Accessory Foramina in the Body of Sphenoid Bone
Aggarwal B*, Gupta M**, Goyal N***
Abstract
An accessory foramen was observed in the body of the sphenoid bone in the middle
cranial fossa of a base of dried skull while teaching the under-graduates. The foramen
extended from the body of sphenoid bone to the sphenoid air sinus but did not
communicate with the nasopharynx. This prompted the present investigation that
was done on 95 bases of skulls and16 individual sphenoid bones for the presence of
accessory foramen in body of sphenoid bone. It was found that accessory foramina
varying in size, number and location were present in body of 15 sphenoid bones. The
large foramina probably result either due to a persistent craniopharyngeal canal or
developmental defects during ossification of the sphenoid bone .The small foramina
are probably vascular. The knowledge of these foramina may be important to the
radiologists, endocrinologists and anthropologists.
Introduction
T
he foramina that are present in the
middle cranial fossa are the foramen
ovale, foramen rotundum and the foramen
spinosum as mentioned in the text-books
of anatomy. Occasionally present foramen
related to the sphenoid bone such as the
pterygospinous, petro-clinoid and the
emissary sphenoid foramen have
previously been mentioned by authors.1,2
However, foramina in the body of the
sphenoid bone have not been documented
much. In the present study, accessory
foramina varying in size, number and
location were observed in the body of the
sphenoid bone in the middle cranial fossa.
The accessory foramina could be
labeled as remnant of cranio-pharyngeal
canal that runs from the anterior part of
*Assistant Professor, Department of Anatomy, Gian
Sagar Medical College and Hospital, Banur, Patiala,
Punjab, India, * Professor and Head, Department of
Anatomy, Swami Devi Dayal Dental College and
Hospital, Golpura, Barwala, Haryana, ** Assistant
Professor, Department of Anatomy, CMC, Ludhiana,
Punjab, India.
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the sphenoid bone to the exterior of the
skull and marks the original position of the
pouch of Rathke.3 Three typical sites of
remnants of Rathke's pouch have been
described as intracranial-within the
hypophyseal fossa, interosseous-within
the body of sphenoid bone and
pharyngeal-within the roof of
nasopharynx.4
It has been reported earlier that the
middle cranial fossa communicates with
the orbit through the optic canal and
superior orbital fissure, with the
pterygopalatine fossa through the foramen
rotundum and it communicates with the
infratemporal fossa through the foramen
ovale and the foramen spinosum. 5
Communication of the middle cranial
fossa with the sphenoid air sinus has not
been mentioned earlier but, the foramina
that were observed in the present study
communicated with the sphenoid air
sinus.
Bombay Hospital Journal, Vol. 54, No. 2, 2012
Thus, the present study was
undertaken to observe the number, size,
location and communication of the
foramina in the body of the sphenoid bone
in middle cranial fossa of dried skulls.
foramina
Material and Methods
Ninety five adult dried base of skulls
and sixteen individual sphenoid bones of
unknown sex and origin were studied for
the presence of accessory foramina in the
body of the sphenoid bone in the middle
cranial fossa. These skulls were taken
from the archives of Department of
Anatomy of Gian Sagar Medical and
Dental College, Banur, Patiala, Swami
Devi Dayal Dental College and CMC,
Ludhiana.
Fig1. Shows large accessory foramina (AF) located
laterally in the body of the sphenoid (BS) in the middle
cranial fossa in base of skull, tuberculum sellae (TS),
anterior clinoid process (ACP), foramen rotundum (FR).
The location and number of the
foramina in the body of sphenoid bone
were observed and noted. The diameters of
the foramina were measured with the help
of a divider with a fixing device and digital
Vernier calipers.
The communication of the foramina
with the sphenoid air sinus and the
nasopharynx was also observed and
noted. This was confirmed radiologically
by subjecting these skulls to X-ray.
Observations
In the present study, ninety five adult
dried skulls and sixteen individual
sphenoid bones were studied for the
presence of accessory foramina in the body
of the sphenoid bone in the middle cranial
fossa. Foramina varying in number,
location and size were observed in the body
of 15 sphenoid bones.
In 6 sphenoid bones, a single, circular
foramen with smooth rounded margins
was observed (Figs. 1 and 2). Three
Bombay Hospital Journal, Vol. 54, No. 2, 2012
Fig2. Shows large accessory foramina (AF) located
centrally in the body of the individual sphenoid
bone, tuberculum sellae (TS), jugum sphenoidale
(JS), lesser wing of sphenoid (LWS).
were located centrally and three laterally
in the body of the sphenoid bone. The
average diameter of these foramina was
1.84 mm. These foramina communicated
with the sphenoid air sinus but not with
the nasopharynx. The communication was
confirmed radiologically by subjecting
these skulls to X-ray.
In 9 sphenoid bones, there were 3 to 4
minute foramina located centrally in the
body of sphenoid bone (Fig 3). These
foramina were pin-head sized.
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represents a complex structure in terms of
its anatomy and embryology. It is formed
by the fusion of different primordia whose
embryonic origins are different. The
complexity of its development and nonfusion of its parts may lead to abnormal
foramina.8
Fig 3. Shows minute accessory foramina (AF) in the
body of the sphenoid (BS) in the middle cranial
fossa, jugum sphenoidale (JS), tuberculum sellae
(TS), anterior clinoid process (ACP).
Discussion
In the present study a single foramen,
having smooth margins and an average
diameter of 1.84 mm was observed in 6
sphenoid bones. Numerous pin-head sized
foramina (3-4 in number) were found in 9
sphenoid bones.
A case report of a foramen in the body
of the sphenoid bone located anterolateral
to the sella turcica has been reported
earlier.6 The diameter of the foramen was
however not mentioned. A foramen similar
to that reported by Nayak6 with average
diameter of 1.84 mm was observed in 3
sphenoid bones in the present study.
