Summary

The middle cranial fossa contains several well-documented foramina namely the foramen ovale, spinosum, and rotundum each serving as critical conduits for neurovascular structures. While morphological variants of these lateral foramina have been explored, medial foramina associated with the sella turcica remain underreported, particularly in African populations. This study aimed to document and describe a rare anatomical variation involving bilateral foramina located anteroinferior to the sella turcica in an adult Ugandan skull. A dry adult skull from the osteological collection at Habib Medical School, Islamic University in Uganda, was examined during a routine anatomy lab demonstration. A detailed morphological and morphometric assessment was performed using a magnifying glass, digital imaging, and calibrated vernier calipers. In addition to the presence of normal lateral foramina and a stenosed foramen rotundum, a distinct pair of bilateral oval-shaped foramina was identified. These measured 6.7 × 7.1 mm (left) and 6.9 × 6.9 mm (right), and were located inferior to the optic canals and anterior clinoid processes, within the anterior wall of the hypophyseal fossa. A probe inserted through these openings communicated directly with the sphenoid sinuses. No other abnormal cranial base features were identified. Morphometric data were collected and tabulated. This case represents a previously undocumented variant of middle cranial foramina medially positioned at the level of the Sella turcica. Its embryological origin may involve incomplete mesenchymal fusion, or alternatively, acquired erosion due to chronic sinusitis. The variant holds potential clinical relevance in neurosurgery and radiologic interpretation of skull base pathology.

Keywords

Sella turcica foramina variant, Uganda, Middle cranial fossa

Summary

The purpose of the present study was to analyze the frontispiece of Andreas Vesalius’ De Humani Corporis Fabrica, examining the editions related to this work and counting the number of animal species different from Homo sapiens sapiens, as well as their possible meaning. It was found that the number of animals depicted ranges between 7 and 9, depending on the edition, a figure that differs from what has been reported by other authors over time. The hypothesis regarding the physiological meaning related to Macaca sylvanus (Barbary macaque) is also challenged, since the work is eminently anatomical rather than physiological.

Keywords

Anatomy, History

Summary

The approach to the anterior and middle cranial fossae poses significant challenges for neurosurgeons due to the numerous critical structures encountered in this region. The orbitozygomatic approach (OZA), developed as an extension of the pterional approach (PA), allows access not only to the anterior and middle cranial fossae but also to the orbit. Therefore, a thorough understanding of the regional anatomy is essential to minimize surgical risks. The objective of this study is to describe the anatomy of the OZA, emphasizing the anatomical landmarks relevant to the approach. This study was conducted using five cadaveric heads preserved in 5% formalin, one dry skull, standard dissection instruments, a drill and Gigli saw, a high-speed drill, and a high-resolution camera. A stepwise, layer-by-layer dissection was performed to detail the anatomical features of the approach. The OZA provides broad access to the cranial fossae and orbit with reduced brain retraction, thereby minimizing potential damage to the parenchyma and surrounding neurovascular structures. Dissection began with the superficial layers (skin, subcutaneous tissue, temporalis muscle, and skull) to reduce approach-related morbidity. After performing the craniotomy, the temporal and frontal lobes, orbit, and lateral fissure were widely exposed. Dissection of the lateral fissure enabled access to deeper structures via multiple pathways. With meticulous microsurgical technique, this approach creates a wide and practical surgical corridor. However, its complexity lies in the proximity to deep vascular structures, where inadvertent injury may result in significant morbidity and mortality. The OZA is a highly complex approach, requiring extensive anatomical knowledge and practice. Cadaveric dissection provides a three-dimensional and topographic understanding of the neurovascular relationships along the surgical route, thereby enhancing the surgeon’s familiarity with the region and ultimately improving clinical outcomes.

Keywords

Orbitozygomatic approach, Pterional approach, Transzygomatic approach