CRANIAL BASE (Lat. - BASIS CRANII)

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Presentation transcript:

CRANIAL BASE (Lat. - BASIS CRANII) Prof. Peter Stanko, MD, PhD Oral and Maxillofacial Surgeon Dpt. of Stomatology & Maxillofacial Surgery Comenius University, St Elisabeth Hospital

BASIS CRANII (CRANIAL BASE) A/ BASIS CRANII EXTERNA (external cranial base, outer surface) = three AREAS: ▪ area anterior (syn. nasoorbitalis) ▪ area medialis ▪ area posterior (syn. vertebronuchalis) B/ BASIS CRANII INTERNA (internal cranial base, inner surface) = three CRANIAL FOSSAE: ● fossa cranii ant. ● fossa cranii med. ● fossa cranii post.

External cranial base – I. AREA ANTERIOR (synonym NASOORBITALIS) -medially top of the nasal cavity (meatus nasi sup. dx. + sin.) -laterally roof of the orbits (l. dx. + l. sin.).

External cranial base

External cranial base – II. AREA MEDIALIS -Area pharyngea (clivus) -foramina for. n. V. (for. rotundum, for. ovale) → n. maxillartis, n. mandibulartis -foramina for vessels (canalis caroticus, for. jugulare) -both Temporomandibular joints (abbr. TMJ, Lat. – Articulatio temporomandibularis)

External cranial base

External cranial base – III. AREA POSTERIOR (synonym VERTEBRONUCHALIS) -Foramen occipitale magnum -Atlantooccipital joint (Lat. – Articulatio atlantooccipitalis)

External cranial base

External cranial base

Internal cranial base – I. FOSSA CRANII ANTERIOR -Lamina cribrosa (horizontalis) ossis ethmoidalis -Crista galli (insertion of falx cerebri).

Internal cranial basis - FOSSAE CRANII

Os ethmoidale Crista gali Lamina cribrosa (horizontal) Lamina perpendicularis (vertical) Labyrintus - Celullae ethmoidales (ant., mediae, post.)

Internal cranial base – II. FOSSA CRANII MEDIA -sella turcica (location for hypophysis) ………..roof of sinus sphenoidalis -os petrosum (pyramid) ……..ganglion trigeminale Gasseri (cavum trig. Meckeli) -foramina (for. rotundum, for. ovale) → n. maxillartis, n. mandibulartis

Os sphenoidale

Ganglion trigeminale Gasseri

Internal cranial base – III. FOSSA CRANII POSTERIOR ► Foramen occipitale magnum ► C N S (pons Varolli + medula oblongata + cerebellum).

For. occipitale magnum

Central Nervous System (C N S)

Practical value of the knowledge of cranial base anatomy -trunc anaesthesia (n. maxillaris, n. mandibularis) -infiltration in facial palsy (n. VII) -traumatology (fractures, CNS injuries etc.).

Areas of weakness of cranial base (Lat. – loci minoris resistentiae) Predilection of fracture lines, especially in sites of conection of the weak and strong bones. Thickness of the bones - comparison of the three cranial fossae (cr.f.): ● the anterior cr. f. is the most thin and exposed, ● the medial cr.f. is strong but exposed indirectly through the coronoid process, ●the posterior cr.f. is thick and rarely exposed.

Usual course of fracture lines in cranial base fractures