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Investigation of Foramen Rotundum and Foramen Ovale Morphometric in Trigeminal Neuralgia Patients

Year 2024, , 208 - 215, 27.08.2024
https://doi.org/10.46332/aemj.1454755

Abstract

Purpose: This study aimed to investigate the morphometric structure of the foramen ovale (FO) and foramen rotundum (FR) through Computerized Tomography (CT) images of individuals diagnosed with trigeminal neuralgia (TN) without any vascular compression.

Materials and Methods: The study was approved by the Tokat Gaziosmanpaşa University Clinical Research Ethics Committee on March 2, 2023, with approval number 83116987-143. Thirty-four patients (16 males, 18 females) diagnosed with Trigeminal Neuralgia (TN) at the Clinic of Neurology, Tokat Gaziosmanpaşa University Faculty of Medicine, and 34 individuals (15 males, 19 females) selected as the control group (CG) were retrospectively analyzed. CT images of all participants were obtained in the coronal, sagittal, and transverse planes using the Horos software. Plane adjustments were applied to these images, referred to as modified planes, for morphometric measurements.

Results: There was no significant difference in the mean length and width measurements of the FO between individuals with TN and the CG on the side with nerve involvement (p>0.05). The mean length and width measurements of the FR on the affected side in the trigeminal neuralgia group (TNG) were significantly smaller when compared to the CG (p<0.001). It was found that increasing age significantly affected nerve involvement on the right side (p=0.005).

Conclusion: We believe that knowledge of the morphology of FO and FR would contribute to clinicians in the diagnostic and interventional treatment approaches of TN.

References

  • 1. Arıncı K, Elhan A. Anatomi. 7. baskı. Türkiye: Güneş Tıp Kitapevi; 2020.
  • 2. Taner D. Fonksiyonel nöroanatomi. 7. baskı. Türkiye: ODTÜ Yayıncılık; 2018.
  • 3. Chen ST, Yang JT, Yeh MY, Weng HH, Chen CF, Tsai YH. Using diffusion tensor imaging to evaluate microstructural changes and outcomes after radiofrequency rhizotomy of trigeminal nerves in patients with trigeminal neuralgia. PLoS One. 2016;11(12):e0167584.
  • 4. Goh BT, Poon CY, Peck RH. The importance of routine magnetic resonance imaging in trigeminal neuralgia diagnosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92(4):424-429.
  • 5. Neto HS, Camilli JA, Marques MJ. Trigeminal neuralgia is caused by maxillary and mandibular nerve entrapment: greater incidence of right-sided facial symptoms is due to the foramen rotundum and foramen ovale being narrower on the right side of the cranium. Med Hypotheses. 2005;65(6):1179-1182.
  • 6. Erbagci H, Kizilkan N, Sirikci A, Yigiter R, Aksamoglu M. Computed tomography based measurement of the dimensions of foramen ovale and rotundum in trigeminal neuralgia. Neurosciences (Riyadh). 2010;15(2):101-104.
  • 7. Natsis K, Repousi E, Sofidis G, Piagkou M. The osseous structures in the infratemporal fossa: foramen ovale, bony spurs, ossified ligaments and their contribution to the trigeminal neuralgia. Acta Neurochir (Wien). 2015;157(1):101-103.
  • 8. Mueller D, Obermann M, Yoon MS, et al. Prevalence of trigeminal neuralgia and persistent idiopathic facial pain: a population-based study. Cephalalgia. 2011;31(15):1542-1548.
  • 9. Hamlyn PJ, King TT. Neurovascular compression in trigeminal neuralgia: a clinical and anatomical study. J Neurosurg. 1992;76(6):948-954.
  • 10. Kolluri S, Heros RC. Microvascular decompression for trigeminal neuralgia. A five-year follow-up study. Surg Neurol. 1984;22(3):235-240.
  • 11. Richards P, Shawdon H, Illingworth R. Operative findings on microsurgical exploration of the cerebello-pontine angle in trigeminal neuralgia. J Neurol Neurosurg Psychiatry. 1983;46(12):1098-1101.
  • 12. Ishikawa M, Nishi S, Aoki T, et al. Operative findings in cases of trigeminal neuralgia without vascular compression: proposal of a different mechanism. J Clin Neurosci. 2002;9(2):200-204.
  • 13. Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis. Brain. 2001;124(12): 2347-2360.
  • 14. Liu P, Zhong W, Liao C, Liu M, Zhang W. Narrow foramen ovale and rotundum: a role in the etiology of trigeminal neuralgia. J Craniofac Surg. 2016;27(8): 2168-2170.
  • 15. Rao BS, Yesender M, Vinila BS. Morphological variations and morphometric analysis of foramen ovale with its clinical implications. Int J Anat Res. 2017;5(1):3394-3397.
  • 16. Li S, Liao C, Qian M, Yang X, Zhang W. Narrow ovale foramina may be involved in the development of primary trigeminal neuralgia. Front Neurol. 2022;13: 1013216.
  • 17. Wang Q, Chen C, Guo G, Li Z, Huang D, Zhou H. A prospective study to examine the association of the foramen ovale size with ıntraluminal pressure of pear-shaped balloon in percutaneous balloon compression for trigeminal neuralgia. Pain Ther. 2021;10(2):1439-1450.
  • 18. Patil J, Kumar N, K G MR, et al. The foramen ovale morphometry of sphenoid bone in South Indian population. J Clin Diagn Res. 2013;7(12):2668-2670.
  • 19. Akcay E, Chatzioglou GN, Gayretli O, Gurses IA, Ozturk. A Morphometric measurements and morphology of foramen ovale in dry human skulls and its relations with neighboring osseous structures. Medicine. 2021;10(3):1039-1046.
  • 20. Somesh MS, Sridevi HB, Prabhu LV, et al. A morphometric study of foramen ovale. Turk Neurosurg. 2011;21(3):378-383.
  • 21. Kastamoni Y, Dursun A, Ayyildiz VA, Ozturk K. An investigation of the morphometry and localization of the foramen ovale and rotundum in asymptomatic individuals and patients with trigeminal neuralgia. Turk Neurosurg. 2021;31(5):771-778.
  • 22. Hwang SH, Lee MK, Park JW, Lee JE, Cho CW, Kim DJ. A morphometric analysis of the foramen ovale and the zygomatic points determined by a computed tomography in patients with idiopathic trigeminal neuralgia. J Korean Neurosurg Soc. 2005;38(3):202-205.
  • 23. Kumar A, Sehgal R, Roy TS. A morphometric analysis and study of variations of foramina in the floor of the middle cranial fossa. J Anat Soc India. 2016;65(2): 143-147.
  • 24. Kitt CA, Gruber K, Davis M, Woolf CJ, Levine JD. Trigeminal neuralgia: opportunities for research and treatment. Pain. 2000;85(1-2):3-7.
  • 25. Katusic S, Beard CM, Bergstralh E, Kurland LT. Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945-1984. Ann Neurol. 1990;27(1):89-95.
  • 26. Barker FG 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD. The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med. 1996;334(17):1077-1083.

