Bombay Hospital Journal, Vol. 54, No. 2, 2012

Accessory Foramina in the Body of Sphenoid Bone

Aggarwal B*, Gupta M**, Goyal N***

*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.

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

he foramina that are present in the Tmiddle 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 1,2previously been mentioned by authors.

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

the sphenoid bone to the exterior of the

skull and marks the original position of the 3pouch of Rathke. 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

p h a r y n g e a l - w i t h i n t h e r o o f o f 4nasopharynx.

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 5ovale and the foramen spinosum.

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.

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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.

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.

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

foramina

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).

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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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 6earlier. The diameter of the foramen was

however not mentioned. A foramen similar 6to that reported by Nayak 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 7of the sphenoid bone. The sphenoid bone

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 non-

fusion of its parts may lead to abnormal 8foramina.

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 9craniopharyngeal canal. 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 10as 0.42% of asymptomatic population.

Case reports of broad persistent

craniopharyngeal canal have been 11, 12presented. Another case of supra-sellar

and infra-sellar craniopharyngiomas with

a persistent craniopharyngeal canal was 13also reported.

These defects with a larger size were

called large craniopharyngeal canal and 14transsphenoidal canal. It was suggested

that these large craniopharyngeal canals

w e r e d u e t o t r a n s s p h e n o i d a l 15meningoencephalocoele. A case of

transsphenoidal canal was reported

associated with nasopharyngeal extension 16of a normally functioning pituitary gland.

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.

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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.

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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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