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PubMed1991

Persistence of the foramen of Huschke in the adult: an osteological study.

The foramen of Huschke, which appears during the embryological development of the tympanic bone, usually closes by the age of five years. A review of 377 dried skulls revealed that the foramen of Huschke was present in adult life in 7% of the skulls examined. A patent foramen of Huschke in the adult may, in rare cases, be the cause of temporomandibular joint herniation or fistulization through the anterior wall of the bony external canal.

Adult↗

PubMed1991

[The seated position in patent foramen ovale?].

Anesthetic management of patients presenting for posterior cranial fossa surgery in the seated position includes detection and treatment of venous air embolism. Atrial positioning of a central venous (cv) line may be verified by either X-ray or an atrial ECG tracing. We report a case where a chest X-ray film proved superior. A 26-year-old white female was scheduled for posterior cranial fossa exploration. A cv line was inserted via the left antecubital vein; the chest X-ray film documented correct positioning of the catheter tip within the atrium but an aberrant course of the superior vena cava. Echocardiography was performed in the induction room and indicated a patent foramen ovale. In view of the risk of paradoxical air embolism, surgery was postponed. Subsequent cardiologic and radiologic examinations revealed a patent foramen ovale and a persisting left superior vena cava draining into a dilated coronary sinus. Surgery was rescheduled and carried out uneventfully in the prone position. This case demonstrates: 1) an advantage of a thoracic-X-ray film compared to atrial ECG tracing as not only the catheter tip position, but also the course of the catheter can be identified; and 2) the usefulness of preoperative screening for a patent foramen ovale in patients scheduled for surgery in the seated position.

Adult↗

PubMedDate not supplied

A jugular foramen schwannoma simulating an acoustic tumor with recovery of retrolabyrinthine cochleovestibular function.

Our literature review has tabulated 33 jugular foramen neuromas that appeared either as a neurologic "syndrome of the jugular foramen" like a glomas tumor, or similar to an acoustic tumor. The few posterior fossa tumors involving the eighth nerve or encroaching upon it that have been removed and resulted in cochleovestibular preservation or recovery have been reviewed. A rare case of jugular foramen schwannoma with cochleovestibular preservation after total removal has been extensively studied with preoperative and postoperative cochleovestibular tests.

Adult↗

PubMed1991

Lumbar intervertebral foramens. An in vitro study of their shape in relation to intervertebral disc pathology.

The lumbar intervertebral foramens of 20 isolated cadaveric spines were investigated by the use of a molding technique to assess their dimensions accurately and how intervertebral disc pathology altered their configuration. Oval foramens predominated over auricularly shaped foramens when the disc was normal, but when the disc was abnormal, the converse was true. Foraminal size varied from 40 to 160 mm2 but showed great variation even at individual levels; these were not accurately reflected by simple radiologic measurements.

Adolescent↗

PubMedDate not supplied

[Position of the mandibular foramen in relation to the width of the ramus and the gonial angle of the mandible].

The aim of this study was to investigate the position of the mandibular foramen in relation to the width of the ramus and the gonial angle of the mandible. One hundred fourty-two dry human mandibles of adults were used. It was found that only the size of the gonial angle affects the anterioposterior position of the foramen. We didn't observe any relation between the inferior-superior position of the foramen and the above parameters.

Adult↗

PubMed1990

[Contents of the transversal foramen of the seventh cervical vertebra].

The purpose of our study was to evaluate the individual variations of the foramen sometimes has the same dimensions as the foramen of the other cervical vertebrae, but it can also be smaller, or absent. In cases where the foramen is present in the seventh cervical vertebra, vascular or nerve structures (or both) can be occasionally observed within. When the transverse foramina are found to contain none of the above structures, what then is to be found within this space? According to our results, the transverse foramina of the seventh cervical vertebra almost universally contain vascular and nerve branches as well as fibrous and adipose tissue. This report concerns the results of the macroscopic and microscopic studies concerning the contents of the transverse foramina of the seventh cervical vertebra.

Cervical Vertebrae↗

PubMed1989

[Right-left auricular shunt caused by patent foramen ovale at a multi-purpose intensive care unit. Apropos of 3 cases].

Three cases of symptomatic right-to-left interatrial shunt through a patent foramen ovale were detected in the course of a case of paradoxical embolism related to a massive pulmonary embolism, a case of refractory hypoxemia after cardiopulmonary bypass and a case of refractory hypoxemia in a patient with tricuspid endocarditis. According to anatomic studies, the incidence of patent foramen ovale is 25-30% in healthy people. In that case any pathological event generating an increase in the right atrial pressure higher than the left atrial pressure may induce a right-to-left shunt with systemic arterial desaturation and possible paradoxical embolization. The reported cases emphasize the advantage of ultrasonic examinations (contrast sonocardiography, pulsated or coloured Doppler) to show the right-to-left atrial shunt. The demonstration of this acquired shunt requires appropriate measures in order to reverse the atrial gradient. Sometimes a specific therapy is required such as caval filter insertion in case of pulmonary embolization or surgical closure of foramen ovale in some patients.

