Evaluation of foramen lacerum morphometry on brain computer tomography by using 3D Slicer method

The foramen lacerum located at the base of the skull is the safest way to approach the arteria carotis interna and Vidian canal in cases requiring surgical intervention. In our study, we aimed to reveal the FL and its relationship with the related surrounding structures by morphologic and morphometric measurements. In our study, brain computed tomography image series of 45 females (mean age: 46.79 ± 14.60 years) and 32 males (mean age: 47.60 ± 17.61 years) who underwent 3D brain computed tomography (CT) for various reasons at Balıkesir University Faculty of Medicine, Department of Radiology were analyzed. The length and width of the foramen lacerum, Vidian canal length, Vidian canal to fissura pterygosphenoidalis and Vidian canal to canalis palatovaginalis angles were measured. All measurements were performed with 3D Slicer computer software program. As a result of the analysis, the length of the right and left foramen lacerum and the width of the left side foramen lacerum were found to be higher in males compared to females (p<0.05). Vidian canal length did not differ between men and women (p>0.05). When we evaluated the angle between the right and left Vidian canal and fissura pterygosphenoidalis, this angle was found to be wider in men than in women (p<0.05). There was a statistically significant negative correlation between age and right Vidian canal length in all individuals (r = - 0.248, p= 0.029). Right and left foramen lacerum types were also analyzed in our study. Accordingly, four types of FL were identified as Type 1 (normal FL), Type 2 (canal FL), Type 3 (bridged FL) and Type 4 (no FL). Right FL types were found to be 70.1%, 15.6% and 14.3% in the above order. Left FL type rates were 72.7%, 11.7% and 15.6%. Type 4 was not seen in our study. In the medical field, it is important to be aware of individual variations rather than generalizations in order to make accurate diagnoses and direct patients to the right treatments. Therefore, morphometric analysis of FL will contribute to anatomists, clinicians and the literature in terms of determining safe interventional routes in cases requiring possible surgical intervention in these regions.