The prevalence and morphometric features of mastoid emissary vein on multidetector computed tomography

Background: The aim of the study was to evaluate the prevalence and morphometric features of mastoid emissary vein (MEV) on multidetector computed tomography (MDCT) scans, emphasize its clinical significance and review its surgical implications. Materials and methods: Cranial and temporal bone MDCTs of 248 patients (496 sides) were analysed by 2 radiologists. Mastoid foramen (MF) was defined on the 3 dimensional volume rendered (3DVR) images. The MF and mastoid emissary canal (MEC) were investigated in axial thin slices and the diameters of the largest MF and MEC were measured. Mean diameters of MF and MEC were determined. The number of the mastoid foramina was noted. Differences in MF prevalence by sex and side were evaluated. Results: The overall prevalence of MEC was 92.3%. It was observed in 91.5% of women and 93.3% of men. MEC was present on the right side in 84.7% and on the left side in 82.3% of temporal bones. The mean diameter of MF was 1.92 +/- +/- 1.02 mm on the right and 1.84 +/- 0.98 mm on the left. In both sides the number of the MF's changed from absent to triple. The mean diameter of MEC was 1.58 +/- 0.86 mm on the right and 1.48 +/- 0.79 mm on the left side. The mean diameter of MEC was significantly larger in men. No significant correlation was detected between age and the MEC diameter. Conclusions: The preoperative detection of mastoid emissary veins is necessary. The radiologists should be familiar with their clinical significance and variant appearances and report them accurately. Knowledge of their morphology and surgical implications by the surgeons will make them aware to avoid unexpected and fatal complications while operating in the suboccipital and mastoid area. MDCT is a reliable diagnostic tool for imaging the MEC and MF.