1
|
Demir BT, Eşme S, Patat D, Bilecenoğlu B. Clinical and anatomical importance of foramen magnum and craniocervical junction structures in the perspective of surgical approaches. Anat Cell Biol 2023; 56:342-349. [PMID: 37460407 PMCID: PMC10520862 DOI: 10.5115/acb.23.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 09/23/2023] Open
Abstract
This study was conducted to investigate the clinical and anatomical importance of the relevant region from the perspective of surgical approaches by determining the morphometric analysis of the craniocervical junction and foramen magnum (FM) region and determining their distances from important anatomical points. This research was carried out with 59 skulls found at the Anatomy Laboratories of Erciyes and Ankara Medipol University. Metric measurements of FM and condyle, FM shape, condyle-fossa relationship, and pharyngeal tubercle (PT) were made in mm-based dry bone samples of unknown age and sex. The distance between the anterior notches and the FM was 87.01±4.35, the distance between the anterior notches and the PT was 77.70±4.24, the distance between the PT-sphenooccipital junction was 13.23±2.42, and the FM index was 81.86±7.47. The anteroposterior and transverse lengths of FM were determined as 33.80±2.99 and 27.72±2.30, respectively. The morphometric and morphological data available regarding the craniocervical junction showed significant differences between populations. Comprehensive knowledge of this topic will provide a better approach to treat Arnold Chiari Malformation, FM meningiomas, and other posterior cranial fossa lesions. Therefore, we believe that FM and craniocervical junction morphology will be a guide not only for anatomists, but also for radiologists, neurosurgeons, ENT surgeons, and orthopedists.
Collapse
Affiliation(s)
- Berin Tuğtağ Demir
- Department of Anatomy, School of Medicine, Ankara Medipol University, Ankara, Türkiye
| | - Simge Eşme
- Department of Anatomy, School of Medicine, Ankara Medipol University, Ankara, Türkiye
| | - Dilara Patat
- Department of Anatomy, School of Medicine, Ankara Medipol University, Ankara, Türkiye
| | - Burak Bilecenoğlu
- Department of Anatomy, School of Medicine, Ankara Medipol University, Ankara, Türkiye
| |
Collapse
|
2
|
Thintharua P, Chentanez V. Morphological analysis and morphometry of the occipital condyle and its relationship to the foramen magnum, jugular foramen, and hypoglossal canal: implications for craniovertebral junction surgery. Anat Cell Biol 2023; 56:61-68. [PMID: 36635090 PMCID: PMC9989787 DOI: 10.5115/acb.22.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 12/06/2022] [Accepted: 12/11/2022] [Indexed: 01/14/2023] Open
Abstract
Anatomical knowledge of the occipital condyle (OC) and its relationships to surrounding structures is important for avoiding injury during craniovertebral junction (CVJ) surgeries. This study was conducted to evaluate the morphology and morphometry of OC and its relationship to foramen magnum, jugular foramen (JF), and hypoglossal canal (HC). Morphometric parameters including length, width, height, and distances from the OC to surrounding structures were measured. The oval-like condyle was the most common OC shape, representing for 33.0% of all samples. The mean length, width and height of OC were 21.3±2.4, 10.5±1.4, and 7.4±1.1 mm, respectively. Moreover, OC was classified into three types based on its length. The most common OC length in both sexes was moderate length or type II (62.5%). The mean distance between anterior tips and posterior tips of OC to basion, and opisthion were 11.5±1.4, 39.1±3.3, 25.2±2.2, and 27.4±2.7 mm, respectively. The location of intracranial orifice of HC was commonly found related to middle 1/3 of OC in 45.0%. JF was related to the anterior 2/3 of OC in 81.0%, the anterior 1/3 of OC in 12.5%, and the entire OC length in 6.5%. These morphological analysis and morphometric data should be taken into consideration before performing surgical operation to avoid CVJ instability and neurovascular structure injury.
Collapse
Affiliation(s)
- Pakpoom Thintharua
- Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Vilai Chentanez
- Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
3
|
Oberman DZ, Baldoncini M, Rabelo NN, Ajler P. Morphometric analysis of posterior cranial fossa and surgical implications. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2021; 12:178-182. [PMID: 34194165 PMCID: PMC8214228 DOI: 10.4103/jcvjs.jcvjs_205_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/31/2021] [Indexed: 11/04/2022] Open
Abstract
Background Posterior cranial fossa (PCF) is an important area in terms of anatomy and surgery. It is a common site of many neoplastic, vascular, and degenerative lesions. Craniovertebral surgeries require special attention regarding detailed information about the morphology and morphometry of this region. The aim of this study was to analyze the morphometric characteristics of PCF and distances between the inner base of the skull. Materials and Methods An observational, retrospective cross-sectional study was made. Fifty-five dry human skulls of unknown sex were measured ascertained using digital Vernier caliper with 0.01 mm precision. Results The morphometric analysis of the mean length and width of the FM was 34.51 mm and 29.85 mm, respectively. We found a significant difference (P < 0.05) among the distance between the posterior tip of occipital condyle and basion of the right and left sides. Conclusion According to our observations, the present study yielded detailed morphometry of the PCF and neurovascular relationship. It can facilitate successful instrumentation and minimize neurovascular injuries. Furthermore, it provides safe and suitable data for guiding neurosurgical procedures. The major limitation of this study was the lack of knowledge regarding the age and gender of the participants whose skull base was studied.
