Radiological study of sphenoid emissary venous patterns and their clinical implications in South African cohorts

Introduction The trigeminal rhizotomy procedure is considered suitable for treating trigeminal neuralgia, although cases of intracranial bleeding have been reported. The sphenoid emissary veins (SEVs) are likely to be punctured during this surgical procedure as they travel with the mandibular nerve via the foramen ovale or the sphenoid emissary foramen, if present. Objective The study aimed to explore the venous patterns of SEVs in relation to age and sex in the South African population. Materials and methods One hundred computed tomography images were utilised. The course of the veins in relation to the mandibular nerve, as well as its relation to the foramen ovale and/or the sphenoid emissary foramen, was analysed. Results Regarding the venous pattern of the veins in relation to foramina, of the three patterns that were found, Type B was the most predominant type in all parameters studied. In addition, for the course of the veins in relation to the mandibular nerve, four patterns were found. The medial and perineural types were the most prevalent on the right and left sides, respectively, with a statistically significant association of p = 0.02 (left) and p = 0.01 (right) found for population. Conclusion Knowledge of the course of the veins in this specific population is crucial in minimising surgical complications related to the treatment of trigeminal neuralgia.