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The Investigation of the Course of Trigeminal Nerve in the Cranial Base and Histological Analysis

Year 2008, Volume: 13 Issue: 3, 171 - 175, 01.06.2008

Abstract

Objectives: The root of trigeminal nerve (Cr5) and its trigeminal ganglion (TG) are located in the middle cranial fossa which has important anatomical relations. We thought that anatomical and histological studies of Cr5 and TG would increase surgical success carried out in this region. In this study, we aimed to investigate the morphological features and variations of Cr5 and the associated structures. Material and Methods: A total of 40 intracranial portions of Cr5 's obtained from 20 forensic autopsy cadavers were studied and tissue samples were taken. The intracranial course of Cr5 was examined carefully, and possible types of variations were investigated. Then, tissue samples taken were stained with Hematoxylin&Eosin and Mallory's anilin blue collagen staining histologically. Results: Mean length of Cr5's was found as 25.32±2.90 mm and TG's width as 13.5±1.2 mm. In four cases, motor root was located inferomedially to the sensorial root. Cr5's were located near to vascular structures particularly. Total number of bundles was found as 71.75±8.20. Diameters of the fibers of the big fascicule and the small fascicule were found as 9.11±0.98 µm and 3.17±0.26 µm respectively. Satellite cells were observed more in TG. Collagen/neuron ratios was calculated as 2/5 and 1/6 in TG and Cr5 respectively. Conclusion: This study might contribute to enlighten the demography of Cr5 in our country, clinical sciences, surgical success and some related disorders. In addition, variable collagen/neuron ratios found in TG and Cr5 (as can vary in diabetes and multiple sclerosis) also further suggest that more investigation is needed.©2008, Firat University, Medical Faculty.

References

  • Woolfall P, Coulthard A. Trigeminal nerve: anatomy and pathology. The British Journal of Radiology 2001; 74: 458–467.
  • Shankland WE. The trigeminal nerve. Part I: An over-view. Cranio 2000; 18: 238-248.
  • Williams LS, Schmalfuss IM, Sistrom CL et al. MR Imaging of the Trigeminal Ganglion, Nerve, and the Perineural Vascular Plexus: Normal Appearance and Variants with Correlation to Cadaver Specimens. AJNR Am J Neuroradiol 2003; 24: 1317– 1323.
  • Love S, Coakham HB. Trigeminal Neuralgia: Pathology and Pathogenesis. Brain 2001; 124: 2347-2360.
  • El Gammal T, Brooks BS. Trigeminal neuralgia. Radiology 2004; 231: 284.
  • Theil D, Derfuss T, Paripovic I et al. Latent herpesvirus infection in human trigeminal ganglia causes chronic immune response. Am J Pathol 2003; 163: 2179-2184.
  • Chang PC, Fischbein NJ, McCalmont TH et al. Perineural Spread of Malignant Melanoma of the Head and Neck: Clinical and Imaging Features. AJNR Am J Neuroradiol 2004; 25: 5–11.
  • Al-Mefty O, Ayoubi S, Gaber E. Trigeminal schwannomas: removal of dumbbell-shaped tumors through the expanded Meckel cave and outcomes of cranial nerve function. J.Neurosurg 2002; 96: 453-463.
  • Akkol İ, Sucu HK, Bezircioğlu H. Cerebellar tumor causing trigeminal dysfunction. Journal of neorological sciences 2004; 21: 315-318.
  • Lobato RD, Rivas JJ, Sarabia R, Lamas E. Percutaneous microcompression of the gasserian ganglion for trigeminal neuralgia. J Neurosurg 1990; 73: 804-805.
  • Gusmao S, Oliveira M, Tazinaffo U, Honey CR. Percutaneous trigeminal computerized tomography fluoroscopy. J Neurosurg 2003; 99: 785-786. rhizotomy guided by
  • Ziyal IM, Sekhar LN, Ozgen T, Soylemezoglu F, et al. The trigeminal nerve and ganglion: an anatomical, histological, and radiological study addressing the transtrigeminal approach. Surg Neurol 2004; 61: 564-574.
  • Duus P. Nöroloji. Oğuz Y, Özkaynak S, Önal MZ (Çevirenler). 3. Baskı, Ankara: Palme Yayıncılık, 2001.
  • Ueda F, Suzuki M, Fujinaga Y, Kadoya M, Takasima T. In vivo anatomical analysis of arterial contact with trigeminal nerve: detection with three-dimensional spoiled grass imaging. The British Journal of Radiology 1999; 72: 838-845.
  • Arrese I, Lobato RD, Alen JF, et al. Acute subdural and intratemporal hematoma as a complication of percutaneous compression of the gasserian ganglion for trigeminal neuralgia. Neurocirugia (Astur) 2005; 16: 177-182.
  • Bolay H, Reuter U, Dunn AK, et al. Intrinsic brain activity triggers trigeminal meningeal afferents in a migraine model. Nature Medicine 2002; 8:110-112.
  • Meaney JFM, Eldridge PR, Dunn LT et al. Demostration of neurovascular compression in trigeminal neuralgia with magnetic resonance imaging. J Neurosurg 1995; 83: 799-805.
  • Smoliar E, Smoliar A, Sorkin L, Belkin V. Microcirculatory bed of the human trigeminal nerve. Anat Rec 1998; 250: 245-249.
  • Go JL, Kim PE, Zee CS. The trigeminal nerve. Semin Ultrasound CT MR 2001; 22: 502-520.
  • Kamel HAM, Toland J. Trigeminal Nerve Anatomy: Illustrated Using Examples of Abnormalities. AJR Am J Roentgenol 2001; 176: 247-251.
  • Ezure H, Goto N, Nonaka N, Goto J, Tani H. Morphometric analysis of the human trigeminal nerve. Okajimas Folia Anat Jpn 2001; 78: 49-53.
  • Pennisi E, Cruccu G, Manfredi M, Palladini G. Histometric study of myelinated fibers in the human trigeminal nerve. J Neurol Sci 1991; 105: 22-28.
  • Goto N. Discriminitive staining methods for nervous system. Luxol fast blue-periodic acid-schiff-hematoxylin triple stain subsidiary staining methods. Stain Technol 1987; 62: 305-315.
  • Uz A, Tüccar E, Tekdemir İ, Elhan A. The course of the ophtmalmic nerve both in the cavernous sinus and orbit. Turkish Neurosurgery 1998; 8: 87-90.
  • LaGuardia JJ. Number of neurons and non-neuronal cell in human trigeminal ganglia. Neurol Res 2000; 22: 565-566.
  • Katılmış H, Özdemir I, Öztürkcan S, ve ark. Diabetli Bir Hastada Multipl Kraniyal Sinir Tutulumu Gösteren Kavernöz Sinüs ve İnternal Karotid Arter Trombozu. Turk Arch Otolaryngol 2004; 42: 98-104.
  • Ishikawa H, Ezure H, Goto N, Kamiyama A, Yanai T. Morphometric difference in the human maxillary nerve fibers between dentulous and edentulous jaw subjects. Okajimas Folia Anat Jpn 2005; 81: 129-134.
  • Shankland WE. The trigeminal nerve. Part IV: the mandibular division. Cranio 2001; 19: 153-161.
  • Kabul Tarihi:17.10.2008

