Top

Published in:

01-10-2011 | Anatomic Variations

Doubled foramen rotundum and maxillary nerve fenestration

Author: Mugurel Constantin Rusu

Published in: Surgical and Radiologic Anatomy | Issue 8/2011

Abstract

Even though the doubled foramen rotundum (FR) can be identified once within the literature, there are no details of the contents at that level. We present here an anatomical case demonstrating the maxillary nerve (MN) duplication at the level of an unilateral doubled FR: the accessory nervous trunk of the MN separately left the trigeminal ganglion on the outer side of the MN main trunk and coursed beneath the main trunk of the MN canal, within the sphenoidal greater wing, to join infero-medially that main trunk at the entrance in the pterygopalatine fossa. Overall, the MN appeared as fenestrated, with a thin bony plate separating the two cords of the nerve traversing the skull base. Previously undocumented, the MN duplication may interfere with various surgical exposures interfering with the foramen rotundum and may explain atypical sensory syndromes and functional impairment during skull base trauma or anesthesia.

Alfieri A, Jho HD (2001) Endoscopic endonasal cavernous sinus surgery: an anatomic study. Neurosurgery 48:827–836. (discussion 836–837)PubMed

Bergman RA, Afifi AK, Miyauchi R (2006) Illustrated encyclopedia of human anatomic variation. http://www.anatomyatlases.org/AnatomicVariants/SkeletalSystem/Text/SphenoidBone.shtml (Accessed Nov 21, 2010)

Berkovitz BKB, Moxham BJ, Langdon JD (2003) The temporomandibular joint and pterygopalatine fossa. In: Langdon JD, Berkovitz BKB, Moxham BJ (eds) Surgical anatomy of the infratemporal fossa. Martin Dunitz, London, pp 49–52

Binning MJ, Couldwell WT (2009) Fenestration of the oculomotor nerve by a duplicated posterior cerebral artery and aneurysm. Case report. J Neurosurg 111:84–86PubMedCrossRef

Choudhry R, Anand M, Choudhry S, Tuli A, Meenakshi A, Kalra A (1999) Morphologic and imaging studies of duplicate optic canals in dry adult human skulls. Surg Radiol Anat 21:201–205PubMedCrossRef

Feneis H, Dauber W (2000) Pocket atlas of human anatomy-based on the international nomenclature, 4th edn. Thieme, Stuttgart

Fukushima T (2009) Management of cavernous sinus lesions. In: Sindou M (ed) Practical handbook of neurosurgery from leading neurosurgeons, vol. 2, Intracranial tumors. Intraoperative Explorations, Pediatrics. Springer, New York, pp 129–155

Horiuchi T, Kyoshima K, Oya F, Kobayashi S (1997) Fenestrated oculomotor nerve caused by internal carotid-posterior communicating artery aneurysm: case report. Neurosurgery 40:397–398. (discussion 398–399)PubMedCrossRef

House PA, Couldwell WT (2005) De novo fenestration of the optic nerve. Case illustration. J Neurosurg 102:390

10.

Lee KJ (1978) The sublabial transseptal transsphenoidal approach to the hypophysis. Laryngoscope 88:1–65PubMedCrossRef

11.

O’Rahilly R, Müller F (2006) The embryonic human brain. An atlas of developmental stages, 3rd edn. John Wiley & Sons, Hoboken, pp 39–40CrossRef

12.

Rhoton AL Jr (2009) The middle cranial base and cavernous sinus. In: Dolenc VV, Rogers L (eds) Cavernous sinus. Developments and future perspectives. Springer, New York, pp 3–27

13.

Rusu MC, Ivaşcu RV, Cergan R, Păduraru D, Podoleanu L (2009) Typical and atypical neurovascular relations of the trigeminal nerve in the cerebellopontine angle: an anatomical study. Surg Radiol Anat 31:507–516PubMedCrossRef

14.

Stojčev Stajčić L, Gačić B, Popović N, Stajčić Z (2009) Anatomical study of the pterygopalatine fossa pertinent to the maxillary nerve block at the foramen rotundum. Int J Oral Maxillofac Surg 39:493–496PubMed

15.

Tsutsumi K, Ohno H, Okada Y, Fujimaki T, Kirino T (1999) Fenestrated oculomotor nerve caused by meningioma around the cavernous sinus: a surgical pitfall in tumor removal: case report. Neurosurgery 44:395–396. (discussion 396–397)PubMedCrossRef

16.

Tubbs RS, Hill M, May WR, Middlebrooks E, Kominek SZ, Marchase N, Shoja MM, Loukas M, Oakes WJ (2008) Does the maxillary division of the trigeminal nerve traverse the cavernous sinus? An anatomical study and review of the literature. Surg Radiol Anat 30:37–40PubMedCrossRef

Title: Doubled foramen rotundum and maxillary nerve fenestration
Author: Mugurel Constantin Rusu
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: Surgical and Radiologic Anatomy / Issue 8/2011
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-011-0810-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Doubled foramen rotundum and maxillary nerve fenestration

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 8/2011

Relation of discoid lateral meniscus and cord-like anterior intermeniscal ligament: morphological and clinical study

The neglected anatomical and clinical aspects of pterygoid canal: CT scan study

Reliability of magnetic resonance imaging measurements of the cross-sectional area of the muscle contractile and non-contractile components

Iatrogenic femoral nerve injury: a systematic review

Temporal lobe association fiber tractography as compared to histology and dissection

Moving and fusion of the pancreatic buds in the rat embryos during the embryonic period (carnegie stages 13–17) by a three-dimensional computer-assisted reconstruction