The sphenoid bone presents several anatomical variations, including accessory foramina, such as the foramen meningo-orbitale, the foramen of Vesalius, the canaliculus innominatus and the palatovaginal canal, which may be involved in tumor invasion or surgery of surrounding structures. Therefore, clinicians and surgeons have to consider these variants when planning surgical interventions of the cranial base. The prevalence of each variant is reported in the published literature, but very little information is available on the possible correlation among different variants. Here, 300 CT scans of patients (equally divided among males and females) were retrospectively assessed to investigate the presence of the foramen meningo-orbitale, the foramen of Vesalius, the canaliculus innominatus and the palatovaginal canal. Possible differences in the prevalence of each accessory foramen according to sex were assessed, as well as possible correlations among different variants through the Chi-square test (p< 0.01). Overall, the prevalence of the foramen meningo-orbitale, the foramen of Vesalius, the canaliculus innominatus and the palatovaginal canal was 30.7%, 67.7%, 14.0% and 35.3%, respectively, without any difference according to sex (p> 0.01). A significant positive correlation was found between the foramen of Vesalius and canaliculus innominatus, both in males and in females (p< 0.01). In detail, subjects with canaliculus innominatus in 85.7–100.0% of cases also showed the foramen of Vesalius, independently from sex and side. The present study provided novel data about the prevalence of four accessory foramina of the sphenoid bone in an Italian population, and a correlation between the foramen of Vesalius and the canaliculus innominatus was found for the first time. As these accessory foramina host neurovascular structures, the results of this study are thus useful for appropriate planning surgical procedures that are tailored to the anatomical configuration of the patient and for improving techniques to avoid accidental injuries in cranial base surgery. Knowledge of the topography, frequencies and the presence/absence of these additional foramina are pivotal for a successful procedure. Clinicians and surgeons may benefit from these novel data for appropriate recognition of the variants, decision-making, pre-operative and treatment planning, improvement of the procedures, screening of patients and prevention of misdiagnosis.
蝶骨存在多种解剖变异，包括脑膜眶孔、维萨里孔、无名小管及腭鞘管等副孔，这些结构可能涉及肿瘤侵袭或周围结构的手术操作。因此，临床医生和外科医师在规划颅底手术时需充分考虑这些变异。现有文献已报道各变异的出现率，但关于不同变异间潜在关联性的研究甚少。本研究回顾性分析了300例患者的CT影像（男女各半），旨在探查脑膜眶孔、维萨里孔、无名小管及腭鞘管的存在情况。通过卡方检验（p<0.01）评估各副孔出现率的性别差异，并探究不同变异间的相关性。结果显示：脑膜眶孔、维萨里孔、无名小管及腭鞘管的总体出现率分别为30.7%、67.7%、14.0%和35.3%，且无性别差异（p>0.01）。维萨里孔与无名小管在男女患者中均呈显著正相关（p<0.01），具体表现为85.7%-100.0%的无名小管存在者同时伴有维萨里孔，该关联性与性别及侧别无关。本研究首次报道了意大利人群中蝶骨四个副孔的出现率数据，并首次发现维萨里孔与无名小管间的相关性。由于这些副孔内含神经血管结构，本研究结果有助于制定符合患者解剖特征的个体化手术方案，并优化颅底手术技术以避免意外损伤。掌握这些额外孔道的形态、出现频率及存在与否对手术成功至关重要。临床医师可借助这些新数据准确识别变异、优化决策与术前规划、改进手术流程、完善患者筛查并预防误诊。
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