The investigation of cranial fossae in the intracranial cavity of fixed cadaveric skull bases: associations with sex, laterality, and clinical significance.

PURPOSE: Our study aims to investigate three parts of the intracranial cavity, their distances to essential anatomical landmarks, and the correlations between these distances with sex, laterality, and surgical significance. METHODS: The cranial nerve foraminae and essential surgical landmarks of each fossa were investigated bilaterally in 30 adult formalin-fixed cadaveric heads. Measurements, including lengths, depths, diameters, and horizontal distances to each other, to the midline of the skull, and to the outer lateral margin of the skull, were recorded on both sides. RESULTS: The optic canal (OC) depth, internal auditory meatus (IAM) width, CNVII and CNIX diameters, and accessory hypoglossal canal (HC) distance were significantly greater on the left side (p < 0.05). CNVI length, CNV diameter, CNXI length, and the distances of the HC and accessory HC from the skull were significantly greater on the right side (p < 0.05). In males, correlations were found between the length of the left CNVIII and the right IAM diameter (r = 0.864, p = 0.001), right CNVIII length (r = 0.709, p = 0.022), right accessory HC length (r = 0.847, p = 0.016), and right-sided skull distance (r = 0.829, p = 0.042). In females, correlations were noted between IAM depth and length, right IAM location relative to the skull, left CNIX and CNX lengths, left CNXII length, left accessory HC location relative to the skull, and accessory HC length. CONCLUSIONS: The findings of the current study indicate inherent asymmetry, sexual dimorphism, and variability in certain cranial nerves among cadaveric heads, which could have implications for surgical procedures, neuroanatomical studies, and clinical assessments. The study revealed side disparities and correlations within cranial fossa formations and essential surgical landmarks in both genders.

A Rare Case of Primary Posterior Abdominal Wall Muscle Hydatid Cyst With Thoracolumbar Spinal Extension.

Primary intramuscular hydatid cysts are uncommon due to the contractile nature of muscles and their lactic acid content. Hydatid cysts with spinal extension are sometimes seen with primary vertebral body involvement. Our patient presented with a slow-growing posterior abdominal wall mass, and upon magnetic resonance imaging (MRI), it was revealed to be several cystic lesions in the abdomen wall with extension through the neural foramina into the spinal canal. The key differentials for spinal canal masses with neural foraminal expansion and muscle involvement are peripheral nerve sheath tumors. Our case report adds hydatid cysts to the differentials for well-defined cysts with variable intensities on MRI.

Discovery of an Anteriorly Deviated, Partially Ossified Xiphoid Process With a Large, Teardrop-Shaped Foramen in a Male Cadaver.

The sternum, or "breastbone," is a principal bony component of the anterior thoracic wall and comprises the manubrium of the sternum, the body of the sternum, and the xiphoid process. The xiphoid process is the most inferior of these elements and commonly presents as a small, solid bone shaped like an inverted triangle. However, clinical literature has reported numerous variations in its size, shape, and presentation, likely the result of its lengthy embryological development from cartilage into fully ossified bone. In this case report, a rare, anteriorly deviated, partially ossified xiphoid process with a large, teardrop-shaped foramen is presented that was discovered during a routine cadaveric dissection of a 75-year-old male within an undergraduate anatomy course. Although anatomical variations in the xiphoid process are often asymptomatic and often only found incidentally through CT or X-ray scans, healthcare professionals should be aware of such variations to avoid both misdiagnoses as well as iatrogenic complications.

Vascular Foramina of Dry Human Talus: A Morphological Study.

