Abstract
PurposeThe purpose of the study was to analyze the total prevalence, morphologic, and morphometric characteristics of the pterygospinous (PS) bar and its gender and ethnic differences among populations. PS bar is an ossified anatomic structure stretching between the posterior margin of the lateral pterygoid lamina to the angular spine of the undersurface of the sphenoid, with potential clinical implications. There is no consensus in the literature on its prevalence, morphologic, and morphometric characteristics.MethodsA thorough search of databases was conducted. Data on the prevalence, morphology, i.e., ossification type (complete and incomplete), side, gender, laterality, and morphometrics, of the PS bar were extracted and pooled into a meta-analysis.ResultsA total of 35 studies (n = 14,047 subjects) were analyzed. The overall pooled prevalence of a complete PS bar was 4.4% (95% CI 3.7–5.1), while the overall pooled prevalence of an incomplete PS bar was significantly higher (11.6% [95% CI 8.5–15.2]). A complete PS bar was more prevalent among males and was more commonly unilaterally, on the left side.ConclusionThe overall prevalence of PS bar is quite common. It could be of importance for clinicians who should consider its potential presence when planning surgical approaches to the retropharyngeal and parapharyngeal space.
Highlights
The pterygospinous (PS) bar was first described by Fillipo Civinini in 1829, as an ossified structure stretching from the posterior free margin of the lateral pterygoid lamina to the angular spine of the undersurface of the greater wing of the sphenoid bone (Fig. 1) [5]
The PS bar is often confused with the pterygoalar (PA) bar [5, 26], as both bars are localized close to the foramen ovale (FO) area [9]
The analysis revealed that the incomplete PS bar was most common among Europeans (15.4% [95% CI 12.2–18.8]), followed by South Americans (15.3% [95% CI 9.8–21.8]) and North Americans (12.6% [95% CI 3.3–25.8]), with the lowest pooled prevalence found in Asians (8.4% [95% CI 3.9–14.3]), though the differences were not significant (Table 3)
Summary
The pterygospinous (PS) bar was first described by Fillipo Civinini in 1829, as an ossified structure stretching from the posterior free margin of the lateral pterygoid lamina to the angular spine of the undersurface of the greater wing of the sphenoid bone (Fig. 1) [5]. The PS bar can be present either uni- or bilaterally, and the extent of ossification can vary between sides. A completely ossified PS bar may form a PS (or Civinini’s) foramen [19] through which passes the medial pterygoid vessels and nerve [30]. The PS bar may be found either below or medial to the FO, whereas the PA bar lies lateral to the FO or runs beneath it, dividing FO into two parts [19] (Fig. 4). The size of a PS foramen may vary even when occurring bilaterally. It may occur as one large foramen (even up to 10 mm in diameter) or it may be divided into five distinctly separate foramina of variable size [5]
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