Abstract
A group of intrinsic ligaments of the sphenoid bone which connect the anterior, middle and posterior clinoid processes occasionally get ossified and give rise to various types of ossified interclinoid bars. In present study the incidence of various types of ossified interclinoid bars were observed in 200 dry human skulls of unknown age and sex belonging to department of Anatomy of various Medical Colleges of Gujarat region. The interclinoid bars are classified on the basis of two classifications, proposed by Rani Archana et al and Keyers. Rani Archana et al, classified interclinoid bars into four types : Type I (caroticoclinoid foramen) bridge present between anterior and middle clinoid process, Type II bridge between anterior, middle and posterior clinoid process, Type III bridge between anterior and posterior clinoid process and Type IV bridge between the middle and posterior clinoid process. Each interclinoid bar was classified into contact, incomplete, complete types based on the classification of Keyers. In present study total incidence of interclinoid bars was 18%. Type I were present in 10.5%, out of which 8% were complete and 2.5% were incomplete. Types II in 3.5%, amongst them 2% were complete and 1.5% was mixed. Type III in 4%, out of which 2% were complete and 2% were incomplete. Total incidence of caroticoclinoid foramens was 14.5%, out of which 11.5% were complete and 3% were incomplete. Total incidence of sellar bridge was 7.5%, out of which 4.5% were complete and 3% were incomplete. Presence of osseous interclinoid bars may cause compression of surrounding structures like the cavernous sinus and its content, sphenoid sinus and pituitary gland. Therefore, detailed anatomical knowledge of various types of interclinoid bars can increase the success of diagnostic evaluation and surgical approaches to the region.
Highlights
The ossification of ligamentous structures in various parts of the body may result in a clinical problem such as compression of neighbouring structures and complications in regional surgery
The anterior clinoid processes are formed by the medial and anterior prolongations of the lesser wing of the sphenoid bone, the posterior clinoid processes are present at the end of the dorsum sellae and the middle clinoid processes are present on either side of tuberculum sellae
Ossification of interclinoid ligament that connecting anterior and posterior clinoid processes is termed as interclinoid osseous bridge or sella Turcica Bridge
Summary
The ossification of ligamentous structures in various parts of the body may result in a clinical problem such as compression of neighbouring structures and complications in regional surgery. The carotico-clinoid ligament connecting anterior and middle clinoid processes sometime get ossified forming the carotico-clinoid foramen which transmits one of the segment of internal carotid artery. Ossification of interclinoid ligament that connecting anterior and posterior clinoid processes is termed as interclinoid osseous bridge or sella Turcica Bridge. Ossification of the ligaments connecting the clinoid processes of the sphenoid bone may give rise to bony bridges. According to Basmajian[5] and Breathnach[6] these bridges are related to the cavernous sinus, internal carotid artery, and pituitary gland In surgical procedures such as exposure of the cavernous sinus through superior approach and in the management of paraclinoid aneurysm, excision of anterior clinoid process becomes mandatory. Presence of ossified interclinoid bars poses difficulty in removal of anterior clinoid process and enhances the risk of damage to the adjacent important structures. The obtained results were compared with those of other studies on different populations
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