ABSTRACT
The recognition of emissary foramens is important not only for understanding the regional neurovascular anatomy, but also to distinguish normal from potentially abnormal structures. Thus, the aim of this study was to review the literature on anatomical and clinical aspects of the mastoid, parietal and sphenoid emissary foramens. It was found that the emissary foramen presents importance in clinical practice because it acts as a route of spread of extracranial infection to the intracranial structures and also possible complications in neurosurgery, due to its influence in the performance of techniques such as radiofrequency rhizotomy for treatment of trigeminal neuralgia. The anatomical knowledge of the emissary foramens is important due to variability in their incidence in the human skull and its relation to the dura mater sinuses.
El reconocimiento de forámenes emisarios es importante no sólo para la comprensión de la anatomía neurovascular regional, sino también para distinguir lo normal a partir de estructuras potencialmente anormales. El objetivo de este estudio fue revisar la literatura sobre los aspectos anatómicos y clínicos del proceso mastoide, huesos parietal y esfenoides y forámenes emisarios. El foramen emisario adquiere importancia en la práctica clínica debido a que actúa como una vía de propagación de la infección extracraneal a las estructuras intracraneales, y también con las posibles complicaciones en neurocirugía, debido a su influencia en el desarrollo de técnicas como rizotomía por radiofrecuencia en el tratamiento de neuralgia del trigémino. El conocimiento anatómico de los forámenes emisarios es importante debido a la variabilidad en su incidencia en el cráneo humano y su relación con los senos de la duramadre.
Subject(s)
Humans , Skull/anatomy & histology , Veins/anatomy & histology , Parietal Bone/anatomy & histology , Skull/innervation , Sphenoid Bone/anatomy & histology , Dura Mater , Mastoid/anatomy & histologyABSTRACT
The right side was affected in 61% of reported cases and the left side was affected in 39% of approximately 30,000 patients with trigeminal neuralgia (TN) affected on only one side. Side-to-side asymmetry of neurovascular compression in healthy persons cannot account for side-to-side asymmetry in TN. Size asymmetry and shape asymmetry of the rotundum and ovale foramens may account for the higher incidence of TN on the right side. This paper proposes a multiple factors theory: the summation of multiple factors reaches a critical level at which TN occurs. It is rational that entrapment of the maxillary and mandibular nerves when they cross the ovale and rotundum foramens is one of the factors which cause TN. The multiple factors theory can account for a TN patient without neurovascular compression and a healthy person with neurovascular compression.
ABSTRACT
The right side was affected in 61% of reported cases and the left side was affected in 39% of approximately 30,000 patients with trigeminal neuralgia (TN) affected on only one side. Side-to-side asymmetry of neurovascular compression in healthy persons cannot account for side-to-side asymmetry in TN. Size asymmetry and shape asymmetry of the rotundum and ovale foramens may account for the higher incidence of TN on the right side. This paper proposes a multiple factors theory: the summation of multiple factors reaches a critical level at which TN occurs. It is rational that entrapment of the maxillary and mandibular nerves when they cross the ovale and rotundum foramens is one of the factors which cause TN. The multiple factors theory can account for a TN patient without neurovascular compression and a healthy person with neurovascular compression.
ABSTRACT
Los procedimientos clínicos a nivel del hueso mandibular en Odontología, en las etapas de diagnóstico, planificación y tratamiento, son rutinarios. Para poder realizar dichas fases, es relevante conocer en forma precisa la anatomía mandibular, con el fin de minimizar los riesgos en los procedimientos anestésicos, quirúrgicos y protésicos. El uso de radiografías panorámicas es cada vez más frecuente, las cuales permiten un estudio de la anatomía mandibular bilateral. El objetivo del presente estudio fue analizar la morfología de la mandíbula a través radiografías panorámicas, estudiando específicamente la ubicación de estructuras, como el foramen mandibular en relación a los diferentes márgenes de la rama de la mandíbula. El foramen mental se analizó en relación con el cuerpo mandibular, y se revisaron las longitudes de la rama y cuerpo mandibulares. Se estudiaron 50 radiografías panorámicas, sin diferencia de género, el rango de edad estaba entre 25 y 72 años y sin patología disfuncional. Los forámenes mandibular y mental, en este estudio no mostraron variaciones significativas. La ubicación del foramen mandibular se encontró estable en ambos lados.
In dentistry, the clinical procedures at mandible level, in the diagnosis, planification and treatment stages are rutinaries. To develop these phases it's necessary to know the mandible's anatomy to minimize the risks in anesthetic, surgical and prosthetic procedures. The use of panoramic radiographies is becoming more common every day and they aL1ow studying the bilateral mandible anatomy. This study's goal was to analyze the mandible's morphology throw panoramic radiographies. This was got by the study of the structures location such as the mandible's foramen in relation to the different margins of the mandible's branches. The mentonian foramen was analyzed in relation to mandible body and the sizes of the mandible body and the mandible branch were checked. Both genders v50 panoramic radiographies were analyzed. The age range was between 25 to 72 years old. They didn't present dysfunctional pathology. In this study, the mandible and mental foramens didn't show significant variations. The mandible foramen's location was found stable in both sides.