Bilateral giant and unilateral duplicated sphenoidal tubercle

Area of Science:

• Anatomy
• Radiology
• Surgical Anatomy

Background:

• The sphenoidal tubercle (SphT), or pyramidal tubercle, is an anatomical landmark on the greater sphenoidal wing.
• It is often overlooked despite its potential to obstruct surgical approaches to the pterygopalatine fossa.

Observation:

• A routine cone beam computed tomography (CBCT) scan revealed bilateral giant sphenoidal tubercles in an adult male.
• One SphT was bifid, featuring a main 9.17 mm partition and a secondary laminar part.
• The contralateral SphT measured 14.80 mm.

Findings:

• The observed giant and bifid sphenoidal tubercles are, to our knowledge, unprecedented in anatomical literature.
• These large structures significantly alter the infratemporal surface of the greater sphenoidal wing, forming pterygoid foveae.

Implications:

• Giant sphenoidal tubercles pose significant challenges for surgical access to the pterygopalatine fossa and skull base.
• Awareness of these anatomical variations is crucial for neurosurgeons and head and neck surgeons.
• Further anatomical studies are warranted to determine the prevalence of such variations.