Folia Morphol. Vol. 70, No. 4, pp. 263–271 Copyright © 2011 Via Medica O R I G I N A L A R T I C L E ISSN 0015–5659 www.fm.viamedica.pl Anatomical variances and dimensions of the superior orbital fissure and foramen ovale in adults F. Burdan1, 2, W. Umławska3, W. Dworzański1, R. Klepacz4, J. Szumiło4, E. Starosławska2, A. Drop5 1Department of Human Anatomy, Medical University of Lublin, Lublin, Poland 2St. John’s Cancer Center, Lublin, Poland 3Department of Anthropology, University of Wroclaw, Wroclaw, Poland 4Department of Pathomorphology, Medical University of Lublin, Lublin, Poland 5Department of General Radiology and Nuclear Medicine, Medical University of Lublin, Lublin, Poland [Received 13 June 2011; Accepted 24 August 2011] The aim of the study was the retrospective morphological analysis of se- lected structures of the middle cranial fossa, i.e. foramen ovale and supe- rior orbital fissure, in relation to the external head and cranial diameters in adults from the Lublin region (Poland). The study was performed on data collected during computed tomography examinations of 60 individuals (age 20–30 years), without any cranial or brain abnormalities. Based on the post-processing reconstructions, 3-dimensional views of the skull and head were obtained. The length and width of both structures, as well as thickness of the frontal, temporal, and occipital squamae, were measured. The morphology of the ovale foramina and superior orbital fissures were checked. The length and width of the skull and head were the only pa- rameters that significantly differed between males and females. The thick- ness of the frontal and temporal squama was insignificantly lower in males than in females. Almond and oval shapes were the most typical for the foramen ovale. The superior orbital fissure was found as a wide form — with or without accessory spine originating from its lower margin or as a laterally narrowed form. The length and width of the foramen ovale were insignificantly higher in males than in females. The same results were found for the area of the right superior orbital fissure. The thickness of the fron- tal and occipital squamae influenced the thickness of the temporal squa- ma. The analysed individuals had asymmetrical, oval, or almond-shape ovale foramina. Unlike the seldom visible laterally narrowed form of the superi- or orbital fissure, a wide form with or without accessory spine was the most commonly observed. The diameters of both superior orbital fissures and ovale foramina indicated the asymmetry of the neurocranium. (Folia Morphol 2011; 70, 4: 263–271) Key words: foramen ovale, superior orbital fissure, skull, middle cranial fossa Address for correspondence: Prof. F. Burdan, MD, PhD, ERT, Human Anatomy Department, Medical University of Lublin, ul. Jaczewskiego 4, 20–090 Lublin, Poland, e-mail: [email protected] 263 INTRODUCTION formed to estimate the length and width of the head. The middle cranial fossa is an important area of According to the guidelines for anthropological re- the skull, which contains the main part of the tem- search [18, 22], the length of the head was assumed poral lobes laterally and the pituitary gland central- to be the distance between the glabella and opisto- ly [3, 22]. Some other important anatomical struc- cranion on the occipital squama (g-op). The width tures such as selected dura mater venous sinuses, was measured between the two most remote points cranial nerves, and meninges are also there. Beside located on the right and the left side of the head (eu- the anterior and posterior cranial fossae, the mid- eu). Furthermore, using volumetric option, spatial dle one is also connected with an orbit by the optic imaging of the skull was performed in order to mea- canal and superior orbital fissure, with a pterygo- sure the length (g-op) and width (eu-eu) of the skull. palatine fossa by the foramen rotundum, as well as After removing the calvaria the length and width with the base of the skull by the foramen ovale, spi- of the ovale foramina were measured. Using the op- nosum, and lacerum. The greater and lesser petros- tion of automatic field setting, the area of both supe- al hiatus/canal connects the structure with a facial rior orbital fissures was estimated. The area of the oval canal and a tympanic cavity, respectively. Some other foramina (FoA) and the cross-sectional area of the skull foramens — regarded as anatomical variances of (SA) were calculated using the following formula: sphenoid wings and on the level of surrounded syn- FoA = pab; SA = pab, where a and b indicate the chondroses