ANOMALOUS CANALS OF THE CLIVUS: ANATOMICAL CONSIDERATIONS AND THE ROLE OF CONE BEAM COMPUTED TOMOGRAPHY IN DIAGNOSTIC EVALUATION

Abstract

The Clivus is a bony structure of the central skull base that supports some vital structures in the skull. Although CT and MRI are traditionally used for evaluation of this area, recent studies suggest that Cone-Beam Computed Tomography (CBCT), due to its high spatial resolution, lower radiation dose and routine use in dentistry may also serve as a potential tool for detecting anomalous canals of the Clivus. This review highlights the significance of accurate diagnosis of some key anomalous canals found in the clival region such as Fossa Navicularis Magna, Canalis Basilaris Medianus, and Craniopharyngeal Canal. These anatomically variant foramina, although often found incidentally, may be misinterpreted as fractures or pathological lesions or serve as pathways for infection. Hence, an in-depth understanding of the anatomy, embryological development, neural and vascular relationships of the Clivus and potential anatomical variations in the area becomes imperative. This review highlights the clinical significance of such anomalous clival canals and how Cone-Beam Computed Tomography (CBCT) can aid oral radiologists and dental professionals recognise these canals during routine imaging.