Branching of the foramen rotundum. A rare variation of the sphenoid

The human orbit communicates with the middle cranial fossa through several canals and openings. Some of them (optic canal, superior orbital fissure) are constant, others (meningo-orbital foramen, Warwick's foramen, metoptic canal) are less frequent. Here we report a rare variation of the foramen rotundum which, opening into the orbit with a branching canal, represented a further connecting pathway between the orbit and the middle cranial fossa. Such variation was detected in about 1.06% of individuals and it was almost always located on the right side. Only in one cases it could be found left-sided and in another skull it was spotted bilaterally. The vari- ation consisted of the branching of a 5 mm long canal from the lateral wall of the foramen rotun- dum that opened into the orbit. In general the diameter of the canal was comprised between 0.5 and 0.6 mm but it could be as large as 1 mm or as thin as 0.2 mm. The canal, straight and directed slightly superolaterally, likely transmitted the zygomatic nerve and/or part of the infraorbital nerve. To our knowledge, an independent entrance through a dedicated canal of such nerves has never been reported. The surgeons operating in this region, either neurosurgeons or ophthalmologists, should be aware of the possible variation in the course of these nerves.