Circularity, Solidity, Axes of a Best Fit Ellipse, Aspect Ratio, and Roundness of the Foramen Ovale: A Morphometric Analysis With Neurosurgical Considerations

AbstractThe structure of the foramen ovale of the sphenoid bone is clinically important, particularly with regard to surgical procedures that cannulate the foramen such as percutaneous trigeminal rhizotomy for the treatment of trigeminal neuralgia, percutaneous biopsy of parasellar lesions, and electroencephalographic analysis of the temporal lobe among patients undergoing selective amygdalohippocampectomy. Differences in the morphology of the foramen ovale (FO) have been reported to contribute to difficulties in the cannulation of the FO. Reports regarding the structure of the FO, however, use subjective and ambiguous descriptions of morphology, including “oval,” “truly oval,” “elongated oval,” “elongated,” “semicircular,” “almond,” “round,” “rounded,” “slit,” “irregular,” “D shape,” and “pear.” Therefore, it is necessary to describe the structure of the FO with reproducible objective morphometric data. This study analyzed 169 foramina to determine normative morphometric shape descriptions of the following: area, perimeter, circularity, solidity, axes of a best fit ellipse, aspect ratio, and roundness. The shape descriptors reported herein may aid in identification and description of structural variation in FO including bony projections encroaching upon the foramina and may improve surgical approaches to transovale cannulation.