14 research outputs found
Treatment of giant congenital cysts of the midline in adults: Report of two cases and review of the literature
A computed tomography study on the olfactory fossa in dried skulls
Purpose: The computed tomography (CT) study investigates the olfactory fossa (OF) morphometry and morphology. Methods: Fifty Greek adult dried skulls were macroscopically investigated for the detection of the OF morphological patterns and after a multiplanar CT reconstruction, the OF morphometry was accurately calculated using a digital ruler. Results: Types I and II surface contour patterns were the most frequently identified (36 and 32%), followed by types III, IV, and V (16, 12, and 4%). Crista galli mean length, height, and width were 19.46 ± 2.34 mm, 12.69 ± 2.7 mm, and 5.18 ± 1.11 mm. The OF mean maximum length was 22.29 ± 2.16 mm on the right and 22.10 ± 2.44 mm on the left side, and symmetry was detected. The OF median values of the maximum depth for its anterior, middle, and posterior third were 4.91 mm, 4.72 mm, and 2.78 mm on the right and 4.55 mm, 4.75 mm, and 2.55 mm on the left side. Symmetry was observed in any third of the OF. The OF median values of the surface maximum width for the anterior, middle, and posterior thirds were 9.29 mm, 11.48 mm, and 13.07 mm. A significant gradual increase of the OF surface maximum width was detected in the anteroposterior direction in the total sample (p < 0.001), with the highest value (23.12 mm) in the posterior third. A significant (p < 0.001) very strong (rs = −0.798) and a moderate (rs = −0.524) negative linear correlation in the OF anterior and middle third were, respectively, identified between its maximum depth and width. No gender impact was identified. Conclusions: The study helps to familiarize with the calculation of the OF dimensions and simplifies the understanding of its complex anatomy, to reach successful surgical planning and minimize perioperative complications. © 2022, The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature
Incidence and morphometry of caroticoclinoid foramina in Greek dry human skulls
Background: Ossification of the caroticoclinoid ligament (CCL) and formation of a caroticoclinoid foramen (CCF) may impose significant risk to neurosurgeons by impeding mobilization of the cavernous segment of the internal carotid artery. Although safe surgical access to the clinoidal space is related to understanding the CCF anatomical and ethnic variants, there remains a paucity of studies of the morphology and bony relationships. The current study provides a systematic morphological and morphometric analysis of the CCF, the ossification of the CCL extending between the anterior and middle clinoid processes, and their relations in a Greek population. Materials and methods: The incidence of unilateral and bilateral CCF, types (complete, incomplete, and contact) of ossified CCLs, and foramina diameter according to side and gender were determined in 76 Greek adult dry skulls. Findings were correlated with the morphology of optic strut (OS) (presulcal, sulcal, postsulcal, and asymmetric). Results: A CCF was detected in 74% of the specimens. The majority of skulls (51.4%) had bilateral CCF, whereas 22.3% of the skulls had unilateral foramina. Incomplete CCF were observed in 69.3%, complete in 19.8%, and contact type in 10.9%. The mean CCF diameter was 0.55 ± 0.07 cm on the left and 0.54 ± 0.08 cm on the right side. Side symmetry existed, although there were no significant differences according to gender. The CCF were more prominent in skulls with a sulcal type of OS. Conclusions: The results of the present study augment the current knowledge on the morphology of key anatomical landmarks, CCF, and CCL ossification in the sellar area, indicating population differences. A significant side asymmetry in caroticoclinoid osseous bridging and foramina is highlighted. These findings are necessary for a safe surgical access to the clinoidal area. © 2018, Springer-Verlag GmbH Austria, part of Springer Nature
An anatomical study on metopic suture variants in Greek adult dried skulls
Background: The metopic suture (MS), at the vertical axis between the two halves of the frontal bone appears as the result of lack of ossification. Its persistence is called metopism. The current study records the frequency of MS persistence, its morphological variants, and its coexistence with Wormian bones (WBs) in adult skulls.Material – Method: Eighty (41 male and 39 female) Greek adult dried skulls were investigated for the MS presence. For a further MS evaluation, the skulls were divided into 3 groups: 1st group (MS absence), 2nd group (complete MS) and 3rd group (incomplete MS). The incomplete MS was classified into the following morphological variants: Y, V, U, H shapes and linear and double linear types. Skulls used were also inspected for the WBs presence.Results: The MS was identified in 69 skulls (86.25%). Its absence was found in 11 skulls (13.8%) with similar frequencies in males and in females. The incomplete MS was prevalent (78.8%), while the complete one (metopism) was recorded in 7.5%. The incomplete MS dominant type was the linear (26.3%) followed by the V-type (17.5%), the double linear (15%), the H-type (8.8%), the U-type (6.3%) and the Y-type (5%). A percentage of 20% of the skulls had WBs in the lambdoid suture. A unique trigonocephaly case was identified with WBs in the lambdoid suture.Conclusion: The knowledge of MS persistence is valuable in clinical practice, as it can be erroneously considered as a frontal bone fracture in imaging studies. Neurosurgeons are obliged to be aware of this variant to provide the patient with the most appropriate and safe care. Furthermore, metopism is important in paleo-demography and forensic medicine
Atlas posterior arch and vertebral artery’s groove variants: a classification, morphometric study, clinical and surgical implications
Background: The third part of the vertebral artery (VA) coursing in vertebral artery groove (VAG) may be injured during posterior craniocervical junction approaches. Objective: The current study classifies all possible variants of the posterior arch (PA) of the atlas vertebra (C1), focusing on VAG and calculates their incidence. PA and VAG morphometry is studied in correlation with gender and age. Clinical and surgical implications of recorded variants are provided in an effort to explain associated pathology. The usefulness of three-dimensional computed tomography (3D-CT) in detecting PA variants is highlighted. Materials and methods: Two hundred and forty-four Greek adult dry C1 were classified in types according to PA morphology [i.e. presence of an imprint or a distinct VAG and occurrence of a partially or completely ossified dorsal (PDP or CDP) or lateral (PLP or CLP) ponticle unilaterally or bilaterally]. Combined variants were also included. Results: A VAG and an imprint were detected in 42.62% and 15.16%. A PDP and CDP were observed in 18.03% and 15.98%, while a CLP and PLP in 2.05% and 1.64%, respectively. Combined PDP and PLP were detected in 2.05%, a CDP and CLP similarly to a CDP and PLP in 1.23% and a PDP and CLP in 0.40%. Conclusions: Variants’ classification will contribute to an in depth understanding of the complex C1 anatomy and may explain cases of VA entrapment and injury during PA fixation. Surgeons should carefully study 3D-CT imaging to ensure type, location, size and shape of C1 ponticles in combination with VAG morphology and VA course before screw insertion. © 2019, Springer-Verlag France SAS, part of Springer Nature