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Alpergin BC, Beger O, Özpişkin ÖM, Erdin E, Kılınç MC, Alpergin S, Gündoğan NM, Çalışır ES, Eroglu U. Radiologic evaluation of the Vidian canal in the pediatric population. Surg Radiol Anat 2024; 46:1015-1025. [PMID: 38780788 DOI: 10.1007/s00276-024-03393-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 05/19/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE This examination aimed to display the size and topographic position of the Vidian canal (VC) in normal children. METHODS 180 pediatric subjects aged 1-18 years were included this computed tomography examination. The distances of VC to certain landmarks, and VC length were measured. The locations of VC according to the sphenoid sinus, and the medial plate of pterygoid process were classified as three types, separately. RESULTS The distances of VC to the vomerine crest, midsagittal plane, round foramen, and the superior wall of sphenoid sinus were measured as 12.68 ± 3.17 mm, 10.76 ± 2.52 mm, 8.62 ± 2.35 mm, and 14.16 ± 5.00 mm, respectively. The length and angle of VC were measured as 12.00 ± 2.52 mm, and 16.60 ± 9.76°, respectively. According to the sphenoid bone, VC location was identified as Type 1 in 113 sides (47.5%), as Type 2 in 70 sides (29.4%), and as Type 3 in 55 sides (23.1%). According to the medial plate of pterygoid process, VC location was identified as Type A in 274 sides (76.1%), as Type B in 55 sides (15.3%), and as Type C in 31 sides (8.6%). VC location types correlated with pediatric ages, but not sex or side. CONCLUSION With advancing pediatric age, the protrusion of VC into the sphenoid sinus increases, and VC shifts from medial to lateral side of the medial plate of pterygoid process.
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Affiliation(s)
| | - Orhan Beger
- Department of Anatomy, Faculty of Medicine, Gaziantep University, 27310, Gaziantep, Turkey.
| | - Ömer Mert Özpişkin
- Department of Neurosurgery, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Engin Erdin
- Department of Neurosurgery, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Mustafa Cemil Kılınç
- Department of Neurosurgery, Çorum Erol Olçok Training and Research Hospital, Hitit University, Çorum, Turkey
| | - Selen Alpergin
- Department of Otorhinolaryngology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | | | - Ebru Sena Çalışır
- Department of Anatomy, Faculty of Medicine, Gaziantep Islam Science and Technology University, Gaziantep, Turkey
| | - Umit Eroglu
- Department of Neurosurgery, Faculty of Medicine, Ankara University, Ankara, Turkey
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Tanner JA, Jethwa B, Jackson J, Bartanuszova M, King TS, Bhattacharya A, Sharma R. A Three-Dimensional Print Model of the Pterygopalatine Fossa Significantly Enhances the Learning Experience. ANATOMICAL SCIENCES EDUCATION 2020; 13:568-580. [PMID: 31904166 DOI: 10.1002/ase.1942] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 12/23/2019] [Accepted: 01/03/2020] [Indexed: 05/22/2023]
Abstract
The pterygopalatine fossa (PPF) is a bilateral space deep within the skull that serves as a major neurovascular junction. However, its small volume and poor accessibility make it a difficult space to comprehend using two-dimensional illustrations and cadaveric dissections. A three-dimensional (3D) printed model of the PPF was developed as a visual and kinesthetic learning tool for completely visualizing the fossa, its boundaries, its communicating channels, and its neurovascular structures. The model was evaluated by analyzing student performance on pre- and post-quizzes and a student satisfaction survey based on the five-point Likert scale. The first cohort comprised of 88 students who had never before studied the PPF. The second cohort consisted of 30 students who were previously taught the PPF. Each cohort was randomly divided into a control group who were provided with a half skull and an intervention group that were provided with the 3D printed model. The intervention group performed significantly better on the post-quiz as compared to the control group in cohort I (P = 0.001); while not significant, it also improved learning in cohort II students (P = 0.124). Satisfaction surveys indicated that the intervention group found the 3D printed model to be significantly more useful (P < 0.05) as compared to the half skull used by the control group. Importantly, the effect sizes for cohorts I and II (0.504 and 0.581, respectively) validated the statistical results. Together, this study highlights the importance of 3D printed models as teaching tools in anatomy education.