Adult↗

PubMed1989

Chronic intermittent gastric volvulus within the foramen of Morgagni.

Hernia through the foramen of Morgagni is uncommon in adults. Chronic gastric volvulus within the foramen of Morgagni is very rare. In this report, we describe a patient who presented with symptoms of gastric outlet obstruction due to chronic intermittent gastric volvulus in the foramen of Morgagni.

Chronic Disease↗

PubMedDate not supplied

CT evaluation of the greater sciatic foramen in patients with sciatica.

Sciatic and lower extremity neurologic symptoms may be from pathologic involvement of the sacral plexus or sciatic nerve in the region of the greater sciatic foramen. Twenty-five patients were reviewed who presented consecutively over a 4 year period with sciatic symptoms secondary to pathologic changes in the greater sciatic foramen. Malignant neoplasm alone (18 patients) and malignant neoplasm associated with infection (two patients) account for most of these cases. Neurogenic tumors (three patients), both benign and malignant, and infection alone (three patients) were less frequent. Although sciatic symptoms usually derive from spinal abnormalities, the evaluation of sciatic symptoms should not be considered complete without CT scanning of the greater sciatic foramen.

Adult↗

PubMed1988

[Huschke's foramen].

Morphological analysis of the tympanic part of the temporal bone has lead us to comment a particular structure: the foramen of Huschke. This foramen is founded during the embryological development and results from the growth and fusion of two tympanic tubercles. The foramen of Huschke normally closes up like a diaphragm before the age of five years. It may however, persist in a few rare cases (2/300).

Ear, Middle↗

PubMed1988

[Obturator foramen approach in vasovasostomy: studies on a cadaver].

We tested the obturator foramen approach first reported by Shafik in 1982, on an 84-year-old male cadaver. By this approach, the ductus deferens is by-passed through the obturator foramen for the reanastomosis in patients who require excision of a long segment of the ductus deferens. The length of the ductus deferens spared by this method was 10.5 cm. Preservation of the deferential artery and protection of the obturator nerve and vessels were considered to be essential in the operation. When the ductus deferens was cut more distal than the internal inguinal ring, this method was not feasible because the distal part of the vas was too short to come out to the upper scrotal region through the obturator foramen.

Aged↗

PubMed1979

Jugular foramen neurinomas.

Three patients with neurinomas of the jugular foramen are described. One of them had a small tumor confined within the jugular foramen and each of the other two had a tumor originating from the glossopharyngeal nerve. The common feature in all these patients was the presence of marked enlargement of the jugular foramen. Polytomography, jugular venography and bilateral retrograde vertebral arteriography were used to make the diagnosis. Total removal of their tumors was successfully accomplished using microsurgical technique. Forty-two other cases in the world literature are reviewed and analyzed.

Accessory Nerve↗

PubMed1979

[Fascia canals of the greater sciatic foramen and their practical importance].

Fasciae and fat tissue spaces in the gluteal region, topography of the suprapiriform and infrapiriform foramina have been studied by means of a complex anatomical experimental technique. The suprapiriform foramen should be considered as a fascialosseous canal, as it is 4-4.5 cm long and 0.6-1.0 cm wide. It is formed by the upper margin of the greater sciatic notch covered with a thin fascia, fasciae of the gluteal and piriform muscles and the parietal layer of the pelvic fascia. The proper fascial vaginae of the upper gluteal vessels and nerves are adhered to fascial walls of the canal. This peculiarity is used for the method of ligation of the superior gluteal artery within the limits of the suprapiriform canal. The infrapiriform foramen is either narrow or wide enough (up to 2.0 cm in diameter). Inferior gluteal vessels at the level of the sacrospinous ligament go from the parietal layer of the pelvic fascia into the duplicature of the deeper layer of musculus gluteus maximus. The inferior gluteal nerve, above the lower margin of the piriform muscle, ajoining the vessels gets into the fissure of the parietal layer of the pelvic fascia, under the lower margin neurovascular fasciculus also goes through the fissure of the pelvic fascial parietal layer, downward and parallel to the inferior gluteal vessels. The knowledge of possible ways of connections through the canals of the greater sciatic foramen, fat tissue spaces at the subperitoneal level of the small pelvis and the gluteal region is of great practical value.

Buttocks↗

PubMed1983

[Paradoxical embolism through a patent foramen ovale. 4 cases].

