Background: The study investigates the size of the foramen ovale (FO) in relation to the presence and absence of the emissary sphenoidal foramen (ESF). Any possible alteration of the FO size in relation to the ESF (unilateral or bilateral) presence and absence was also examined. Materials and methods: One-hundred and ninety-five (117 male and 78 female) Greek adult dry skulls were investigated. Results: The ESF was present in 40% of the skulls (21.5% bilaterally and 18.5% unilaterally). No statistical significant difference was detected between ESF presence or absence and its unilateral or bilateral occurrence. The ESF existence had no relation to the FO size. Conclusions: The ESF absence or presence has no effect on FO size. The emissary sphenoidal vein is an additional venous pathway connecting cavernous sinus with the pterygoid venous plexus. These findings enhance that the venous plexus of the FO is a constant trait. The meticulous knowledge of the middle cranial fossa anatomy is of paramount importance during transovale procedures, as the outcome of cannulation may be affected by the existence of ESF, the confluence FO-ESF, the existence of osseous spurs and bridging into the FO. (Folia Morphol 2018; 77, 1: 90–98)
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