Grüber's ligament is the most reliable landmark of the abducens nerve in the transnasal transclival view.

The petroclival segment of the abducens nerve was dissected in the interdural space which is also called Dorello's canal, the petroclival venous gulf, or the sphenopetroclival venous confluence-using the transnasal approach in 20 specimens obtained from 10 adult cadaveric heads.

The petroclival segment of the abducens nerve clearly crossed and attached to Grüber's ligament in the interdural space, as noted in the transnasal view. The average length of the dural porus to the intersection on the abducens nerve was 5.2 ± 1.0 mm. The length of the posterior clinoid process (PCP) to the intersection on Grüber's ligament was 6.4 ± 2.6 mm. The average width of Grüber's ligament at the midsection was 1.6 ± 0.5 mm.

Grüber's ligament is considered a useful landmark, and it is visible in most adults. Thus, surgeons can find the abducens nerve safely by visualizing inferolaterally along Grüber's ligament from the PCP 1).

Tomio R, Toda M, Sutiono AB, Horiguchi T, Aiso S, Yoshida K. Grüber's ligament as a useful landmark for the abducens nerve in the transnasal approach. J Neurosurg. 2014 Nov 7:1-5. [Epub ahead of print] PubMed PMID: 25380109.
  • grueber_s_ligament.txt
  • Last modified: 2015/03/03 08:17
  • (external edit)