MIDDLE CRANIAL FOSSA

Floor of the Middle Cranial Fossa

 The floor of the middle cranial fossa resembles a butterfly- consrsting of a small median part and
an expanded lateral part on each side.
 The middle cranial fossa is demarcated from the anterior cranial fossa by:

(a) the posterior free border of the lesser wing of the sphenoid on each side, and

(b) the limbus sphenoidalis in the median region. The limbus is an anterior edge of
shallow transverse area called sulcus chiasmaticus.

 The middle cranial fossa is demarcated from the posterior cranial fossa by:

(a) the superior border of the petrous temporal bone on each side, and ,

(b) the dorsum sellae (a rectangular plate of bone) in the median region.

Median part of the middle cranial fossa

 The median part of the fossa is formed by the body of the sphenoid, which is more or less
cuboidal.

 The median region, from before backward, presents the following features:

A. Sulcus chiasmaticus, leading on each side into the optic canal which leads into the orbit

B. Sella turcica (Turkish saddle)

- it is hollowed out upper surface of the body of the sphenoid (hypophyseal fossa) bounded in front by
the tuberculum sellae- the posterior edge of sulcus chiasmaticus - and behind by the dorsum sellae. The
lateral ends of the tuberculum sellae bear the middle clinoid processes and the lateral ends of the
dorsum sellae bear the post. clinoid processes.

- it consists of three parts :

1. the tuberculum sellae,
2. the hypophyseal fossa (is occupied by the pituitary gland in life
 3. the dorsum sellae.

 The carotid groove is a shallow sulcus on either side of the body of the sphenoid lateral to the
hypophyseal fossa. It begins at the foramen lacerum, runs upward, then forward, and finally
upward again to end at the medial to the anterior clinoid process. The passage of internal
carotid artery occupies this groove.
 Sometimes the middle and anterior clinoid processes are united by a bony bar forming
caroticoclinoid foramen for the Passage of internal carotid artery.

N.B. the median part ( region ) of the middle cranial fossa is linked to a bed with four clinoid processes
representing the four bed-posts ( Gr. Kline = a bed )

Lateral Part ot the Middle Cranial Fossa

The lateral part of the middle cranial fossa on each side is formed by the upper surface of the greater
wing of the sphenoid together with the anterior surface of the petrous temporal bone and the
squamous part Of the temporal bone. lt lodges the temporal lobe of the cerebral hemisphere.

it is limited in front by sharp posterior border of the lesser wing of the sphenoid, and behind by sharp
upper border of the petrous temporal bone. These bony ridges are related to the sphenoparietal and
superior petrosal sinuses respectively.

Greater Wing of the Sphenoid

The greater wing of the sphenoid presents:

1. Four foramina arranged roughly in a semicircular array. From behind forward these are a follows:

a) Foramen spinosum is posteriormost and located at t e posterior tip of the greater wing. It is so
called because on the undersurface of the greater Wing at this point is the spine of sphenoid.
b) Foramen oval is located juut in front and medial to the forame spinosum. The reason for its
name is obvious.
c) Foramen rotundum is in front and medial to the foramen ovale. it leads downward and forward
into the pterygopalatine fossa.
d) Superior orbital fissure (an elongated triangular fissure) is in front and lateral to foramen
rotundum under the overhanging shelf of the lesser wing of the sphenoid. It is actually located
between the body, lesser wing, and greater wing 3r the sphenoid.
 Of these four openings, however, only the first two can be seen on the inferior surface of the
base of the skull.

N.B. in addition to the four foramina, sometimes two more foramina present In the greater wing of the
sphenoid. These are:
Emissary sphenoidal foramen (of Vesalius): It lies medial to foramen ovale and conveys an emissary vein
from the cavernous sinus.
Canaliculus innominatus: It is located on a bar of bone between the foramen ovale and foramen
spinosum. It transmits the lesser petrosal never when the latter does not pass through foramen ovale.

2. Groove for middle meningeal vessels leads forward from the foramen spinosum: After a short
distance, the groove divides into the anterior and posterlor grooves, which lodge the anterior and
posterior branches of middle meningeal vessels. The anterior groove continues to the pterion and then
arches upward and backward across the parietal bone. At the pterion, the groove may be converted into
a bony—tunnel, thereby increasing the possibility of tearing the middle meningeal vessels in trauma on
the side of the skull in the pterion region.
The posterior groove passes backward across the squamous part of the temporal bone.

