins of the pterygoid and has its posterolateral margin at the lateral edges plates (Figs 2A; 4B, C, and E; and 5B and C).
    [Show full text]
  • Morphometric Analysis of Sella Turcica and Its
    International Journal of Dental and Health Sciences Original Article Volume 04,Issue 01 MORPHOMETRIC ANALYSIS OF SELLA TURCICA AND ITS CLINICAL SIGNIFICANCE Priya Damodaran1, Yuvaraj.M2, Priyadarshini.A3, Sankaran.P.K4, Kalaiarasi.P5, Madhu Radhakrishnan6 1. Student, Compulsory Rotarory Residential Internship, Ragas dental college and hospital, Tamil nadu 2. Tutor, Department of Anatomy, Saveetha medical college and hospital, Thandalam, Tamil nadu 3. Tutor, Department of Anatomy, Saveetha medical college and hospital, Thandalam, Tamil nadu 4. Associate professor, Department of Anatomy, Saveetha medical college and hospital, Thandalam, Tamil nadu 5. Student, Compulsory Rotarory Residential Internship, Ragas dental college and hospital, Tamil nadu 6. Student, Compulsory Rotarory Residential Internship, Ragas dental college and hospital, Tamil nadu ABSTRACT: Sella turcica is an important and commonly used cranial landmark in many ventures. This work aims to measure and study sella turcica size and shape variations which is important for neurologists and neurosurgeons to avoid any damage to the sellar region and in identifying any pathological signs involving pituitary gland. The study was done with 102 dried human skulls where the gender of the skulls was not taken into consideration. The study was mainly concentrated to analyze the parameters of sella turcica. The average of sella turcica length, breadth and depth were calculated to be 10.59mm, 10.76mm and 9.23mm respectively. Most commonly found shape of sella turcica is normal (56.8%). These observations are essential in providing reference standard values. Keywords: Sella turcica, Sella size, Sella shape, Hypophyseal fossa INTRODUCTION The Sella turcica, a saddle shaped chiasma, inferiorly by sphenoid sinus, depression, is an important bony entity medially by cavernous sinus, oculomotor which is located in the body of the nerve, trochlear nerve, abducent nerve, sphenoid bone of the middle cranial ophthalmic nerve, maxillary nerve, fossa and is bounded by the two anterior internal carotid artery.
    [Show full text]
  • Connections of the Skull Made By: Dr
    Connections of the skull Made by: dr. Károly Altdorfer Revised by: dr. György Somogyi Semmelweis University Medical School - Department of Anatomy, Histology and Embryology, Budapest, 2002-2005 ¡ © ¡ © ¡ ¡ ¡ § § § § § § § § § ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¦ ¢ £ ¤ ¥ ¥ ¢ £ ¤ ¥ ¨ ¤ ¢ ¤ ¥ ¨ ¢ ¨ ¢ ¢ ¤ ¥ ¨ ¥ ¢ £ ¥ ¥ ¢ £ £ ¤ ¥ ¥ ¢ £ ¢ ¥ ¨ ¥ ¤ ¥ ¨ £ ¢ ¢ ¢ ¤ ¥ ¢ ¢ # " 4 4 + 3 9 : 4 5 + + 3 4 + + 1 3 6 6 6 6 ! ) ) ) ) ) ) ) ) ) ) ) % / 0 7 , / 0 , % , ( ( % & ( % ( & , ( % / 0 , / 0 7 , ( , % / % ( ( & , % % , ( & % % . % / % 0 , 0 0 , ' * $ ' ' * 8 $ ' * ' - 2 $ = < ; ? @ > B A Nasal cavity 1) Common nasal meatus From where (to where) Contents Cribriform plate Anterior cranial fossa Olfactory nerves (I. n.) and foramina Anterior ethmoidal a. and n. Piriform aperture face Incisive canal Oral cavity Nasopalatine a. "Y"-shaped canal Nasopalatine n. (of Scarpa) (from V/2 n.) Sphenopalatine foramen Pterygopalatine fossa Superior posterior nasal nerves (from V/2 n.) or pterygopalatine foramen Sphenopalatine a. Choana - nasopharynx - Aperture of sphenoid sinus Sphenoid sinus -- ventillation (paranasal sinus!) in the sphenoethmoidal recess 2) Superior nasal meatus Posterior ethmoidal air cells (sinuses) -- ventillation (paranasal sinuses!) 3) Middle nasal meatus Anterior and middle ethmoidal air cells -- ventillation (paranasal sinuses!) (sinuses) Semilunar hiatus (Between ethmoid bulla and uncinate process) • Anteriorly: Ethmoidal infundibulum Frontal sinus -- ventillation (paranasal sinus!) • Behind: Aperture of maxillary sinus
    [Show full text]