It was stated earlier that the sphenoid
bone develops from presphenoid and
basisphenoid, separated by a cartilage
plate till birth. After ossification of
sphenoid bone, the cartilage may be
represented by one or two centrally or
laterally placed fossae or foramina. These
foramina are probably the result of
developmental defects during ossification
of the sphenoid bone.7 The sphenoid bone
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Earlier studies reveal that the fossae or
foramina in the sphenoid bone are due to
remnants of the Rathke's pouch within the
body of the sphenoid bone and called
craniopharyngeal canal. 9 The term
craniopharyngeal canal is used to describe
a small and vertical midline defect,
measuring less than 1.5 mm in diameter.
Its incidence in adults has been reported
as 0.42% of asymptomatic population.10
Case reports of broad persistent
craniopharyngeal canal have been
presented.11, 12 Another case of supra-sellar
and infra-sellar craniopharyngiomas with
a persistent craniopharyngeal canal was
also reported.13
These defects with a larger size were
called large craniopharyngeal canal and
transsphenoidal canal.14 It was suggested
that these large craniopharyngeal canals
were due to transsphenoidal
meningoencephalocoele. 15 A case of
transsphenoidal canal was reported
associated with nasopharyngeal extension
of a normally functioning pituitary gland.16
The large foramina are probably due to
persistent craniopharyngeal canal or due
to the result of developmental defects
during ossification of the sphenoid bone.
The small foramina represent the remnant
of a vascular channel formed during
osteogenesis.
Bombay Hospital Journal, Vol. 54, No. 2, 2012
Churchill ltd, 1965; 200-6.
Conclusion
The knowledge of the normal and
variant positions of canals and foramina of
skull is important for the radiologists,
neurosurgeons, endocrinologists,
anthropologists and anatomists.
References
1.
2.
Srisopark SS. Ossification of some normal
ligaments of the human skull which produce
new structures: the pterygospinous and
pterygoalar bars and foramina, and the
caroticoclinoid foramen. J Dent Assoc Thai 1974;
24(4): 213-24.
Williams P L, Bannister LH, Berry MM, Collin SP,
Dyson M, Dussek JE et al. Skull. In: Gray's
Anatomy. 38th ed. New York: Churchill
Livingstone Publishers, 2000; 547-612.
8.
Catala M. Embryology of the Sphenoid bone. J
Neuroradiol 2003; 30(4): 196-200.
9.
McGregor AL and Plessis DJ. The anatomy of
congenital errors. In: Synopsis of Surgical
Anatomy. 10th ed. Bombay: K.M. Varghese
Company, 1969; 355-453.
10. Arcy LB. The craniopharyngeal canal reviewed
and reinterpreted. Anat Rec 1950; 106: 1-16.
11. Hughes ML, Carty AT, White FE. Persistent
hypophyseal (craniopharyngeal) canal. Br J
radiol 1999; 72(854): 204-6.
12. Dupuch KM, Smoker WRK, Graucer W. A rare
expression of Neural Crest Disorders: An
Intrasphenoidal Development of the Anterior
Pituitary Gland. Am J Neuroradiol 2004; 25:
285- 8.
13. Chen CJ. Suprasellar and infrasellar
craniopharyngiomas with a persistent
craniopharyngeal canal: case report and review
of the literature. Neuroradiology 2001; 43(9):
760-2.
3.
Williams P L, Bannister LH, Berry MM, Collin SP,
Dyson M, Dussek JE et al. Musculoskeletal
system. In: Gray's Anatomy. 38th ed. New York:
Churchill Livingstone Publishers, 2000; 264-97.
4.
Baker R.C, Edwards L.F. Early development of
the human pharyngeal hypophysis- a
preliminary report. Ohio J. Sci 1948; 68:241.
14. Currarino G, Maravilla KR, Salyer KE.
Transsphenoidal canal (large craniopharyngeal
canal) and its pathologic implications. AJNR
1985; 6: 39-43.
5.
Breathnach AS. Cranial bones. In: Frazer's
Anatomy of Human Skeleton. 6th ed. London: J
and A Churchill ltd, 1965; 61-9.
15. Larsen JL, Bassoe HH. Transsphenoidal
meningocele with hypothalamic insufficiency.
Neuroradiology 1979; 18: 205-9.
6.
Nayak S. An abnormal foramen connecting the
middle cranial fossa with sphenoidal air sinus- a
case report. The Internet Journal of Biological
Anthropology 2008; 2(1).
7.
Breathnach AS. Sphenoid. In: Frazer's Anatomy
of Human Skeleton. 6th ed. London: J and A
16. Ekinci G, Kilic T, Baltaciolu F, Elmaci I, Altun E ,
Pamir M. N, Erzen C. Transsphenoidal ( large
craniopharyngeal canal) canal associated with a
normally functioning pituitary gland and
nasopharyngeal extension, hyperprolactinemia
and hypothalamic hamartoma. AJR; 180: 76-7.
Oral Ivabradine is safe in Acute Heart Failure
Aim: To study the safety and efficacy of Oral Ivabradine in patient with Acute heart failure with sinus
tachycardia.
Result: Oral Ivabradine was well tolerated across the group without any significant haemodynamic
comprise. It also caused a significant reduction in heart rate in majority of the patients from a mean
122 bpm at time of admission to a mean of 78 bpm during discharge with no significant reduction in
mean arterial pressure (pre Ivabradine 83 mmhg, post Ivabradine 82 mmhg)
Conclusion: Oral Ivabradine is a safe and effective addition in management of patient with Acute
Heart Failure.
N. Kumar, M. Minocha, P. Joshi, S. Shrivastava, A Omar, Indian Heart J. 2011;63:492-598;547
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