Collapse
Affiliation(s)
| | - Matias Baldoncini
- Department of Neurosurgery, San Fernando Hospital, Buenos Aires, Argentina
| | | | - Pablo Ajler
- Department of Neurosurgery, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
4
|
Aida SH, Zurifa A, Ilvana H, Senad Š, Maida RT, Izeta A, Kapo Sanita M, Rifat H. Bioanthropological analysis of human occipital condyles using geometric morphometric method. Saudi J Biol Sci 2020; 27:3415-3420. [PMID: 33304150 PMCID: PMC7715034 DOI: 10.1016/j.sjbs.2020.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 11/17/2022] Open
Abstract
Sex differences are present in all parts of the body, including the skeletal system. Several methods are used to analyze the sex differences of skeleton, while more recently, a new method called geometric morphometry has been used. The aim of this study was to examine the sexual dimorphism of occipital condyles on human skulls originating from the population of Bosnia and Herzegovina using the geometric morphometric method. Material and methods The study was conducted on 214 human skulls of known gender from Bosnian population. For analysis of sexual dimorphism of occipital condyles, we used geometric morphometry, where all the skulls were scanned to obtain three-dimensional skull models. On the obtained models, we marked anthropometric points on occipital condyles in a Landmark Editor program from which we exported data in the form NTSYS file and analyzed it in MorphoJ program. Results First principal component PC1 describes 26.917% of total variability, the second principal component PC2 describes 20.992% of total variability, while the first eight principal components together describe 100% of total variability. The greatest variability between the male skulls and female skulls was present in the anterior-posterior diameter (length of occipital condyles). Discriminant functional analysis of the shape and size of the occipital condyles was possible with 69.50% accuracy for male skulls and with 60.27% accuracy for female skulls. The size of the occipital condyles showed a statistically significant effect on sexual determination. Discriminant functional analysis of the shape of the occipital condyles without affecting size enabled the determination of gender with with 65.96% accuracy for male skulls and with 63.01% accuracy for female skulls. Conclusion Analysis of sexual dimorphism of occipital condyles using geometric morphometry showed statistically significant differences in the shape and size of occipital condyles between the sexes. The accuracy of sex determination based on occipital condyles was higher for male gender.
Collapse
Affiliation(s)
- Sarač-Hadžihalilović Aida
- Department of Anatomy, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Ajanović Zurifa
- Department of Anatomy, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
- Corresponding author at: Čekaluša 90, 71 000 Sarajevo, Bosnia and Herzegovina
| | - Hasanbegović Ilvana
- Department of Anatomy, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Šljuka Senad
- Department of Biology, Faculty of Science, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Rakanović-Todić Maida
- Department of Pharmacology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Aganović Izeta
- Department of Imunology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Maleškić Kapo Sanita
- Department of Pharmacology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Hadžiselimović Rifat
- Academician, Prof. emeritus University of Sarajevo, Bosnia and Herzegovina, Institute for Genetic Engineering and Biotechnology Sarajevo (INGEB), Bosnia and Herzegovina
| |
Collapse
|
5
|
Jagtap R, Wazzan T, Hansen M, Kashtwari D. Condylar jugular diverticulum: A report of 3 cases. Imaging Sci Dent 2019; 49:251-256. [PMID: 31583209 PMCID: PMC6761058 DOI: 10.5624/isd.2019.49.3.251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/05/2019] [Accepted: 06/19/2019] [Indexed: 12/30/2022] Open
Abstract
Jugular bulb diverticulum is an irregular extension of the jugular bulb into the temporal bone that may be symptomatic or asymptomatic. The jugular bulb has rarely been reported to extend into the occipital condyle; such extension is termed a condylar jugular diverticulum and is characterized as a defect in the occipital condyle contiguous with the jugular bulb. This report details 3 cases of condylar jugular diverticulum. Extension of the jugular bulb into the ipsilateral occipital condyle was noted as an incidental finding on cone-beam computed tomographic (CBCT) images of 3 patients. All 3 patients were asymptomatic, and this finding was unrelated to the initial area of interest. CBCT use is becoming ubiquitous in dentistry, as it allows 3-dimensional evaluation, unlike conventional radiography. Proper interpretation of the entire CBCT is essential, and recognition of the indicators of condylar jugular diverticulum may prevent misdiagnosis of this rare entity.