and sutures — were also revealed [31]. half of the length and width of the oval, respectively. Knowledge about the localisation of the men- Moreover, the thickness of the frontal squama (1 cm tioned structures, their size, and anatomical variations above the centre of the right supraorbital margin), right is important for both physicians and anthropologists temporal squama (1 cm above the upper pole of the [9, 20, 22, 31]. The aim of the study was the retro- external acoustic opening), and the occipital squama spective morphological analysis of selected structures (1 cm above the right transverse sinus and 1 cm aside of the middle cranial fossa, i.e. foramen ovale and su- from the internal occipital protuberance) were mea- perior orbital fissure, in relation to the external head sured. All measurements were performed using man- and cranial diameters in adult individuals from the ufactory calibrated measurement window which guar- Lublin Region (Poland). Both structures were selected anteed full repeatability of results. since they are relatively big and easily visible in radio- The obtained data was presented using: arith- logical examinations and their morphologies were not metical mean (M), 95% coefficient interval (CI), me- extensively studied before in a contemporary Europe- dian (Me), minimal-maximal values (min–max), and an population. Unlike most of the previous studies in standard deviation (SD). Depending on data distri- which the cranial morphology was evaluated on his- bution, checked by Kolmogorov-Smirnov test, dif- torical and/or archaeological material [1, 8, 27, 28, 33, ferences were analysed by t-Student or Mann-Whit- 37–40], the current study was performed radiologi- ney U test. The correlations between examined pa- cally using computed tomography images of skulls rameters were checked by Spearman’s rank. Nomi- without any developmental abnormalities. nal scale measures were analysed by Chi-square test with Fisher correction. A 0.05 level (p < 0.05) of MATERIAL AND METHODS probability was used as the criterion of significance. This study was conducted on the retrospective data from the First Department of Radiology and RESULTS Nuclear Medicine, Medical University of Lublin. In all analysed cases, well-developed cranial struc- Records of 60 randomly selected Caucasian patients tures were found. Morphologically, they correspond- in the age group 20–30 years (30 males — 24.66 ± ed to the calendar age of the patients, a fact which 3.37 years, 30 females — 24.76 ± 2.72 years) were was confirmed by the complete disappearance of the examined. None of the patients had significant cra- frontal suture as well as intra-occipital and spheno- nial or cerebral abnormalities. occipital synchondroses. Sutures of the calvaria showed All examinations were performed by means of complete development without distinctive features of LightSpeed Ultra CT 64-row VCT (GM Medical Sys- senile atrophy. Large, radiologically visible additional tem). They were conducted with a standard clinical cranial bones were not found in any of the cases. protocol in layers 5 and 2.5 mm above and below The length and the width of the head were sig- the upper Frankfort line, respectively. During post- nificantly higher in males than in females (Table 1). processing, spatial imaging of soft tissues was per- Similar observations were made for external dimen- 264 Table 1. Diameters (mm) of head and skull in examined males (M) and females (F) Sex M –95 CI (%) +95 CI (%) Me Min Max SD P Head length M 196.423 193.560 199.286 194.650 183.000 213.000 7.667 0.001 F 188.507 185.972 191.041 190.100 171.500 199.900 6.788 Head width M 166.223 164.109 168.338 165.500 154.900 183.000 5.663 0.0001 F 157.723 155.601 159.846 158.100 148.300 169.000 5.685 Cranial length M 178.600 176.503 180.697 179.000 167.000 189.100 5.617 0.0004 F 171.057 167.567 174.546 172.000 145.500 189.900 9.345 Cranial width M 149.547 146.615 152.479 148.850 136.600 178.000 7.852 0.0042 F 143.517 140.602 146.432 143.250 128.300 170.100 7.807 Frontal squama thickness M 4.069 3.729 4.409 4.200 2.400 6.500 0.893 0.7813 F 4.228 3.727 4.729 4.200 1.900 7.300 1.213 Temporal squama thickness M 3.277 2.912 3.641 3.150 1.700 5.600 0.975 0.3219 F 3.520 3.139 3.901 3.300 1.900 7.300 1.020 Occipital squama thickness M 3.930 3.618 4.242 4.050 2.000 6.100 0.837 0.3292 F 3.820 3.423 4.217 3.800 2.200 7.800 1.063 A B Figure 1. A. Skull length (SL; y = 74.5097 + 0.5212x; Rs = 0.43, p < 0.001) in relation to head length (HL); B. Skull width (SW; y = 40.0689 + 0.6573x; Rs = 0.61, p < 0.001) in relation to head width (HW).