Background The talus is the second largest tarsal bone and makes the osseous link between the leg and foot region. The branches of the dorsalis pedis, posterior tibial, and peroneal arteries enter vascular foramina (VF) on the various surfaces of the talus and provide intraosseous blood supply. Understanding the morphology and morphometry of VF might be helpful in reducing the risk of vascular injury associated with surgical interventions to the talus.  Aim and objectives The purpose of this study is to contribute reference data for the morphology of VF of talus in a sample from Türkiye. Materials and methods This study was performed on 62 dry talus samples from Türkiye. The number, location, size, and foraminal index of the VF were evaluated on each talus. The total and medial surface lengths, distances of the closest and furthest foramina on the inferior surface, and distances of the closest and furthest foramina on medial surface were measured. Results No VF was detected on articular surfaces and the head of the talus. The majority of VF (1754; 81.17%) were detected on the neck, and 708 (40.36%) were located on the inferior surface of the neck. On the body, VF was mostly detected on the medial surface (233; 57.25%). The mean foraminal indices of the closest and furthest foramina on the inferior surface were 38.85% and 77.89%, respectively. The mean foraminal index of the closest foramina on the medial surface was 33.52%, and the furthest foramina on the medial surface was 63.91%. The total number of VF on 62 tali was determined as 2161. The majority (1521; 70.38%) of the size of VF was ≥0.6 mm. The mean total length was 55.14±4.69 mm, and the medial surface length was 49.18±4.18 mm. Conclusion Knowing the morphologic and morphometric properties of the VF gains importance during surgical interventions to the talus to reduce vascular damage. According to our results, lateral approaches to the talus may be safer than other approaches. To our knowledge, there is no study about the morphology of VF of the talus in Türkiye samples. We believe that the results of this study will provide reference data for morphology and morphometry of VF of talus.

Scapular foramina - a systematic review with meta-analysis based on 3316 scapulae.

PURPOSE: In the present study, we want to systematize the previous studies on the scapular foramina (SF) and nutrient foramina (NF) with emphasis on the clinical relevance of this topic. Although seemingly not important, radiologists, clinicians and surgeons should be aware of the presence and characteristics of the SF and NF and look out for possible mistakes that may cause harm to the patients during either the diagnostic process or surgery. METHODS: A comprehensive search was conducted in multiple databases, including PubMed, Scopus, Web of Science, Embase, Cochrane Library and Google Scholar. The whole process was divided into three stages. In the first stage, the following search terms were used: ((scapular foramina) or (scapular foramen) or (scapular nutrient foramina) or (scapular nutrient foramen) or (scapula foramen) or (scapula foramina) or (scapula nutrient foramina)). RESULTS: The results of the present meta-analysis were based on a total of 3316 studied scapulae. A pooled prevalence of scapulae in which at least one SF was found was set to be 11.29%. The most common localization of the SF was found to be the infraspinous fossa, in which the SF occurred with the prevalence of 52.31%. Subsequently, a pooled prevalence of scapulae in which at least one NF occurs was established at 74.23%. CONCLUSION: The presented data contribute to a comprehensive understanding of the prevalence, distribution, and characteristics of suprascapular and nutrient foramina in scapulae, considering different topographical areas, genders, and sides.

Lineage-specific requirements of Alx4 function in craniofacial and hair development.

BACKGROUND: Disruption of ALX4 causes autosomal dominant parietal foramina and autosomal recessive frontonasal dysplasia with alopecia, but the mechanisms involving ALX4 in craniofacial and other developmental processes are not well understood. Although mice carrying distinct mutations in Alx4 have been previously reported, the perinatal lethality of homozygous mutants together with dynamic patterns of Alx4 expression in multiple tissues have hindered systematic elucidation of the cellular and molecular mechanisms involving Alx4 in organogenesis and disease pathogenesis. RESULTS: We report generation of Alx4f/f conditional mice and show that tissue-specific Cre-mediated inactivation of Alx4 in cranial neural crest and limb bud mesenchyme, respectively, recapitulated craniofacial and limb developmental defects as found in Alx4-null mice but without affecting postnatal survival. While Alx4-null mice that survive postnatally exhibited dorsal alopecia, mice lacking Alx4 function in the neural crest lineage exhibited a highly restricted region of hair loss over the anterior skull whereas mice lacking Alx4 in the cranial mesoderm lineage exhibited normal hair development, suggesting that Alx4 plays partly redundant roles in multiple cell lineages during hair follicle development. CONCLUSION: The Alx4f/f mice provide a valuable resource for systematic investigation of cell type- and stage-specific function of ALX family transcription factors in development and disease.

Topography and morphometry of the infraorbital and mandibular foramen of the common sloth (Bradypus variegatus) for use in the application of perineural anaesthesia.

A local anaesthetic block performed in cranial and mandibular foramina contributes towards analgesia and the reduction of systemic anaesthesia in procedures in the oral cavity. However, anatomical differences between in wild animals may require adaptations to the anaesthetic and surgical manoeuvres of the head used in domestic animals. With that in mind, we aimed to describe the topography and morphometry of the infraorbital and mandibular foramina in Bradypus variegatus, to support perineural anaesthetic approaches in the cranio-mandibular region of this species. We demonstrated that in B. variegatus there is no significant variability in the morphometric data, allowing access to the studied foramina to occur in a similar way in adult individuals. Finally, we understand that the techniques for the infraorbital and mandibular foramen needed to be adapted due to the anatomical singularities of the species, which culminated in new reference points for more assertive needle positioning.