Trigeminal Nevralji Hastalarında Foramen Rotundum ve Foramen Ovale’nin Morfometrik Olarak İncelenmesi

Year 2024, , 208 - 215, 27.08.2024
https://doi.org/10.46332/aemj.1454755

Abstract

Amaç: Bu çalışmanın amacı, herhangi bir vasküler bası olmaksızın trigeminal nevralji (TN) tanısı alan bireylerin Bilgisayarlı Tomografi (BT) görüntüleri aracılığıyla foramen ovale (FO) ve foramen rotundum'un (FR) morfometrik yapısını araştırmaktır.

Araçlar ve Yöntem: Çalışma, Tokat Gaziosmanpaşa Üniversitesi Klinik Araştırmalar Etik Kurulu, 02.03.2023 tarihinde 83116987-143 sayılı kararla onaylandı. Tokat Gaziosmanpaşa Üniversitesi Tıp Fakültesi Nöroloji Kliniğinde TN tanısı almış 34 hasta (16 erkek, 18 kadın) ile kontrol grubu (KG) olarak belirlenen 34 olgu (15 erkek, 19 kadın) retrospektif olarak incelendi. Tüm bireylerin BT görüntüleri Horos programı kullanılarak koronal, sagittal ve transvers düzlemlerde elde edildi. Elde edilen görüntüler üzerinde düzlem düzeltmeleri yapıldı ve bunlar modifiye düzlemler olarak adlandırıldı. Morfometrik ölçümler modifiye edilmiş düzlemler üzerinde gerçekleştirildi.

Bulgular: TN'li bireyler ile sinir tutulumu olan taraftaki KG arasında FO'nun ortalama uzunluk ve genişlik ölçümlerinde anlamlı bir fark yoktu (p>0.05). Trigeminal nevralji grubunda (TNG) etkilenen taraftaki FR'nin ortalama uzunluk ve genişlik ölçümleri KG'ye kıyasla anlamlı olarak daha küçüktü (p<0.001). Artan yaşın sağ taraftaki sinir tutulumunu anlamlı olarak etkilediği bulundu (p=0.005).

