Effect of clival bone growth on the localization of the abducens nerve at the petroclival region: a postmortem anatomical study

Abstract

Purpose To investigate the effect of the clival bone pattern on the abducens nerve (AN) localization in the petroclival region between the Pediatric and Adult Groups. Methods This study used 12 pediatric and 17 adult heads obtained from the autopsy. The length and width of the clivus and the length of the petrosphenoidal ligaments (PSLs) were measured. The ratio of the length and width of the clivus was accepted as the clival index (CI). The localization of the AN at the petroclival region below the PSL, classified as lateral and medial, were recorded. Results The average length of the clivus was 26.92 +/- 2.88 mm in the Pediatric Group, and 40.66 +/- 4.17 mm in the Adult Group (p < 0.001). The average width of the clivus was 22.35 +/- 2.88 mm in the Pediatric Group, and 29.96 +/- 3.86 mm in the Adult Group (p < 0.001). The average value of the CI was 1.20 in the Pediatric Group and 1.36 in the Adult Group (p = 0.003). The length of the PSL was 7.0 +/- 1.47 mm in the Pediatric Group and 11.05 +/- 2.95 mm in the Adult Group (p < 0.001). The nerve was located below the medial side of the PSL in the Pediatric Group and below the lateral side in the Adult Group (p = 0.002). Conclusions The petrous apex localization of the AN in adults compared with pediatric subjects could be related to the increased growth in the length of the clivus than its width.