Are the Ethmoidal Foramina Through the Frontal Bone, Ethmoid Bone, or Frontoethmoidal Suture?

INTRODUCTION: To investigate the locations of the anterior, middle, and posterior ethmoidal foramina and their relationships to the frontoethmoidal suture. METHODS: One hundred twenty sides from sixty adult human skulls were used. Specimens with significant damage to the medial orbit wall were excluded. The number of ethmoidal foramina (anterior, middle, and posterior) on the medial orbital wall and the relationship of each foramen to the frontoethmoidal suture were recorded and classified as follows: Type I: superior to the frontoethmoidal suture; Type II: on the frontoethmoidal suture; Type III: inferior to the frontoethmoidal suture. RESULTS: Of the ninety-four sides, fourteen (14.9%) had one foramen, sixty-two (66.0%) had two , and eighteen (19.1%) had three. In total, 192 ethmoidal foramina were observed. Among the fourteen sides with one foramen, eight foramina were anterior and six were posterior. Among the 192 ethmoidal foramina, 162 were eligible for fur ther classification (74 anterior, 14 middle, and 74 posterior). Types I, II, and III ethmoidal foramina were found in 38.3% (62/162), 61.7% (100/162), and 0% (0/162), respectively. CONCLUSIONS: Our current study found a higher incidence of type I than previously reported. It is important to be aware of the significant incidence of foramen variations when the medial orbit wall is manipulated during surgery. Unless caution is observed, an inadvertent surgical injury can occur and lead to life-threatening complications. Therefore, a good understanding of orbital anatomy and its potential variations is critical for improving patient out comes.

Anatomic Assessment of L1-S1 Neuroforaminal Dimensions Using Computed Tomography in 1,000 Patients: A Follow-Up Study.

OBJECTIVES: While the radiographic criteria for diagnosing central lumbar stenosis are well described, criteria for diagnosing neuroforaminal stenosis (NFS) are unclear. Prior research has utilized magnetic resonance imaging (MRI) to characterize neuroforaminal dimensions (NFDs). However, this approach has inherent limitations that can adversely impact measurement accuracy. Existing literature on the use of computed tomography (CT) to investigate normal NFDs is limited. The purpose of the present study was to describe normal lumbar NFDs that would aid in the establishment of objective quantitative criteria for the diagnosis of NFS. METHODS: This study evaluated CT imaging of 494 female and 506 male subjects between 18 and 35 years of age to determine normal NFDs, specifically the sagittal anteroposterior width, craniocaudal height, and area. Statistical analyses were performed to assess differences in NFDs according to variables including sex, height, weight, body mass index, and ethnicity. RESULTS: Without differentiating between sides or disc levels, mean NFDs were 8.71 mm for sagittal anteroposterior width, 17.73 mm for craniocaudal height, and 133.26 mm2 for area (n = 10,000 measurements each). Male subjects had larger NFDs than females at multiple levels. Asian and Caucasian subjects had larger NFDs than Hispanic and African American subjects at multiple levels. There were no associations between NFDs and anthropometric factors. CONCLUSIONS: The present study describes normal lumbar NFDs in young, healthy patients. NFDs were influenced by sex and ethnicity but not by anthropometric factors.

Differences in MRI measurements of lateral recesses and foramina in degenerative lumbar segments in upright versus decubitus symptomatic patients.

