蝶骨表现出几种解剖变异,包括附属孔,比如脑膜眶,Vesalius的孔,无名管和腭阴道管,可能参与肿瘤侵袭或周围结构的手术。因此,临床医生和外科医生在计划颅底手术时必须考虑这些变异.在已发表的文献中报道了每种变体的患病率,但是关于不同变体之间可能的相关性的信息很少。这里,回顾性评估了300例患者的CT扫描(男性和女性均分),以调查是否存在脑眶孔,Vesalius的孔,无名管和腭阴道管。根据性别评估了每个附属孔患病率的可能差异,以及通过卡方检验不同变体之间可能的相关性(p<0.01)。总的来说,大孔脑眶的患病率,Vesalius的孔,无名管和腭阴道管占30.7%,67.7%,14.0%和35.3%,分别,无性别差异(p>0.01)。在Vesalius孔和无名管之间发现了显着的正相关。男性和女性(p<0.01)。详细来说,在85.7-100.0%的病例中,无名管的受试者也显示了Vesalius孔,独立于性和侧面。本研究提供了有关意大利人群中蝶骨四个辅助孔的患病率的新数据,首次发现了Vesalius孔与无名管之间的相关性。作为这些附属孔的宿主神经血管结构,因此,这项研究的结果对于根据患者的解剖结构制定适当的手术计划以及改进技术以避免颅底手术中的意外伤害是有用的.了解地形,频率和这些额外孔的存在/不存在是成功手术的关键。临床医生和外科医生可能会从这些新数据中受益,以适当识别变异,决策,术前和治疗计划,改进程序,筛查患者,预防误诊。
The sphenoid bone presents several anatomical variations, including accessory foramina, such as the foramen meningo-orbitale, the foramen of Vesalius, the canaliculus innominatus and the palatovaginal canal, which may be involved in tumor invasion or surgery of surrounding structures. Therefore, clinicians and surgeons have to consider these variants when planning surgical interventions of the cranial base. The prevalence of each variant is reported in the published literature, but very little information is available on the possible correlation among different variants. Here, 300 CT scans of patients (equally divided among males and females) were retrospectively assessed to investigate the presence of the foramen meningo-orbitale, the foramen of Vesalius, the canaliculus innominatus and the palatovaginal canal. Possible differences in the prevalence of each accessory foramen according to sex were assessed, as well as possible correlations among different variants through the Chi-square test (p < 0.01). Overall, the prevalence of the foramen meningo-orbitale, the foramen of Vesalius, the canaliculus innominatus and the palatovaginal canal was 30.7%, 67.7%, 14.0% and 35.3%, respectively, without any difference according to sex (p > 0.01). A significant positive correlation was found between the foramen of Vesalius and canaliculus innominatus, both in males and in females (p < 0.01). In detail, subjects with canaliculus innominatus in 85.7-100.0% of cases also showed the foramen of Vesalius, independently from sex and side. The present study provided novel data about the prevalence of four accessory foramina of the sphenoid bone in an Italian population, and a correlation between the foramen of Vesalius and the canaliculus innominatus was found for the first time. As these accessory foramina host neurovascular structures, the results of this study are thus useful for appropriate planning surgical procedures that are tailored to the anatomical configuration of the patient and for improving techniques to avoid accidental injuries in cranial base surgery. Knowledge of the topography, frequencies and the presence/absence of these additional foramina are pivotal for a successful procedure. Clinicians and surgeons may benefit from these novel data for appropriate recognition of the variants, decision-making, pre-operative and treatment planning, improvement of the procedures, screening of patients and prevention of misdiagnosis.