3. Foramen lacerum lies at the posterior end of the carotid groove on the side of the body of the
sphenoid, posteromedial to the foramen ovale. It is actually a gap between the petrous temporal and
sphenoid bones.

4. Anterior surface of the petrous temporal bone presents the following five features:

(a) Trigeminal impression, a shallow depression medially near the apex of the bone. The trigeminal
ganglion lies on this depression.

(b) Hiatus and groove for the greater petrosal nerve: In front of arcuate eminence, a slit or hiatus for
the greater petrosal nerve is continued as a groove to the foramen lacerum.

(c) Hiatus and groove for the lesser petrosal nerve lie lateral to hiatus and groove for the greater
petrosal nerve and lead to the foramen ovale or canaliculus innominatus, if present.

(d) Arcuate eminence (a rounded elevation) produced by the underlying superior semicircular canal is
located at the middle of the anterior surface of the petrous temporal bone.

(e) Tegmen tympani, a thin plate of bone anterolateral to the arcuate eminence. It forms the roof of
middle ear (tympanic cavity). Its anterior part turns downward into the squamotympanic fissure.

Structures Passing Through Various Canals and Foramina in the Middle Cranial Fossa
Optic Foramen

1. Optic nerve: along with its sheath of meninges, i.e., dura mater, arachnoid mater, and pia mater.
2. Ophthalmic artery: a branch of cerebral part of the internal carotid artery.
3. Sympathetic plexus around the ophthalmic artery.

Superior Orbital Fissure

This fissure is divided into three parts by means of the common tendinous ring of Zinn.

1. Structures passing through the part present within the common tendinous ring:

(a) Superior and inferior divisions of the oculomotor (3rd cranial) nerve.
(b) Nasociliary nerve: It lies between the two divisions of the oculomotor nerve.
(c) Abducent (6th cranial) nerve: It lies lateral to the nasociliary nerve.
(d) Sympathetic root of the ciliary ganglion: It lies between the nasociliary nerve and the lower divisions
of the oculomotor nerve.

2. Structures passing through the part present above and lateral to the common tendinous ring:

(a) Trochlear (4th cranial) nerve

(b) Frontal nerve
(c) Lacrimal nerve
(d) Lacrimal artery
(e) Superior ophthalmic vein
(f) Recurrent meningeal branch of lacrimal artery.

3. Structures passing through the part present below and medial to the common tendinous ring:

Inferior ophthalmic vein

Foramen rotundum
(i) Maxillary nerve.
(ii) Emissary vein.
Foramen ovale (Mnemonic: MALE)

(i) Mandibular nerve.

(ii) Accessory middle meningeal artery.
(iii) Lesser petrosal nerve.
(iv) Emissary vein: connecting the pterygoid venous plexus to the cavernous sinus.

Foramen spinosum
(i) Middle meningeal artery.
(ii) Nerves spinosus.

Foramen lacerum
(i) Meningeal branch of the ascending pharyngeal artery.
(ii) Emissary vein: from the cavernous sinus to the pharyngeal venous plexus.
(iii) Internal carotid artery along with the sympathetic plexus around it enters it from behind and exists
above.
(iv) Greater petrosal nerve enters from posterolateral aspect and leaves anteriorly as a nerve of
pterygoid canal.

N.B. Internal carotid artery and greater petrosal nerve do not pass through and through foramen
lacerum.

The greater petrosal nerve joins the deep petrosal nerve derived from the sympathetic plexus around
the internal carotid artery to form the nerve of the pterygoid canal (Vidian’s nerve) which passes
through the pterygoid canal. The posterior orifice of the pterygoid canal lies in the lower part of the
anterior wall of the foramen lacerum.

Fracture of middle cranial fossa:

The middle cranial fossa IS the commonest site of fracture of the base of the skull. lt is partly because of
Its position but also because It is weakened by numerous foramina and canals. ln fracture of the middle
cranial fossa, the tegmen tympani is usually fractured and the tympanlc membrane is torn. As a result,
there is bleeding from the external acoustic meatus and a leakage of cerebrospinal fluid (called
cerebrospinal otorrhea).

The facial and vestibular cochlear nerves may be damaged. Bleeding may occur through nose and mouth
if the body of the sphenoid is fracture. Vertigo may occur if semicircular canals are involved.