head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2021, vol. 27, issue4
Subject Area: Medicine
DOI: 10.5272/jimab.2021274.4004
Published online: 05 October 2021

Original article

J of IMAB. 2021 Oct-Dec;27(4):4004-4009
Ivan Maslarski1ORCID logo, Lyudmila Belenska-Todorova2ORCID logo Corresponding Autoremail,
1) Department of Anatomy, Histology, Pathology and Forensic medicine, Faculty of Medicine, University of Sofia, Bulgaria.
2) Department of Biology, Medical Genetics and Microbiology, Faculty of Medicine, University of Sofia, Bulgaria.

Purpose: Emissary foramens in the skull and emissary veins (EV), respectively, have been known for a long time, but their importance is often disregarded. In the present study, we introduce variants of occipital emissary foramens (OEF) unilaterally located on the left, close to оccipital condylе in a formation of three apertures that open together in a sinus near clivus.
Material/Methods: Corpses of 30 dеad people were dissected in the Department of Anatomy, and standard techniques for soft tissue separation or maceration of the skull were used. After the removal of the calvaria, fixed bones of the skull were disarticulated.  Foramens were cleaned using a double-ended probe, and depth and diameter measurements were performed using an atomical caliper.
Results: We found variants of mastoid emissary foramens (MEF) situated into two groups, each of a couple of foramens.  Their clinical significance is discussed, compared with existing experience and analysis of their phylogeny and embryogenesis.
Conclusion: We introduce OEF and MEF to be important markers for detection of dural venous sinuses (DVS). The latter, together with EV, provide an important mechanism for decreasing intracranial pressure. This happens due to the absence of a valve apparatus in the veins of the brain, and the lack, or small amount, of muscle tissue. There is a possibility of existing varicose veins, such as those caused by arterio-venous fistulas and the pathology associated with it. We suggest the application of EV in imaging as an important study before surgery by lateral and transcondylar approach to the anterior foramen magnum.

Keywords: emissary veins, arteriovenous fistula, dural venous sinuses, intracranial pressure,

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Please cite this article as: Maslarski I, Belenska-Todorova L. Variants of mastoid and occipital emissary foramens and their clinical correlation. J of IMAB. 2021 Oct-Dec;27(4):4004-4009. DOI: 10.5272/jimab.2021274.4004

Corresponding AutorCorrespondence to: Lyudmila Filipova Belenska-Todorova; Department of Biology, Medical Genetics and Microbiology, Faculty of Medicine, University of Sofia; 1, Kozyak Str., 1407 Sofia, Bulgaria; E-mail: lyudmila_bt@yahoo.com

1. Murlimanju BV, Prabhu LV, Pai MV, Jaffar M, Saralaya VV, Tonse M, et al. Occipital emissary foramina in human skulls: an anatomical investigation with reference to surgical anatomy of emissary veins. Turk Neurosurg. 2011 Jan;21(1)36-8. [PubMed]
2. Jelev L, Malinova L. Occipital emissary foramina in human skulls: review of literature and proposal of a classification scheme of the occipital venous anastomoses in the posterior cranial fossa. Anatomy. 2020 Apr;14(1): 11-15. [Crossref]
3. Halagatti M, Sagar S. An Anatomical study of parietal emissary foramina in dry adult human skulls. Int J Anat Radiol Surg. 2018 Apr;7(2):A020-A022.
4.  Freire AR, Rossi AC, de Oliviera VCS, Prado FB, Caria PHF, Botacin PR. Emissary foramens of the human skull: Anatomical characteristics and its relations with clinical neurosurgery. Int J Morphol. 2013; 31(1):287-292.
5. Keskil S, Gözil R, Calgüner E.  Common surgical pitfalls in the skull. Surg Neurol. 2003 Mar;59(3):228-31. [PubMed]
6. Mortazavi MM, Tubbs RS, Riech S, Verma K, Shoja MM, Zurada A, et al. Anatomy and pathology of the cranial emissary veins: a review with surgial implications. Neurosurgery. 2012 May;70:1312-8. [PubMed]
7. Okudera T, Huang YP, Ohta T, Yokota A, Nakamura Y, Maehara F, et al. development of posterior fossa dural sinuses, emissary veins, and jugular bulb: morphological and radiologic study. AJNR Am J Neuroradiol. 1994 Nov;15(10):1871-83. [PubMed]
8. Jadhav SD, Ambali MP, Zambare BR. Sphenoidal emissary foramen and its clinical consideration. Int J Res Med Sci. 2016 Jul;4(7):2926-2929. [Crossref]
9. Zdilla MJ, Cyrus LM, Laslo JM, Lambert HW. Bilateral duplication of the sphenoidal emissary foramen: A case report with implications for surgeries using transovale cannulation. Anat Physiol. 2014; 4:4. [Crossref]
10. Leonel LCPC, Peris-Celda M, de Sousa SDG, Haetinger RG, Liberti EA. The sphenoidal emissary foramen and the emissary vein: Anatomy and clinical relevance. Clin Anat. 2020 Jul;33(5):767-781. [PubMed]
11. Cakmak PG, Ufuk F, Yagci AB, Sagtas E, Arslan M. Emissary veins prevalence and evaluation of the relationship between dural venous sinus anatomic variations with posterior fossa emissary veins: MR study. Radiol Med. 2019 Jul;124(7):620–7. [PubMed]
12. Cakmak PG, Herek D, Ufuk F, Sagtas E, Arslan M.  Posterior fossa emissary venous canal prevelance and visibility on standard computed tomography. Med-Science. 2019 Sep;8(3):569-72. [Crossref]
13. Miyachi S, Izumi T, Matsubara N, Naito T, Haraguchi K, Wakabayashi T. Mechanism of the formation of dural arteriovenous fistula - the role of the emissary vein. Interv Neuroradiol. 2011 Jun;17(2):195-202. [PubMed].

Received: 04 March 2021
Published online: 05 October 2021

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