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Clinical anatomy of the orbitomeningeal foramina: variational anatomy of the canals connecting the orbit with the cranial cavity

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Abstract

Purpose

In addition to the optic canal and the superior orbital fissure, orbits are connected with the cranial cavity via inconstant canals including the orbitomeningeal foramen. This study has been carried out in order to define many anatomical and radiological details of the orbitomeningeal foramen that are relevant in the clinical practice.

Methods

Almost 1000 skulls and 50 computerized tomographies were examined to determine incidence, number, length, and caliber of the orbitomeningeal foramen as well as the topography of their orbital and cranial openings. A retrospective study of angiographies carried out on more than 100 children was performed to look for arteries candidate to run through the orbitomeningeal foramen.

Results

Orbitomeningeal foramina were detected in 59.46 % of skulls and in 54 % of individuals by computerized tomography. Orbits with two to five foramina were found. Canals were classified as M-subtype or A-subtype depending on their cranial opening. Large foramina, with the caliber ranging between 1 and 3 mm, were found in 12.17 % of orbitomeningeal foramen-bearing orbits. By computed tomography the average caliber measured 1.2 ± 0.3 and 1.5 ± 0.5 mm (p < 0.005) at the orbital and cranial openings, respectively (p < 0.005). Angiographies showed meningo-lacrimal and meningo-ophthalmic arteries, meningeal branches of the lacrimal and supraorbital arteries, and some unidentified arteries that could pass through the orbitomeningeal foramina.

Conclusions

Orbitomeningeal foramina are a common occurrence. When large they may house important arteries that can be the source of severe bleedings during deep dissection of the lateral wall of the orbit. Orbital surgeons should be aware of their existence.

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Acknowledgments

The authors are grateful to Dr. Gianpaolo Mornata and Dr. Gloria Sarasin for their skillful technical assistance and to Radiologic Center Euganea Medica.

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    Authors and Affiliations

    1. Department of Molecular Medicine, Institute of Human Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy

      Veronica Macchi, Andrea Porzionato & Raffaele De Caro

    2. Department of Life Sciences, University of Siena, Via Aldo Moro 2, 53100, Siena, Italy

      Marì Regoli & Eugenio Bertelli

    3. Unit of Neuroimaging and Neurointervention (NINT), Azienda Ospedaliera Universitaria Senese (AOUS), University of Siena, Policlinico “Santa Maria alle Scotte”, Siena, Italy

      Sandra Bracco

    4. Gut Health and Food Safety Institute Strategic Program, Institute of Food Research, Norwich, UK

      Claudio Nicoletti

    5. Section of Radiology, Euganea Medica Center, Via Colombo 3, Sant’Agostino Di Albignasego, 35127, Padua, Italy

      Aldo Morra

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    1. Veronica Macchi
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    3. Sandra Bracco
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    Correspondence to Eugenio Bertelli.

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    Veronica Macchi and Marì Regoli have contributed equally to this work.

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    Macchi, V., Regoli, M., Bracco, S. et al. Clinical anatomy of the orbitomeningeal foramina: variational anatomy of the canals connecting the orbit with the cranial cavity. Surg Radiol Anat 38, 165–177 (2016). https://doi.org/10.1007/s00276-015-1530-8

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