Morphometry and Variations of Foramen Vesalius: Significance in Surgical Approach to Mandibular Nerve.

Background: Foramen Vesalius a small inconsistent foramen in the base of skull for passage of emissary vein from pterygoid plexus of veins to cavernous sinus. Variations in incidence and morphology are reported in literature. The objective of this study as to estimate its incidence in south Indian population and to evaluate the morphometric variations. Materials and Methods: Twenty-two dry skulls belonging to department of anatomy, Azeezia Institute of Medical Sciences, Kollam was studied with respect to base of the skull foramens. Wherever the foramen Vesalius was noted, the specimens were photographed and incidence, laterality was noted. Maximum, minimum and perimeter were noted. Any difference between male and female skulls and differences in right and left side were studied for statistical significance. P<0.05 was considered as significant. Results: We found foramen Vesalius in 40.9% of 44 sides examined. Six skulls had this foramen bilaterally. Three specimens had foramen Vesalius unilaterally and six specimens had it bilaterally. Average diameter of foramen was 1.35 (±0.56) mm from extra cranial aspect. The average diameter and perimeter of foramen in males were significantly lower than females. The average distance between foramen Vesalius and foramen ovale was significantly more in females than in males. Conclusion: Foramen ovale is an inconsistent and asymmetrical foramen in base of skull near foramen ovale. Forty percent of the skulls studied had foramen Vesalius. There is significant difference measurements of right and left side foramens. Considering these variations in infratemporal fossa decreases complications while approaching mandibular nerve and trigeminal ganglion.

Accessory neurovascular foramina on the lingual surface of mandible: Incidence, topography, and clinical implications.

Context: It was suggested that the accessory neurovascular foramina of the mandible might be of significance in relation to the effectiveness of local anesthesia following the routine inferior alveolar nerve block. Aims: To investigate the incidence of neurovascular foramina over the lingual surface of the mandible in South Indian population. Settings and Design: The study was conducted at the department of anatomy. Materials and Methods: The study included 67 human adult dry mandibles, the exact ages and sexes of which were not known. The location and number of neurovascular foramina were topographically analyzed. Statistical Analysis Used: Descriptive statistics. Results: The foramina were observed in 64 mandibles (95.5%) and were often multiple in most of the cases. They were located between the two medial incisors in 8 mandibles (1.9%), between the medial and lateral incisor in 34 mandibles (50.7%; 25-bilateral; 7-right; 2-left), between the lateral incisor and canine in 7 mandibles (10.4%; 2-bilateral; 3-right; 2-left), between the canine and first premolar in 6 cases (8.9%; 3 on each side). Foramina were also present around the genial tubercle in 56 mandibles (83.6%). Among them, 52 mandibles showed a single foramen just above the genial tubercle, 34 mandibles had foramina below the tubercles, 13 mandibles had foramina on the right side of genial tubercle and 17 were having on the left side. Conclusion: Since the anatomical details of these foramina are important to various fields of dentistry and oncology, the present investigation was undertaken. The clinical significance and implications are emphasized.