Abstract
The medial end of the posterior border of the sphenoid bone presents the anterior clinoid process (ACP), which is usually accessed for operations involving the clinoid space and the cavernous sinus. The ACP is often connected to the middle clinoid process (MCP) by a ligament known as the caroticoclinoid ligament (CCL), which may be ossified, forming the caroticoclinoid foramen (CCF). Variations in the ACP other than ossification are rare. The ossified CCL may have compressive effects on the internal carotid artery. Thus, anatomical and radiological knowledge of the ACP and the clinoid space is also important when operating on the internal carotid artery. Excision of the ACP may be required for many skull-based surgical procedures, and the presence of any anomalies such as ossified CCL may pose a problem for neurosurgeons. We observed the presence of ossified CCL in a skull bone. A detailed radiological study of the CCL and the CCF was conducted. Morphometric measurements were recorded and photographs were taken. The ACP was connected to the MCP and was converted into a CCF. Considering the fact that standard anatomy textbooks do not provide morphological descriptions and radiological evaluations of the CCL, the present study may be important for neurosurgeons operating in the region of the ACP.
Highlights
The medial end of the lesser wing of the sphenoid bone forms the anterior clinoid process (ACP).[1]
As described in conventional textbooks of anatomy, the ACP may be joined to the middle clinoid process (MCP) by a ligament or dural fold.[1]
The bony bridge joining the ACP and MCP converts the distal end of the carotid sulcus into an ostium known as the caroticoclinoid ligament (CCL).[2]
Summary
The medial end of the lesser wing of the sphenoid bone forms the anterior clinoid process (ACP).[1] The ACP provides attachment to the free margin of the tentorium cerebelli and is grooved medially by the internal carotid artery.[1] The ACP is joined to the middle clinoid process (MCP) by the caroticoclinoid ligament (CCL), which is sometimes ossified. A dural fold extending between the anterior and middle clinoid processes or ossification of the CCL may result in the formation of the caroticoclinoid foramen (CCF).[1]. The presence of an ossified CCL may form a potential site for compression of the internal carotid artery. During routine osteology teaching for undergraduate medical students, we observed an anomalous CCL in a skull bone. Anomalous ossification of the CCL was noted and the specimen was photographed (Figure 1). Appropriate morphometric measurements were recorded and a proper radiological evaluation was conducted (Figure 2)
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