Concomitant Sphenopterygoid Canal and Duplicated Foramen Rotundum Detected on Computed Tomography Scan

The middle cranial fossa exhibits an interesting typical and variant anatomy. Accessory foramina frequently or rarely exists and transmits emissary veins. The sinus computed tomography scan of a 63-year-old male patient was further examined for its unique morphology. An accessory foramen rotundum (FR) was identified on the left side, 2.67 mm laterally to the typical foramen. Posterolaterally to the typical FR (10.33 mm distance), the intracranial opening of a sphenopterygoid canal was detected. This canal had a length of 22.85 mm and opened extracranially through a pterygoid foramen on the lateral pterygoid plate. The right side of the patient was typical. The unusual coexistence of 2 rare skull base variants was recorded. The accessory FR and sphenopterygoid canal presence were described only in a few case reports in the current literature, while their coexistence has not been reported. Anatomists and clinicians should remember that rare variant foramina can transmit emissary veins, such as the ones presented in the current imaging case.