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Affiliation(s)
- Jordan A Tanner
- Department of Cell Systems and Anatomy, Long School of Medicine, UT Health, San Antonio, Texas
| | - Beeran Jethwa
- Department of Cell Systems and Anatomy, Long School of Medicine, UT Health, San Antonio, Texas
| | - Jeff Jackson
- Office of Undergraduate Medical Education, Long School of Medicine, UT Health, San Antonio, Texas
| | - Maria Bartanuszova
- Department of Cell Systems and Anatomy, Long School of Medicine, UT Health, San Antonio, Texas
| | - Thomas S King
- Department of Cell Systems and Anatomy, Long School of Medicine, UT Health, San Antonio, Texas
- Department of Obstetrics-Gynecology, Long School of Medicine, UT Health, San Antonio, Texas
| | - Arunabh Bhattacharya
- Department of Clinical and Applied Sciences Education, School of Osteopathic Medicine, University of Incarnate Word, San Antonio, Texas
| | - Ramaswamy Sharma
- Department of Cell Systems and Anatomy, Long School of Medicine, UT Health, San Antonio, Texas
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Er K, Schmieder K, Brenke C, Miller D, Parpaley Y, Gierthmuehlen M. Brainatomy: A Novel Way of Teaching Sphenoid Bone Anatomy With a Simplified 3-Dimensional Model. World Neurosurg 2020; 135:e50-e70. [DOI: 10.1016/j.wneu.2019.10.128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/20/2019] [Accepted: 10/21/2019] [Indexed: 11/29/2022]
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Papavasileiou G, Hajiioannou J, Kapsalaki E, Bizakis I, Fezoulidis I, Vassiou K. Vidian canal and sphenoid sinus: an MDCT and cadaveric study of useful landmarks in skull base surgery. Surg Radiol Anat 2020; 42:589-601. [PMID: 31950213 DOI: 10.1007/s00276-019-02414-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/30/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To present the anatomical variations of vidian canal (VC) and sphenoid sinus (SS), relative to other anatomical landmarks of skull base area, which may be helpful for safer surgical approach to this area. MATERIALS MDCT scans (128-row MDCT system) of 90 patients (mean age 62 years) and six cadaveric heads were studied, and the following parameters were evaluated: mean length and types of VC, distance between VC and foramen rotundum (FR) and optic canal (OC), position of the VC regarding the lateral pterygoid plate (MPTG) and petrous ICA, pneumatization of SS, position of intrasinus septum regarding ICA and OC, bone dehiscence and protrusion of ICA and OC into SS. Six cadaveric heads underwent MDCT and endoscopic dissection, and the type and length of VC were evaluated. The statistical significance was assessed using Chi-square (χ2) test. Significance level was set at p < 0.05. RESULTS A statistical analysis was performed between the measurements at both sides, as well as between measurements in MDCT and dissection of the six cadaveric heads. Statistically significant difference was found between right and left sides in the horizontal and vertical distances between FR and VC, as well as between VC and OC. Also, there was a statistically positive correlation between type II of VC and lateral pneumatization on the right side. There was not statistically significant difference concerning VC type and length between MDCT and dissection measurements. CONCLUSION Surgeons addressing skull base surgery must be familiar with the anatomical and positional variations of VC and SS in the preoperative CT images so as to avoid serious complications during surgery.