Nervus Trigeminus'un Basis Cranii İçinde Seyrinin İncelenmesi ve Histolojik Analizi

Year 2008, Volume: 13 Issue: 3, 171 - 175, 01.06.2008

Abstract

Amaç: Nervus trigeminus'un (Cr5) kök kısmı ve ggl. trigeminale (TG), önemli komşuluklara sahip fossa cranii media'da bulunur. Cr5 ve TG ile ilgili yapılan anatomik ve histolojik çalışmaların bu bölgenin cerrahisinde de başarıyı artıracağını düşünmekteyiz. Bu çalışmada, Cr5 ve komşu yapıların morfolojik özellikleri ile varyasyonlarının araştırılması amaçladık. Gereç ve Yöntem: Çalışmamızda; 20 adet adli otopsi kadavralarından elde edilen toplam 40 adet Cr5'in intrakraniyal parçası incelendi ve doku örnekleri alındı. Cr5'in intrakraniyal seyri takip edildi ve olabilecek varyasyonlar incelendi. Daha sonra alınan doku örnekleri Hematoksilen-Eozin ve Mallory'nin Anilin Mavisi Kollajen Boyası ile boyanarak histolojik incelenmesi yapıldı. Bulgular: Cr5'in uzunluğu 25.32±2.90 mm, TG'nin genişliği 13.5±1.2 mm olarak bulundu. Dört olguda radix motoria; radix sensoria'nın medial-alt kısmında diğerlerinde ise medialinde yer alıyordu. Cr5 özellikle vasküler yapılar ile çok yakın seyirliydi. Cr5'in toplam fasikül sayısı 71.75±8.20 olarak bulundu. Büyük çaplı fasiküllerin lif çapları 9.11±0.98 µm, küçük çaplı fasiküllerin lif çapları ise 3.17±0.26 µm olarak belirlendi. TG'de satellit hücrelerin çokluğu gözlendi. Nöron kollojen oranları TG'de (2/5) ve Cr5'te ise (1/6) olarak hesaplandı. Sonuç: Çalışmamız ülkemizdeki Cr5 demografisine, klinik bilimlere, cerrahi başarıya ve oluşabilecek çeşitli hastalıkların aydınlatılmasına katkı sağlayacaktır. Ayrıca çalışmamızda nöron/kollojen oranlarının TG ve Cr5'de farklı olması (diyabet ve multiple skleroziste değiştiği gibi), bu konuda daha ileri araştırmaların gerekli olduğunu düşündürmektedir.©2008, Fırat Üniversitesi, Tıp Fakültesi