Four cases of paradoxical embolism through a patent foramen ovale associated with massive pulmonary embolism are reported. In two cases, patency of the foramen ovale was demonstrated by a new technique: cross-sectional contrast echocardiography potentiated by coughing. The conventional surgical treatment included arterial embolectomy followed by insertion of a caval filter. Embolism recurred on three occasions under mechanical ventilation prior to insertion of the filter. A new sequence of investigations to facilitate detection of paradoxical embolism in patients with unexplained arterial embolism is suggested: (1) blood gas measurements, which reveal associated pulmonary embolism; (2) cough-potentiated cross-sectional contrast echocardiography, which demonstrates a patent foramen ovale and excludes emboligenic cardiopathies; (3) phlebography and pulmonary angiography which complete the diagnosis. To reduce the risk of recurrent embolism, it is recommended to begin treatment by blocking the vena cava without mechanical ventilation. This can be done by inserting a filter through the jugular vein under local anaesthesia. Arterial embolism can then be treated at lesser risk under mechanical ventilation.

Echocardiography↗

PubMed1983

[Patency of the foramen ovale in paradoxical embolism. Detection by contrast echocardiography and the cough provocation test].

Five patients with suspected paradoxical embolism were investigated for patent foramen ovale by contrast echocardiography. Right-to-left shunting was demonstrated in 3 patients: during a Valsalva manoeuvre in one and during coughing fits in all three. Patency of the foramen ovale was confirmed by cardiac catheterization in these 3 patients. In 2 patients the foramen was not patent and the diagnosis of paradoxical embolism was not confirmed. In two other patients, the right and left atrial pressures were measured simultaneously during a Valsalva manoeuvre and during coughing. The normal pressure gradient between the two atria was suppressed during the relaxation stage, resulting in decreased curvature of the interatrial septum which facilitated the flow of blood from the inferior vena cava into the left atrium. Coughing appears to be a simpler and more sensitive test than the Valsalva manoeuvre to induce transient right-to-left atrial shunting.

Cough↗

PubMed1978

The position of the nutrient foramen in the growing tibia and femur of the rat.

In rats of 40, 49 and 59 days of age the positions of the femoral and tibial nutrient foramina were determined by direct measurement, using a travelling microscope. The femoral nutrient foramen remained constant in position with increasing age, whereas the tibial nutrient foramen moved relatively nearer to the distal end of the shaft. In the case of the femur this can be accounted for entirely by differences in growth rates at the epiphyseal plates of the femur compensating for the disproportion in the distances of the foramen from the two plates. In the tibia, however, extension of the extremely oblique nutrient canal as the bone increases in girth is also involved. Bone remodelling in the vicinity of the canal is not necessary to explain the results.

Animals↗

PubMed1983

Growth in the area of the inferior dental foramen of rats.

The object of the present investigation was to see if the bone around the inferior dental nerve remodelled during mandibular growth and development. The investigation was carried out by injecting 27 albino Lewis rats with three fluorescent bone seeking dyes--oxytetracycline HCl (OTC), alizarin red S (ARS), and 2,4 bis-[N,N'-di' (carbomethyl-aminomethyl)] fluorescein (DCAF)--and then studying the bone around the inferior dental foramen. The mandibles of the animals were studied both macroscopically and microscopically under ultraviolet light to investigate the growth processes occurring and to see if the inferior dental foramen was relocated during growth. A quantitative analysis utilizing two specimens was also carried out for the same purpose. The results of both the qualitative and the quantitative analyses showed that the bone around the inferior dental nerve remodeled during mandibular growth. The mandible grew in an upward and backward direction, and the inferior dental foramen was correspondingly relocated in an upward and backward direction to maintain exactly the same position relative to the condyle and the posterior border of the ramus. This study, then, supports Moss's concept of the "unloaded" nerve, and is in keeping with his view of mandibular growth based on the functional matrix theory.

Animals↗

PubMed1984

Small intestine incarceration through the epiploic foramen of the horse.

Fifteen horses were referred to Purdue University or to the University of Georgia because of colic. Each of these horses had small intestine incarcerated through the epiploic foramen. However, signs of pain, gastric reflux, and small intestine distention were not consistent signs, as would have been expected with small intestine strangulation/obstruction. In 10 of the 15 cases, abdominal fluid analysis provided the decisive information needed for surgical intervention. Surgery was performed in 14 cases. The small intestine was incarcerated through the epiploic foramen in a right-to-left direction in 12 cases and in a left-to-right direction in 3 cases. The intestinal incarceration was reduced by gentle traction on the adjacent unaffected intestine. Resection and anastomosis were performed in 10 cases. Twelve of the 14 surgical patients died, and it was believed that the failure to intervene surgically at an earlier time contributed to these poor results. Surgery was delayed in most cases because of the inconsistent clinical signs observed in these horses. It was concluded that small intestine incarceration through the epiploic foramen should be suspected in any case of colic that has inconsistent physical findings and does not resolve in short time. Further, serial abdominal fluid analysis should be used in such cases in order to detect changes or trends that would indicate a lesion requiring surgical intervention.

Animals↗