Variations in carotico clinoid foramen in human skulls in western Maharashtra region and its clinical significance

Pallavi A Kulkarni^1*, Avinash D Shewale², Rohini R Karambelkar³

¹Associate Professor, Department of Anatomy, SKN Medical College and General Hospital, Pune, Maharashtra, INDIA.

²Associate Professor, Department of Anatomy, Yogita Dental College, khed, Chiplun, Dist. Ratnagiri, Maharashtra, INDIA.

⁶Professor, Department of Anatomy, Prakash Institute of Medical Sciences and Research, Islampur, Dist. Sangli, Maharashtra, INDIA.

Email: pakulkarni57@gmail.com

Abstract               The lesser wing of sphenoid bone ends medially as anterior clinoid process (ACP), excision of anterior clinoid process is needed for exposure of clinoid segment of internal carotid artery, expose cavernous sinus and to manage paraclinoid aneurysm. ACP is connected to middle clinoid process by ligament known as carotico clinoid ligament (CCL) which may be ossified forming carotico clinoid foramen (CCF). Sometimes CCL is ossified and may have compressive effect on internal carotid artery. Anatomical knowledge about the dimensions of CCF may be useful in cases of surgery involving removal of ACP. In the present study, eighty two human dried skulls of known sex were studied. It has been observed that the incidence of presence of CCF is 28%; among which CCF was observed more on right side as compared to left side. When CCF was analysed for diameter, sexual variation was observed but, it was not statistically significant. When CCF is present, it is likely to compress internal carotid artery and also cause morphological changes in internal carotid artery. When calibre of internal carotid artery is more than the diameter of CCF there is high possibility of inducing a headache caused by compression of internal carotid artery. The position of CCF is in area close to cavernous sinus. The formation of CCF may change the dimensions of cavernous sinus. Anatomical knowledge of the dimensions of the carotico clinoid foramen may be useful in cases of surgery involving removal of anterior clinoid process.

Key Words: ACP, CCF, CCL, Human skull.