References

  • Woolfall P, Coulthard A. Trigeminal nerve: anatomy and pathology. The British Journal of Radiology 2001; 74: 458–467.
  • Shankland WE. The trigeminal nerve. Part I: An over-view. Cranio 2000; 18: 238-248.
  • Williams LS, Schmalfuss IM, Sistrom CL et al. MR Imaging of the Trigeminal Ganglion, Nerve, and the Perineural Vascular Plexus: Normal Appearance and Variants with Correlation to Cadaver Specimens. AJNR Am J Neuroradiol 2003; 24: 1317– 1323.
  • Love S, Coakham HB. Trigeminal Neuralgia: Pathology and Pathogenesis. Brain 2001; 124: 2347-2360.
  • El Gammal T, Brooks BS. Trigeminal neuralgia. Radiology 2004; 231: 284.
  • Theil D, Derfuss T, Paripovic I et al. Latent herpesvirus infection in human trigeminal ganglia causes chronic immune response. Am J Pathol 2003; 163: 2179-2184.
  • Chang PC, Fischbein NJ, McCalmont TH et al. Perineural Spread of Malignant Melanoma of the Head and Neck: Clinical and Imaging Features. AJNR Am J Neuroradiol 2004; 25: 5–11.
  • Al-Mefty O, Ayoubi S, Gaber E. Trigeminal schwannomas: removal of dumbbell-shaped tumors through the expanded Meckel cave and outcomes of cranial nerve function. J.Neurosurg 2002; 96: 453-463.
  • Akkol İ, Sucu HK, Bezircioğlu H. Cerebellar tumor causing trigeminal dysfunction. Journal of neorological sciences 2004; 21: 315-318.
  • Lobato RD, Rivas JJ, Sarabia R, Lamas E. Percutaneous microcompression of the gasserian ganglion for trigeminal neuralgia. J Neurosurg 1990; 73: 804-805.
  • Gusmao S, Oliveira M, Tazinaffo U, Honey CR. Percutaneous trigeminal computerized tomography fluoroscopy. J Neurosurg 2003; 99: 785-786. rhizotomy guided by
  • Ziyal IM, Sekhar LN, Ozgen T, Soylemezoglu F, et al. The trigeminal nerve and ganglion: an anatomical, histological, and radiological study addressing the transtrigeminal approach. Surg Neurol 2004; 61: 564-574.
  • Duus P. Nöroloji. Oğuz Y, Özkaynak S, Önal MZ (Çevirenler). 3. Baskı, Ankara: Palme Yayıncılık, 2001.
  • Ueda F, Suzuki M, Fujinaga Y, Kadoya M, Takasima T. In vivo anatomical analysis of arterial contact with trigeminal nerve: detection with three-dimensional spoiled grass imaging. The British Journal of Radiology 1999; 72: 838-845.
  • Arrese I, Lobato RD, Alen JF, et al. Acute subdural and intratemporal hematoma as a complication of percutaneous compression of the gasserian ganglion for trigeminal neuralgia. Neurocirugia (Astur) 2005; 16: 177-182.
  • Bolay H, Reuter U, Dunn AK, et al. Intrinsic brain activity triggers trigeminal meningeal afferents in a migraine model. Nature Medicine 2002; 8:110-112.
  • Meaney JFM, Eldridge PR, Dunn LT et al. Demostration of neurovascular compression in trigeminal neuralgia with magnetic resonance imaging. J Neurosurg 1995; 83: 799-805.
  • Smoliar E, Smoliar A, Sorkin L, Belkin V. Microcirculatory bed of the human trigeminal nerve. Anat Rec 1998; 250: 245-249.
  • Go JL, Kim PE, Zee CS. The trigeminal nerve. Semin Ultrasound CT MR 2001; 22: 502-520.
  • Kamel HAM, Toland J. Trigeminal Nerve Anatomy: Illustrated Using Examples of Abnormalities. AJR Am J Roentgenol 2001; 176: 247-251.
  • Ezure H, Goto N, Nonaka N, Goto J, Tani H. Morphometric analysis of the human trigeminal nerve. Okajimas Folia Anat Jpn 2001; 78: 49-53.
  • Pennisi E, Cruccu G, Manfredi M, Palladini G. Histometric study of myelinated fibers in the human trigeminal nerve. J Neurol Sci 1991; 105: 22-28.
  • Goto N. Discriminitive staining methods for nervous system. Luxol fast blue-periodic acid-schiff-hematoxylin triple stain subsidiary staining methods. Stain Technol 1987; 62: 305-315.
  • Uz A, Tüccar E, Tekdemir İ, Elhan A. The course of the ophtmalmic nerve both in the cavernous sinus and orbit. Turkish Neurosurgery 1998; 8: 87-90.
  • LaGuardia JJ. Number of neurons and non-neuronal cell in human trigeminal ganglia. Neurol Res 2000; 22: 565-566.
  • Katılmış H, Özdemir I, Öztürkcan S, ve ark. Diabetli Bir Hastada Multipl Kraniyal Sinir Tutulumu Gösteren Kavernöz Sinüs ve İnternal Karotid Arter Trombozu. Turk Arch Otolaryngol 2004; 42: 98-104.
  • Ishikawa H, Ezure H, Goto N, Kamiyama A, Yanai T. Morphometric difference in the human maxillary nerve fibers between dentulous and edentulous jaw subjects. Okajimas Folia Anat Jpn 2005; 81: 129-134.
  • Shankland WE. The trigeminal nerve. Part IV: the mandibular division. Cranio 2001; 19: 153-161.
  • Kabul Tarihi:17.10.2008
There are 29 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ahmet Songur This is me

