Jemds.com Original Research Article J. Evolution Med. Dent. Sci./eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 5/ Issue 61/ Aug. 01, 2016 Page 4309 MORPHOLOGICAL STUDY OF CAROTICO-CLINOID FORAMEN Sandeep Mohite 1 , Raghunath S. More 2 , Hemalata Mohite 3 1 Associate Professor, Department of Anatomy, Krishna Institute of Medical Sciences, Deemed University, Karad. 2 Assistant Professor, Department of Anatomy, Institute of Medical Sciences, Banaras Hindu University, Varanasi. 3 Tutor, Department of Anatomy, Krishna Institute of Medical Sciences, Deemed University, Karad. ABSTRACT The anterior and middle clinoid processes of sphenoid bone are connected by a ligament called carotico-clinoid ligament, which maybe ossified forming the carotico-clinoid foramen. Ossification of some normally occurring ligaments of the human skull produces the bony bridges that connect to the clinoid processes with other surrounding structures. The ligaments are related to many anatomical structures and when ossified may cause compression of these structures. MATERIALS AND METHODS Total 82 adult human dried crania were studied. To select the crania, integrity of the clinoid processes was evaluated and damaged clinoid processes were excluded. The crania with unilateral or bilateral complete CCF were considered. The morphometry was performed by using vernier caliper. Anteroposterior (AP) and transverse diameters were measured. Statistical analysis was done. RESULTS The incidence of the presence of CCF (Carotico-clinoid foramen) was 28%. CCF was more on right (21) than the left side (19). The AP length of the CCF on right was 0.77 cm while of left side it was 0.60 cm, which was statistically significant. But, breadth on right side, it was 0.56 cm and on it 0.55 cm, which was almost equal on both sides. CONCLUSION The presence of ossified interclinoid ligament makes the removal of the anterior clinoid process more difficult. Knowledge about the ossification of carotico-clinoid ligament (CCL) is important in neurosurgical operations because the presence of an ossified CCL may form a potential site for compression of internal carotid artery. KEYWORDS Carotico-Clinoid Ligament, Clinoid Processes, Carotico-Clinoid Foramen. HOW TO CITE THIS ARTICLE: Mohite S, More RS, Mohite H. Morphological study of carotico-clinoid foramen. J. Evolution Med. Dent. Sci. 2016;5(61):4309-4311, DOI: 10.14260/jemds/2016/983 INTRODUCTION The carotico-clinoid foramen is an inconstant structure, which is located in the anterior cranial fossa composed by the ossification of a fibrous ligament 1 that begins on the anterior clinoid process and binds to the middle clinoid process. 2 Carotico-clinoid foramen allows the passage of one of six segments of the internal carotid artery, the clinoidal segment. 3 The fibrous ossification of ligaments is considered a normal physiological process that occurs with ageing; however, this process is an exception when one considers the formation of the carotico-clinoid foramen. 4 Study by Hochstetter revealed the presence of this foramen in foetuses and children skulls. 5 The ligaments are related to many anatomical structures and when ossified may cause compression of these structures. The carotico-clinoid and interclinoid ligaments are related to the internal carotid artery and oculomotor nerve. 6 In presence of carotico-clinoid foramen, it is impossible to retract or mobilise Financial or Other, Competing Interest: None. Submission 23-06-2016, Peer Review 16-07-2016, Acceptance 23-07-2016, Published 01-08-2016. Corresponding Author: Dr. Raghunath Shahaji More, Assistant Professor, Department of Anatomy, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005. E-mail: psychiatry.more@gmail.com DOI: 10.14260/jemds/2016/983 the cavernous segment of carotid artery even after releasing the proximal and distal carotid rings. Preoperative recognition of carotico-clinoid foramen is important because undue retraction of cavernous segment of internal carotid artery may tear or rupture it and cause fatal cerebral infarction. 7 The carotico-clinoid bridge could cause pressure on the internal carotid artery that lies in the cavernous sinus changing the morphology in the terminal end of the groove of internal carotid artery. 8 Due to greater calibre of internal carotid artery in this region compared to the diameter of carotico-clinoid foramen, the possibility of headache due to compression by the foramen is high. Carotico-clinoid foramen is an important structure due to its relations with cavernous sinus and its contents, sphenoid sinus, and pituitary gland. 4 Several authors studied the anatomical characteristics of Carotico-Clinoid Foramen (CCF) in different population. The Anterior Clinoid Process (ACP) is usually accessed to gain entry into the clinoid space. The ligamentous or the bony form of interclinoid ligament is important in the aneurysms surgery of the intracavernous portion of the internal carotid artery and surgery for tuberculum sellae meningiomas. 9 The presence of ossified interclinoid ligament makes the removal of the anterior clinoid process more difficult and increases the risks especially in the presence of an aneurysm. Therefore, to obtain a satisfactory result from these surgeries, detailed anatomical and morphometric knowledge of the region is necessary.