Mullan's triangle or anteromedial triangle of the middle cranial fossa: a cadaveric study with its surgical importance.

IF 1.4 4区医学 Q2 Medicine Surgical and Radiologic Anatomy Pub Date : 2024-11-01 Epub Date: 2024-09-03 DOI:10.1007/s00276-024-03475-x

Ariyanachi Kaliappan, Rohini Motwani, Mrudula Chandrupatla, Apurba Patra

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Abstract

Background: Surgical approaches to the cavernous sinus (CS) and middle cranial fossa (MCF) can be challenging, particularly for young neurosurgeons. The anteromedial (Mullan's) triangle is a triangle by the side of the CS and constitutes part of the floor of the MCF. The contents include the sphenoid sinus, superior ophthalmic vein, and sixth cranial nerve. The literature contains very little research that has precisely defined and measured the anteromedial triangle while considering anatomical variances minimally.

Methodology: The present study was conducted on the skulls of 25 adult human cadavers which were dissected to expose the anteromedial (Mullan's) triangle on both sides. After precisely defining the triangle on each side, measurements of the three borders were taken, and using Heron's formula, the area of each triangle was calculated.

Results: On average, the length of the medial border was 12.5 (+ 3.1 mm); the length of the lateral border was 9.9 (+ 3.1 mm); the length of the base was 10.75 (+ 2.4 mm) and the area of the anteromedial triangle was 43.9 (+ 15.06 mm²).

Conclusion: Precise anatomical knowledge of the Mullan's triangle enables the treatment of disorders in often deformed anatomy or difficult-to-access structures. That is the reason it is important to gain a thorough understanding of the surgical anatomy and to adopt a safe procedure.

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中颅窝 Mullan 三角区或前内侧三角区：尸体研究及其外科重要性。

背景：海绵窦（CS）和中颅窝（MCF）的手术方法具有挑战性，尤其是对年轻的神经外科医生而言。前内侧（Mullan's）三角是 CS 边上的一个三角形，是 MCF 底部的一部分。其内容包括蝶窦、眼上静脉和第六颅神经。文献中很少有精确定义和测量前内侧三角的研究，同时也很少考虑解剖上的差异：本研究对 25 具成人尸体的头骨进行了解剖，以暴露两侧的前内侧（穆兰三角）。在精确定位两侧三角形后，测量了三条边界，并使用赫伦公式计算了每个三角形的面积：结果：内侧边界的平均长度为 12.5（+ 3.1 毫米）；外侧边界的平均长度为 9.9（+ 3.1 毫米）；基底的平均长度为 10.75（+ 2.4 毫米），前内侧三角形的平均面积为 43.9（+ 15.06 平方毫米）：结论：对穆兰氏三角的精确解剖学知识有助于治疗经常出现畸形解剖或难以接近结构的疾病。因此，全面了解手术解剖结构并采用安全的手术方法非常重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.