Tolgahan Acar This is me

Oğuz Aslan Özen This is me

Orhan Baş This is me

Önder Şahin This is me

Hüdaverdi Küçüker This is me

İbrahim Üzün This is me

Publication Date June 1, 2008
Published in Issue Year 2008 Volume: 13 Issue: 3

Cite

APA Songur, A., Acar, T., Özen, O. A., Baş, O., et al. (2008). Nervus Trigeminus’un Basis Cranii İçinde Seyrinin İncelenmesi ve Histolojik Analizi. Fırat Tıp Dergisi, 13(3), 171-175.
AMA Songur A, Acar T, Özen OA, Baş O, Şahin Ö, Küçüker H, Üzün İ. Nervus Trigeminus’un Basis Cranii İçinde Seyrinin İncelenmesi ve Histolojik Analizi. Fırat Tıp Dergisi. June 2008;13(3):171-175.
Chicago Songur, Ahmet, Tolgahan Acar, Oğuz Aslan Özen, Orhan Baş, Önder Şahin, Hüdaverdi Küçüker, and İbrahim Üzün. “Nervus Trigeminus’un Basis Cranii İçinde Seyrinin İncelenmesi Ve Histolojik Analizi”. Fırat Tıp Dergisi 13, no. 3 (June 2008): 171-75.
EndNote Songur A, Acar T, Özen OA, Baş O, Şahin Ö, Küçüker H, Üzün İ (June 1, 2008) Nervus Trigeminus’un Basis Cranii İçinde Seyrinin İncelenmesi ve Histolojik Analizi. Fırat Tıp Dergisi 13 3 171–175.
IEEE A. Songur, T. Acar, O. A. Özen, O. Baş, Ö. Şahin, H. Küçüker, and İ. Üzün, “Nervus Trigeminus’un Basis Cranii İçinde Seyrinin İncelenmesi ve Histolojik Analizi”, Fırat Tıp Dergisi, vol. 13, no. 3, pp. 171–175, 2008.
ISNAD Songur, Ahmet et al. “Nervus Trigeminus’un Basis Cranii İçinde Seyrinin İncelenmesi Ve Histolojik Analizi”. Fırat Tıp Dergisi 13/3 (June 2008), 171-175.
JAMA Songur A, Acar T, Özen OA, Baş O, Şahin Ö, Küçüker H, Üzün İ. Nervus Trigeminus’un Basis Cranii İçinde Seyrinin İncelenmesi ve Histolojik Analizi. Fırat Tıp Dergisi. 2008;13:171–175.
MLA Songur, Ahmet et al. “Nervus Trigeminus’un Basis Cranii İçinde Seyrinin İncelenmesi Ve Histolojik Analizi”. Fırat Tıp Dergisi, vol. 13, no. 3, 2008, pp. 171-5.
Vancouver Songur A, Acar T, Özen OA, Baş O, Şahin Ö, Küçüker H, Üzün İ. Nervus Trigeminus’un Basis Cranii İçinde Seyrinin İncelenmesi ve Histolojik Analizi. Fırat Tıp Dergisi. 2008;13(3):171-5.