The forgotten foramina: a study of the anterior cribriform plate.

Fiche publication


Date publication

avril 2015

Auteurs

Membres identifiés du Cancéropôle Est :
Pr JANKOWSKI Roger


Tous les auteurs :
Patron V, Berkaoui J, Jankowski R, Lechapt-Zalcman E, Moreau S, Hitier M

Résumé

PURPOSE: The olfactory cleft has garnered interest since the advent of endoscopic skull base surgery. Its precise anatomy, however, is still partially unknown. According to Rouviere, an "ethmoidal foramen" is located in its antero-medial part and contains a process of the dura mater. In a more lateral and anterior location, a second foramen, the "cribroethmoidal foramen", contains the anterior ethmoidal nerve. The aim of this study was to verify the existence of these elements and to establish landmarks for surgery. METHODS: We performed an anatomical and histological study of eight olfactory clefts in four cadavers using both endonasal endoscopic and endocranial dissection. RESULTS: An ethmoidal and a cribroethmoidal foramen were found in, respectively, 100 and 75 % of cases. Their mean length was, respectively, 4.1 and 1.8 mm. They were located, respectively, in mean at 5.3 and 5.8 mm from the anterior ethmoidal artery. CONCLUSION: Our anatomical study demonstrates the existence of both foramina. The ethmoidal foramen clearly represents an area of least resistance in the anterior part of the olfactory cleft, which could predispose to anterior skull base cerebrospinal fluid leaks and meningoceles.

Référence

Surg Radiol Anat. 2015 Apr 1.