Morphological, anatomical, radiological and clinical features of Mladina type 6 nasal septum deformations in humans.

PURPOSE: The objective of this study was to prove the higher frequency of the type 6 deformations overall compared to the results obtained by conventional diagnostic methods, such as computed tomography images and clinical examination. METHODS: The study was performed at the Institute of Anatomy, where a total of 114 randomly selected skulls were examined. The skulls were then scanned in a fixed position using the cone-beam technique (CBCT). The literature epidemiological data of the clinical incidence of type 6 in studies that also used Mladina classification were obtained. RESULTS: There was a statistically significant difference (p < 0.0001) in the frequency of type 6 deformation as diagnosed by visual inspection (22.8%) and computed tomography (7.9%). The frequency obtained by CT imaging amounted 7.9% and was almost the same as the results obtained by a clinical examination which varied between 9 and 11%. CONCLUSIONS: The frequency of type 6 nasal septal deformation is higher by visual inspection of the skulls than by computed tomography imaging at a level of significance of 0.05. The incidence of type 6 findings on coronal CT images of paranasal sinuses is approximately the same as that found with anterior rhinoscopy. Type 6, visible or concealed; probably have one-fourth to one-fifth people in population, so the number of clinically overlooked and/or unrecognized types 6 is much greater than we thought it to be.

An anatomical study of pneumatized crista galli.

The literature data on the incidence of pneumatization of the crista galli based on patients' computed tomography (CT) scans ranges from 3 to 37.5%. This study investigated for the first time the incidence of crista galli pneumatization based on CT scans of human skulls. The study examined 102 randomly selected human skulls (≥20 years of age; 76 males, 26 females). Skulls were scanned in a fixed position using cone beam computed tomography (CBCT) with a field of view of 145 × 130 mm and an isotropic voxel size of 0.25 mm. The scans were recorded in Digital Images and Communications in Medicine format. The CBCT images were analyzed using OnDemand3DTM software. A 2-mm contiguous slice thickness was used in the axial and coronal planes. The width, length, and height (cranial-caudal dimension) of the pneumatized space within the crista galli were measured. The crista galli was found to be pneumatized in even 68 (66.6%) of the 102 skulls. Two types of pneumatized crista galli (PCG) were identified: PCG alone (surrounded by bony walls) and PCG + spongiosis (surrounded by spongy bone). Of the 68 pneumatized skulls, 31 were PCG alone (45.58%) and 37 were PCG + spongiosis (54.42%). The pneumatized regions had a width of 0.9-6.6 mm, length of 2.8-12.9 mm, and height of 3.6-17.1 mm. No statistically significant differences have been found regarding the sex and age. Regarding the proportions of pneumatization, the three types of crista galli have been determined resulting in new, practical classification: type S (small), type M (moderate), and type L (large). The crista galli is not always a compact bone; in some cases, it is filled with spongy bone or pneumatized. In respect of proportions of pneumatization, there are three types of pneumatized crista galli: small, moderate, and large. Pneumatized crista galli can play an important role in clinical work, both as an inflamed sinus or other pathologies (sinusitis cristae galli, mucocoelae) or as a morphologic barrier in neurosurgical approaches to some tumors of the anterior skull base.

Sinus septi nasi: Anatomical study.

The aim of this study was to perform a pioneering investigation into the incidence of pneumatization in human skulls. A total of 93 human skulls (≥20 years of age, 69 males, 24 females) were included in the study. The skulls were scanned in a fixed position using cone beam computed tomography (CBCT). The pneumatized space parameters within the nasal septum-width, length, and height-were measured. Two types of finding were identified: (a) Pneumatization, named "sinus septi nasi" (SSN), and (b) "spongy bone" (SB). The results showed SSN in 32 of the 93 skulls (34.4%). The SSN formations were from 0.5 to 4.2 mm wide, 3.5 to 18.8 mm long, and 3.8 to 17.7 mm high. Tumefactions filled with SB were found in 61 of the 93 skulls (65.59%). These were not suitable for precise measurements since the outer borders were not strictly and well defined on CT scans (perhaps because of the preparation process). In conclusion, the perpendicular plate of the ethmoidal bone is not always compact bone; in 34.4% of cases, it shows a degree of pneumatization. In contrast, an enlarged formation filled with SB is present in 65.59% of cases. The possible sources of pneumatization of this little-investigated region are discussed: sphenoid sinus, frontal sinus, and vomeronasal organ. Clin. Anat. 30:312-317, 2017. © 2017 Wiley Periodicals, Inc.