Collapse
Affiliation(s)
- Rohan Jagtap
- Department of Oral and Maxillofacial Radiology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Taggreed Wazzan
- Department of Oral and Maxillofacial Radiology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Matthew Hansen
- Department of Oral and Maxillofacial Radiology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Deeba Kashtwari
- Department of Oral and Maxillofacial Radiology, College of Dentistry, University of Florida, Gainesville, FL, USA
| |
Collapse
|
6
|
Gumussoy I, Duman SB. Morphometric analysis of occipital condyles using alternative imaging technique. Surg Radiol Anat 2019; 42:161-169. [PMID: 31549198 DOI: 10.1007/s00276-019-02344-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/14/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE The occipital condyles (OCs) are crucial anatomical structures in the cranial base. To our knowledge, there is no cone beam computed tomography (CBCT)-based study on the morphometric analysis of OCs. The aim of this study was to evaluate the morphometric analysis of OCs using CBCT. METHODS CBCT images of 200 OCs from 100 patients of which 39 males and 61 females in the age group of 18-67 years were included in the study population. Linear and angular measurements of OCs were performed. RESULTS The average OC width, length, height, sagittal angle, and effective height were 10.3 ± 1.3 mm, 19.6 ± 2.0 mm, 9.1 ± 1.4 mm, 7.4 ± 1.7 mm, and 35.3 ± 5.2 mm. Condylar width and sagittal angle measurements were found significantly different between the right and left sides; and were not found significant difference between the right and left sides in the measurements of condylar height, length, and effective height. Also the average intercondylar anterior distance (ICAD), intercondylar posterior distance (ICPD), distance between the basion and the anterior apex of the occipital condyle (B-AAOC), distance between the basion and posterior apex of the occipital condyle (B-PAOC), distance between the opisthion and anterior apex of occipital condyle (O-AAOC), and distance between the opisthion and posterior apex of occipital condyle (O-PAOC) were 20.9 ± 1.5 mm, 44.0 ± 2.0 mm, 12.3 ± 1.9 mm, 34.5 ± 4.2 mm, 29.8 ± 1.7 mm, and 27.0 ± 2.1 mm. There was not significant difference in the morphometric measurements among age groups. All morphometric measurements showed a significant difference depending on gender. CONCLUSIONS The morphometric evaluation of OCs may be effectively examined using CBCT. Linear and angular measurements data of OCs in the present study may be used as a reference database for future morphometric and surgical investigations.
Collapse
Affiliation(s)
- Ismail Gumussoy
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Sakarya University, Sakarya, Turkey.
| | - Suayip B Duman
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, İnonu University, Malatya, Turkey
| |
Collapse
|
7
|
Morphometric Evaluation of Occipital Condyles: Defining Optimal Trajectories and Safe Screw Lengths for Occipital Condyle-Based Occipitocervical Fixation in Indian Population. Asian Spine J 2018; 12:214-223. [PMID: 29713401 PMCID: PMC5913011 DOI: 10.4184/asj.2018.12.2.214] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/25/2017] [Accepted: 06/28/2017] [Indexed: 11/17/2022] Open
Abstract
Study Design Computed tomographic (CT) morphometric analysis. Purpose To assess the feasibility and safety of occipital condyle (OC)-based occipitocervical fixation (OCF) in Indians and to define anatomical zones and screw lengths for safe screw placement. Overview of Literature Limitations of occipital squama-based OCF has led to development of two novel OC-based OCF techniques. Methods Morphometric analysis was performed on the OCs of 70 Indian adults. The feasibility of placing a 3.5-mm-diameter screw into OCs was investigated. Safe trajectories and screw lengths for OC screws and C0–C1 transarticular screws without hypoglossal canal or atlantooccipital joint compromise were estimated. Results The average screw length and safe sagittal and medial angulations for OC screws were 19.9±2.3 mm, ≤6.4°±2.4° cranially, and 31.1°±3° medially, respectively. An OC screw could not be accommodated by 27% of the population. The safe sagittal angles and screw lengths for C0–C1 transarticular screw insertion (48.9°±5.7° cranial, 26.7±2.9 mm for junctional entry technique; 36.7°±4.6° cranial, 31.6±2.7 mm for caudal C1 arch entry technique, respectively) were significantly different than those in other populations. The risk of vertebral artery injury was high for the caudal C1 arch entry technique. Screw placement was uncertain in 48% of Indians due to the presence of aberrant anatomy. Conclusions There were significant differences in the metrics of OC-based OCF between Indian and other populations. Because of the smaller occipital squama dimensions in Indians, OC-based OCF techniques may have a higher application rate and could be a viable alternative/salvage option in selected cases. Preoperative CT, including three-dimensional-CT-angiography (to delineate vertebral artery course), is imperative to avoid complications resulting from aberrant bony and vascular anatomy. Our data can serve as a valuable reference guide in placing these screws safely under fluoroscopic guidance.
Collapse
|