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Affiliation(s)
| | - Jiannis Hajiioannou
- Department of Otorhinolaryngology, University Hospital of Larissa, Larissa, Greece
| | - Eutixia Kapsalaki
- Department of Radiology, University Hospital of Larissa, Larissa, Greece
| | - Ioannis Bizakis
- Department of Otorhinolaryngology, University Hospital of Larissa, Larissa, Greece
| | - Ioannis Fezoulidis
- Department of Radiology, University Hospital of Larissa, Larissa, Greece
| | - Katerina Vassiou
- Department of Anatomy, Faculty of Medicine, Biopolis, University of Thessaly, Larissa, Greece
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Akkoca Kaplan F, Bayrakdar İŞ, Bilgir E. Incidence of anomalous canals in the base of the skull: a retrospective radio-anatomical study using cone-beam computed tomography. Surg Radiol Anat 2019; 42:171-177. [PMID: 31446447 DOI: 10.1007/s00276-019-02307-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/17/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Several skull-base foramina including foramen meningo-orbitale, craniopharyngeal canals, canaliculus innominatus, foramen vesalius, palatovaginal canals, and canalis basalis medianus are visible on cone-beam computed tomographs. A good understanding of the anatomical variants of these foramina is important to accurately diagnose fractures, understand the paths that infections may take, and identify associated anomalies. We used cone-beam computed tomography to measure the incidences of skull-base foramen variants in a normal population. METHODS A total of 350 subjects (200 females, 150 males, 6-30 years of age) were included. The prevalences of foramen meningo-orbitale, craniopharyngeal canals, canaliculus innominatus, foramina vesalius, palatovaginal canals, and canalis basalis medianus were evaluated by age and gender. RESULTS Subject age ranged from 6 to 30 years (mean age ± SD = 15.1 ± 4.08). Foramen meningo-orbitale, craniopharyngeal canals, canaliculus innominatus, foramen vesalius, palatovaginal canal, and canalis basalis medianus were observed in 51 (14.6%), 19 (5.4%), 60 (17.1%), 145 (41.1%), 34 (9.7%), and 15 (4.3%) patients, respectively. CONCLUSIONS Skull-base foramina are important clinically and radiologically. Imaging of such variants via cone-beam computed tomography is valuable for both physicians and patients. Few studies of skull-base foramina have used cone-beam computed tomography. Additional research is required for a fuller understanding of this phenomenon.
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Affiliation(s)
- Fatma Akkoca Kaplan
- Department of Dentomaxillofacial Radiology, Eskisehir Osmangazi University, Faculty of Dentistry, Eskisehir, Turkey.
| | - İbrahim Şevki Bayrakdar
- Department of Dentomaxillofacial Radiology, Eskisehir Osmangazi University, Faculty of Dentistry, Eskisehir, Turkey
| | - Elif Bilgir
- Department of Dentomaxillofacial Radiology, Eskisehir Osmangazi University, Faculty of Dentistry, Eskisehir, Turkey
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Meng QG, Lu YT, Wang CX, Tan SP, Wei MH. Visualisation of the vomerovaginal canal during endonasal transpterygoid approaches and CT imaging diagnosis. J Anat 2019; 235:246-255. [PMID: 31318052 DOI: 10.1111/joa.13009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2019] [Indexed: 11/29/2022] Open
Abstract
The vomerovaginal canal (VVC) and palatovaginal canal (PVC) are two canals that open forward to the posterior wall of the pterygopalatine fossa (PPF). Although the anatomy and computed tomography (CT) appearances of the PVC have been well studied, the VVC has been rarely reported, especially in endoscopic examinations. Some studies have even failed to distinguish the PVC from the VVC on CT images. The purpose of this study was to demonstrate the anatomy of the VVC on endoscopy and reveal its differences from the PVC, and to analyse the relative positions of the VVC, PVC, and pterygoid canal on CT images. Ten dry skull bases were studied to observe the structures involved in the formation of the VVC. Dissection of four cadaveric heads was performed to demonstrate the anatomy of the VVC on endoscopy. Coronal CT image analysis in 70 patients was conducted to evaluate the distances and relative positions between the VVC, PVC, and pterygoid canal. The PVC and VVC were also compared on axial CT images. The osteological study showed the top wall of the VVC was the antero-inferior wall of the sphenoid sinus. The VVC may be a helpful landmark in endoscopic endonasal transpterygoid approaches. Steps and discrimination in the dissections of the VVC and PVC were described. The interval between the PVC and VVC could be observed on both coronal and axial CT images. The coronal CT images of patients showed differences in the positions and distances among the three canals at both the anterior and posterior apertures of the PVC. The VVC can be easily mistaken for the PVC if its existence is not suspected. The anatomical morphologies and trajectories of the VVC and PVC differed on both nasal endoscopy and CT. The existence of the VVC should be considered during surgery and CT diagnosis within this area.