Sonuç: FO ve FR morfolojisinin bilinmesinin TN'nin tanısal ve girişimsel tedavi yaklaşımlarında klinisyenlere katkı sağlayacağına inanıyoruz.

References

  • 1. Arıncı K, Elhan A. Anatomi. 7. baskı. Türkiye: Güneş Tıp Kitapevi; 2020.
  • 2. Taner D. Fonksiyonel nöroanatomi. 7. baskı. Türkiye: ODTÜ Yayıncılık; 2018.
  • 3. Chen ST, Yang JT, Yeh MY, Weng HH, Chen CF, Tsai YH. Using diffusion tensor imaging to evaluate microstructural changes and outcomes after radiofrequency rhizotomy of trigeminal nerves in patients with trigeminal neuralgia. PLoS One. 2016;11(12):e0167584.
  • 4. Goh BT, Poon CY, Peck RH. The importance of routine magnetic resonance imaging in trigeminal neuralgia diagnosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92(4):424-429.
  • 5. Neto HS, Camilli JA, Marques MJ. Trigeminal neuralgia is caused by maxillary and mandibular nerve entrapment: greater incidence of right-sided facial symptoms is due to the foramen rotundum and foramen ovale being narrower on the right side of the cranium. Med Hypotheses. 2005;65(6):1179-1182.
  • 6. Erbagci H, Kizilkan N, Sirikci A, Yigiter R, Aksamoglu M. Computed tomography based measurement of the dimensions of foramen ovale and rotundum in trigeminal neuralgia. Neurosciences (Riyadh). 2010;15(2):101-104.
  • 7. Natsis K, Repousi E, Sofidis G, Piagkou M. The osseous structures in the infratemporal fossa: foramen ovale, bony spurs, ossified ligaments and their contribution to the trigeminal neuralgia. Acta Neurochir (Wien). 2015;157(1):101-103.
  • 8. Mueller D, Obermann M, Yoon MS, et al. Prevalence of trigeminal neuralgia and persistent idiopathic facial pain: a population-based study. Cephalalgia. 2011;31(15):1542-1548.
  • 9. Hamlyn PJ, King TT. Neurovascular compression in trigeminal neuralgia: a clinical and anatomical study. J Neurosurg. 1992;76(6):948-954.
  • 10. Kolluri S, Heros RC. Microvascular decompression for trigeminal neuralgia. A five-year follow-up study. Surg Neurol. 1984;22(3):235-240.
  • 11. Richards P, Shawdon H, Illingworth R. Operative findings on microsurgical exploration of the cerebello-pontine angle in trigeminal neuralgia. J Neurol Neurosurg Psychiatry. 1983;46(12):1098-1101.
  • 12. Ishikawa M, Nishi S, Aoki T, et al. Operative findings in cases of trigeminal neuralgia without vascular compression: proposal of a different mechanism. J Clin Neurosci. 2002;9(2):200-204.
  • 13. Love S, Coakham HB. Trigeminal neuralgia: pathology and pathogenesis. Brain. 2001;124(12): 2347-2360.
  • 14. Liu P, Zhong W, Liao C, Liu M, Zhang W. Narrow foramen ovale and rotundum: a role in the etiology of trigeminal neuralgia. J Craniofac Surg. 2016;27(8): 2168-2170.
  • 15. Rao BS, Yesender M, Vinila BS. Morphological variations and morphometric analysis of foramen ovale with its clinical implications. Int J Anat Res. 2017;5(1):3394-3397.
  • 16. Li S, Liao C, Qian M, Yang X, Zhang W. Narrow ovale foramina may be involved in the development of primary trigeminal neuralgia. Front Neurol. 2022;13: 1013216.
  • 17. Wang Q, Chen C, Guo G, Li Z, Huang D, Zhou H. A prospective study to examine the association of the foramen ovale size with ıntraluminal pressure of pear-shaped balloon in percutaneous balloon compression for trigeminal neuralgia. Pain Ther. 2021;10(2):1439-1450.
  • 18. Patil J, Kumar N, K G MR, et al. The foramen ovale morphometry of sphenoid bone in South Indian population. J Clin Diagn Res. 2013;7(12):2668-2670.
  • 19. Akcay E, Chatzioglou GN, Gayretli O, Gurses IA, Ozturk. A Morphometric measurements and morphology of foramen ovale in dry human skulls and its relations with neighboring osseous structures. Medicine. 2021;10(3):1039-1046.
  • 20. Somesh MS, Sridevi HB, Prabhu LV, et al. A morphometric study of foramen ovale. Turk Neurosurg. 2011;21(3):378-383.
  • 21. Kastamoni Y, Dursun A, Ayyildiz VA, Ozturk K. An investigation of the morphometry and localization of the foramen ovale and rotundum in asymptomatic individuals and patients with trigeminal neuralgia. Turk Neurosurg. 2021;31(5):771-778.
  • 22. Hwang SH, Lee MK, Park JW, Lee JE, Cho CW, Kim DJ. A morphometric analysis of the foramen ovale and the zygomatic points determined by a computed tomography in patients with idiopathic trigeminal neuralgia. J Korean Neurosurg Soc. 2005;38(3):202-205.
  • 23. Kumar A, Sehgal R, Roy TS. A morphometric analysis and study of variations of foramina in the floor of the middle cranial fossa. J Anat Soc India. 2016;65(2): 143-147.
  • 24. Kitt CA, Gruber K, Davis M, Woolf CJ, Levine JD. Trigeminal neuralgia: opportunities for research and treatment. Pain. 2000;85(1-2):3-7.
  • 25. Katusic S, Beard CM, Bergstralh E, Kurland LT. Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945-1984. Ann Neurol. 1990;27(1):89-95.
  • 26. Barker FG 2nd, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD. The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med. 1996;334(17):1077-1083.
There are 26 citations in total.

