Evaluation of Anatomical Characteristics of Mandibular Incisive Canal in a Turkish Subpopulation Using Cone Beam Computed Tomography

ABSTRACT Objective: To assess the anatomical characteristics of mandibular incisive canal and to describe the occurrence of anatomical variations according to side, age and gender using cone beam computed tomography (CBCT). Methods: A retrospective study using CBCT images was performed to evaluate mandibular incisive canal in mandible of 100 patients. Both right and left sides were studied (n = 200). Axial, sagittal, cross-sectional and panoramic images were evaluated, and three dimensional images were also reconstructed and evaluated, as necessary. The morphology, course and length of mandibular incisive canals and the inner and outer diameters of the canals were measured. Results: The incisive canal was found in 87% of the scans. The mean endpoint was approximately 10.98 and 10.26 mm anterior to the mental foramen for left and right side, respectively, without a significant difference (p > 0.05). The mean distance from the lower border of the mandible was 10.7 mm and its course was closer to the buccal border at the starting point while it deviates lingually through the anterior of the mandible. Significant difference was found between gender, side and age groups (p < 0.05). Conclusion: Awareness of these anatomical variations is important to avoid neurovascular damage during surgical intervention and anaesthetic applications. Cone beam computed tomography is an effective imaging modality in the detection of lingual foramina and canals. Further studies with larger data samples are necessary in comparison and estimation of anatomical results.

Anesthesia management in Kabuki Make-up syndrome

Kabuki make-up syndrome KMS is a rare condition with a number of characteristic congenital abnormalities. The syndrome is characterized by peculiar facial appearance resembling the make-up of actors in Kabuki, the traditional Japanese theater, skeletal anomalies, dermatoglyphic abnormalities, postnatal growth deficiency, and mental retardation. These are rare reports of central nervous system dysfunctions, other than mental retardation, and no previously described congenital talipes calcaneo-valgus in this syndrome. We report the case of a 22-month-old girl having Kabuki make-up. At presentation, she had an adenoid hypertrophy and a history of recurrent otitis media. She had also delay in motor development, and a postnatal growth deficiency. The variable phenotypic expression is a well-known characteristic of the syndrome. For that reason, we should perform careful morphologic examination in every patient and their parents, and use flexotype laryngoscope Heine, Germany to visualize vocal cord in case of difficult intubation. At preoperative examination, as clinicians, we must be careful regarding patient morphology. Congenital heart defects and epilepsy are important for anesthesia management in KMS