Luciano César Pereira Campos Leonel1, Severino Denicio Gonçalves de Sousa2, Edson Aparecido Liberti3. 1. Department of Surgery, Sector of Anatomy, School of Veterinary Medicine and Animal Science, University of São Paulo, Brazil. Electronic address: lucianoanato@usp.br. 2. Department of Surgery, Sector of Anatomy, School of Veterinary Medicine and Animal Science, University of São Paulo, Brazil. Electronic address: denicio@usp.br. 3. Department of Surgery, Sector of Anatomy, School of Veterinary Medicine and Animal Science, University of São Paulo, Brazil; Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, Brazil. Electronic address: ealiberti@icb.usp.br.
Abstract
OBJECTIVE: Although the Emissary Sinus of Foramen Ovale (ESFO) was first described by Trolard in 1868, its definition remains confused and neglected in the medical literature. This structure represents a vein, two veins, a venous plexus, or a dural sinus? Does it really exist? To understand this topic, this work aimed to describe the anatomy, topography, and microscopic features of the ESFO, precisely characterizing its structure, routes and anatomical correlations. PATIENTS AND METHODS: ESFO from the skull's base of adults were dissected into fifty anatomical blocks and evaluated using Hematoxylin and Eosin, Picro-sirius red and Weigert staining, and by Scanning Electron Microscopy (SEM). RESULTS: ESFO was always present between cavernous sinus and pterygoid plexus on both antimeres, its inferior route passing through the foramen ovale and/or sphenoidal emissary foramen (foramen of Vesalius), anterior to the mandibular branch of trigeminal nerve. Its microscopic arrangement resembled what was found on transverse sinus, that is composed by layers of collagen fibers oriented on transversal and longitudinal planes. It wasn't possible to identify the media and adventitial tunica, features seen in veins, and the elastic layer was very thin near its lumen. SEM analysis showed that, like the transverse sinus, the ESFO was composed by parallel cells that presented a rhombus shape containing central rounded nuclei. CONCLUSION: In summary, the venous channel passing through the foramen ovale and/or sphenoidal emissary foramen (foramen of Vesalius) is a dural venous sinus constituted by dura mater layers and should be considered during surgical approaches near the foramen ovale in the middle cranial fossa.
OBJECTIVE: Although the Emissary Sinus of Foramen Ovale (ESFO) was first described by Trolard in 1868, its definition remains confused and neglected in the medical literature. This structure represents a vein, two veins, a venous plexus, or a dural sinus? Does it really exist? To understand this topic, this work aimed to describe the anatomy, topography, and microscopic features of the ESFO, precisely characterizing its structure, routes and anatomical correlations. PATIENTS AND METHODS: ESFO from the skull's base of adults were dissected into fifty anatomical blocks and evaluated using Hematoxylin and Eosin, Picro-sirius red and Weigert staining, and by Scanning Electron Microscopy (SEM). RESULTS: ESFO was always present between cavernous sinus and pterygoid plexus on both antimeres, its inferior route passing through the foramen ovale and/or sphenoidal emissary foramen (foramen of Vesalius), anterior to the mandibular branch of trigeminal nerve. Its microscopic arrangement resembled what was found on transverse sinus, that is composed by layers of collagen fibers oriented on transversal and longitudinal planes. It wasn't possible to identify the media and adventitial tunica, features seen in veins, and the elastic layer was very thin near its lumen. SEM analysis showed that, like the transverse sinus, the ESFO was composed by parallel cells that presented a rhombus shape containing central rounded nuclei. CONCLUSION: In summary, the venous channel passing through the foramen ovale and/or sphenoidal emissary foramen (foramen of Vesalius) is a dural venous sinus constituted by dura mater layers and should be considered during surgical approaches near the foramen ovale in the middle cranial fossa.