Details

Primary Language English
Subjects Pain, Diagnostic Radiography
Journal Section Original Articles
Authors

Sefa Sönmez 0000-0001-5532-9856

Mert Nahir 0000-0002-8492-3704

Orhan Sümbül 0000-0001-7263-764X

Early Pub Date August 20, 2024
Publication Date August 27, 2024
Submission Date March 18, 2024
Acceptance Date May 23, 2024
Published in Issue Year 2024

Cite

APA Sönmez, S., Nahir, M., & Sümbül, O. (2024). Investigation of Foramen Rotundum and Foramen Ovale Morphometric in Trigeminal Neuralgia Patients. Ahi Evran Medical Journal, 8(2), 208-215. https://doi.org/10.46332/aemj.1454755
AMA Sönmez S, Nahir M, Sümbül O. Investigation of Foramen Rotundum and Foramen Ovale Morphometric in Trigeminal Neuralgia Patients. Ahi Evran Med J. August 2024;8(2):208-215. doi:10.46332/aemj.1454755
Chicago Sönmez, Sefa, Mert Nahir, and Orhan Sümbül. “Investigation of Foramen Rotundum and Foramen Ovale Morphometric in Trigeminal Neuralgia Patients”. Ahi Evran Medical Journal 8, no. 2 (August 2024): 208-15. https://doi.org/10.46332/aemj.1454755.
EndNote Sönmez S, Nahir M, Sümbül O (August 1, 2024) Investigation of Foramen Rotundum and Foramen Ovale Morphometric in Trigeminal Neuralgia Patients. Ahi Evran Medical Journal 8 2 208–215.
IEEE S. Sönmez, M. Nahir, and O. Sümbül, “Investigation of Foramen Rotundum and Foramen Ovale Morphometric in Trigeminal Neuralgia Patients”, Ahi Evran Med J, vol. 8, no. 2, pp. 208–215, 2024, doi: 10.46332/aemj.1454755.
ISNAD Sönmez, Sefa et al. “Investigation of Foramen Rotundum and Foramen Ovale Morphometric in Trigeminal Neuralgia Patients”. Ahi Evran Medical Journal 8/2 (August 2024), 208-215. https://doi.org/10.46332/aemj.1454755.
JAMA Sönmez S, Nahir M, Sümbül O. Investigation of Foramen Rotundum and Foramen Ovale Morphometric in Trigeminal Neuralgia Patients. Ahi Evran Med J. 2024;8:208–215.
MLA Sönmez, Sefa et al. “Investigation of Foramen Rotundum and Foramen Ovale Morphometric in Trigeminal Neuralgia Patients”. Ahi Evran Medical Journal, vol. 8, no. 2, 2024, pp. 208-15, doi:10.46332/aemj.1454755.
Vancouver Sönmez S, Nahir M, Sümbül O. Investigation of Foramen Rotundum and Foramen Ovale Morphometric in Trigeminal Neuralgia Patients. Ahi Evran Med J. 2024;8(2):208-15.

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