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Affiliation(s)
- Qing-Guo Meng
- Department of Otolaryngology, Head and Neck Surgery, Hospital of Shenzhen University, Health science center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yong-Tian Lu
- Department of Otolaryngology, Head and Neck Surgery, Hospital of Shenzhen University, Health science center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Chun-Xia Wang
- Department of Emergency Ward and Intensive Care Unit, Hospital of Shenzhen University, Health science center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Sui-Ping Tan
- Department of Otolaryngology, Head and Neck Surgery, Hospital of Shenzhen University, Health science center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Ming-Hui Wei
- Department of Head and Neck Surgery, National Cancer Hospital/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
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Bahşi İ, Orhan M, Kervancıoğlu P, Yalçın ED. The anatomical and radiological evaluation of the Vidian canal on cone-beam computed tomography images. Eur Arch Otorhinolaryngol 2019; 276:1373-1383. [PMID: 30747319 DOI: 10.1007/s00405-019-05335-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 02/05/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The aim of this study is to explore the anatomy of the Vidian nerve to elucidate the appropriate surgical approach based on preoperative cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS The Vidian canal and its surrounding structures were morphometrically evaluated retrospectively in CBCT images of 400 cases by the Planmeca Romexis program. The types of the Vidian canal were determined and seven parameters were measured from the images. RESULTS Three types of the Vidian canal according to the relationship with the sphenoid bone were found as follows: the Vidian canal totally protruded into the sphenoid sinus (19.75%), partially protruded into sphenoid sinus (44.37%) and embedded inside bony tissue of the body of sphenoid bone (35.87%). The position of the Vidian canal was medial (34.62%), on the same line (55.12%) and lateral (10.25%) to the medial plate of the pterygoid process. The distance between the Vidian canal and the vomerine crest, the mid-sagittal plane, the round foramen, the palatovaginal canal, and the superior wall of the sphenoid sinus, the length of the Vidian canal and the angle between the Vidian canal and the sagittal plane was found to be 16.69 ± 2.14, 13.80 ± 2.00, 8.88 ± 1.60, 5.83 ± 1.37, 23.98 ± 2.68, 13.29 ± 1.71 mm and 25.78° ± 3.68° in males, 14.62 ± 1.66, 11.43 ± 1.28, 8.51 ± 1.63, 5.78 ± 0.57, 22.37 ± 2.07, 12.91 ± 1.26 mm and 23.43° ± 3.07° in females, respectively. CONCLUSIONS Our results may assist with proper treatment for surgical procedures around the Vidian canal with a high success rate and minimal complications. Therefore, the results obtained in this study contribute to the literature.
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Affiliation(s)
- İlhan Bahşi
- Department of Anatomy, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.
| | - Mustafa Orhan
- Department of Anatomy, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Piraye Kervancıoğlu
- Department of Anatomy, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Eda Didem Yalçın
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey
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Tsutsumi S, Ono H, Ishii H, Yasumoto Y. Visualization of the vidian canal and nerve using magnetic resonance imaging. Surg Radiol Anat 2018; 40:1391-1396. [PMID: 30218150 DOI: 10.1007/s00276-018-2105-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 09/10/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Few studies have investigated the vidian nerve (VN) and vidian canal (VC) with the use of magnetic resonance imaging (MRI). The present study aimed to characterize the VC and VN using MRI. MATERIALS AND METHODS A total of 91 patients underwent thin-sliced, contrast MRI. The course of the VC and VN and the relationships with relevant structures were analyzed. RESULTS The VC was identified in 95% of axial images on the right side and in 93% on the left. The course of the VC was delineated in 99% of serial coronal images on both sides. The VN location in the VC was highly variable. The course of the VC and transmitting VN was delineated in 95% of sagittal images on the right side and in 91% on the left. The mean length of the VC was 19.8 mm on the right side and 19.3 mm on the left. Topographical relationships between the anterior genu of the petrous internal carotid artery and the posterior end of the vidian canal could be classified into three types. Of these, the type terminating at the level of the petrous carotid was the most predominant, comprising 76% of 182 sides. The course of the VC and transmitting VN could be classified into four types. The straight type was the most predominant and was found in 41%. CONCLUSIONS The VC and transmitting VN are structures with variable morphologies. Contrast MRI is useful for delineating the VC and VN.
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Affiliation(s)
- Satoshi Tsutsumi
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
| | - Hideo Ono
- Division of Radiological Technology, Medical Satellite Yaesu Clinic, Tokyo, Japan
| | - Hisato Ishii
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Yukimasa Yasumoto
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
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