Coquet Thomas, Lefranc Michel, Chenin Louis, Foulon Pascal, Havet Éric, Peltier Johann
Department of Anatomy and Organogenesis, Faculty of Medicine, University of Picardie Jules Verne, 3 rue des Louvels, 80036, Amiens, Somme, France.
Department of Neurosurgery, Amiens University Hospital, Avenue René Laennec, 80054, Amiens Cedex 1, Salouel, Somme, France.
Surg Radiol Anat. 2018 Jul;40(7):835-840. doi: 10.1007/s00276-018-2003-7. Epub 2018 Mar 15.
In this anatomy report, we describe the first case of abducens nerve duplication limited to the sphenopetroclival venous gulf and the cavernous sinus. The objective point of division of the two duplicated roots was localized at the gulfar face of the dural porus, just distal to the unique cisternal trunk of the abducens nerve, as it pierced the petroclival dural mater. In the gulfar segment, both roots traveled through a variant of Dorello's canal called the "petrosphenoidal canal" and remained separated through the posterior half of the cavernous sinus. Both roots finally fused in the anterior half of the cavernous sinus to innervate the lateral rectus muscle as a single trunk. Although many variants of the abducens nerve have been reported over the recent decades, this anatomic variation has never been previously described and enriches the continuum of abducens nerve variations reported in the literature data. Awareness of this variation is crucial for neurosurgeons, especially during clival or petrosal surgical approaches used for resection of skull base chordomas.
在本解剖学报告中,我们描述了第一例仅限于蝶岩斜静脉沟和海绵窦的展神经重复病例。两条重复神经根的客观分隔点位于硬脑膜孔的沟面,恰好在展神经唯一的脑池段穿出岩斜硬脑膜后。在沟段,两条神经根穿过一种称为“岩蝶管”的多雷洛管变体,并在海绵窦后半段保持分离。两条神经根最终在海绵窦前半段融合,作为单一主干支配外直肌。尽管近几十年来已报道了展神经的许多变体,但这种解剖变异此前从未被描述过,丰富了文献数据中报道的展神经变异的连续性。认识到这种变异对神经外科医生至关重要,尤其是在用于切除颅底脊索瘤的斜坡或岩部手术入路过程中。