OBJECTIVE: To evaluate differences in measurements of the lateral recesses and foramina in degenerative lumbar segments on MR images in symptomatic patients obtained with the patient standing versus lying down and to analyze the relationship between possible differences and patients' symptoms. MATERIAL AND METHODS: We studied 207 disc levels in 175 patients aged between 17 and 75 years (median: 47 years) with low back pain. All patients underwent MRI in the decubitus position with their legs extended, followed by MRI in the standing position. We calculated the difference in the measurements of the lateral recesses (in mm) and in the foramina (area in mm2 and smallest diameter in mm) obtained in the two positions. To eliminate the effects of possible errors in measurement, we selected cases in which the difference between the measurements obtained in the two positions was ≥10%; we used Student's t-tests for paired samples to analyze the entire group and subgroups of patients according to age, sex, grade of disc degeneration, and postural predominance of symptoms. RESULTS: Overall, the measurements of the spaces were lower when patients were standing. For the lateral recesses, we observed differences ≥10% in 68 (33%) right recesses and in 65 (31.5%) left recesses; when patients were standing, decreases were much more common than increases (26% vs. 7%, respectively, on the right side and 24% vs. 7.5%, respectively, on the left side; p < 0.005). For the foramina, decreases in both the area and in the smallest diameter were also more common than increases when patients were standing: on the right side, areas decreased in 23% and increased in 4%, and smallest diameters decreased in 20% and increased 6%; on the left side, areas decreased in 24% and increased in 4%, and smallest diameters decreased in 17% and increased in 8% (p < 0.005). Considering the group of patients in whom the postural predominance of symptoms was known, we found significant differences in patients whose symptoms occurred predominantly or exclusively when standing, but not in the small group of patients whose symptoms occurred predominantly while lying. We found no differences between sexes in the changes in measurements of the recesses or foramina with standing. The differences between the measurements obtained in different positions were significant in patients aged >40 years, but not in younger groups of patients. Differences in relation to the grade of disc degeneration were significant only in intermediate grades (groups 3-6 in the Griffith classification system). CONCLUSION: MRI obtained with patients standing can show decreases in the lateral recesses and foramina related to the predominance of symptoms while standing, especially in patients aged >40 years with Griffith disc degeneration grade 3-6, thus providing additional information in the study of patients who have low back pain when standing in whom the findings on conventional studies are inconclusive or discrepant with their symptoms. Further studies are necessary to help better define the value of upright MRI studies for degenerative lumbar disease.

Can "In-Out-In" posterosuperior screws meet nutrient foramina in patients with femoral neck fractures?

BACKGROUND: The "In-Out-In" (IOI) posterosuperior screw was common in screw fixations of femoral neck fractures. The impacts of the IOI screw on the blood supply of the femoral head have not yet been clarified. The nutrient foramen was damaged when the screw was present in their corresponding cortex surface. This study aimed to evaluate the damage degrees of the nutrient foramina in the femoral neck as the IOI posterosuperior screw was placed in different posterosuperior locations. METHODS: One hundred and eight unpaired dry human cadaveric proximal femurs were scanned by a three-dimensional scanner. Digital data obtained from the proximal femur surface were employed for subsequent analysis. All nutrient foramina in the femoral neck were identified and marked in each subject. A simulation of the anteroposterior, lateral, and axial views was then performed, and regions of interest (ROIs) for IOI posterosuperior screws, with 6.5 mm diameter, were determined in the posterosuperior femoral neck on the axial graphs. Nutrient foramina were counted and analyzed in ROIs and femoral neck, and its damage from the IOI posterosuperior screw was also calculated in different conditions of screw placement. Paired t-tests were used for comparative analyses before and after damage. RESULTS: Most nutrient foramina were located in the subcapital region and the least in the basicervical region in the femoral neck, while the most were located in the transcervical and the least in the subcapital in the ROIs. In addition, most nutrient foramina in ROIs were located in the superior-posterior area of the femoral neck. There were four main locations of IOI posterosuperior screws where the decrease in the nutrient foramina was statistically significant (P < 0.01). The risk zone determined by these locations was located in a posterosuperior square of ROIs with an edge length of 9.75 mm. CONCLUSION: To minimize iatrogenic damage to the blood supply of the femoral head, screw positions could be assessed in anteroposterior and lateral radiographs using a risk zone. The IOI posterosuperior screw in ROIs can be applied to fix femoral neck fractures when feasible in clinical practice. This study could provide surgeons with more alternatives for screw placement in the posterosuperior femoral neck.

Osteological Study of the Parietal Foramen in the Adult Human Skull Bones and its Clinical and Surgical Correlations / Estudio Osteológico del Foramen Parietal en los Huesos del Cráneo Humano Adulto y sus Correlaciones Clínicas y Quirúrgicas

SUMMARY: Parietal emissary foramina (PEF) are small holes, which are localized between the middle and posterior thirds of the parietal bone posterior surface close to the sagittal suture. PEF are important structures that protect the parietal emissary vein, which passes through it. During neurosurgery procedures, parietal foramina (PF) knowledge is crucial. This work aimed to evaluate presence and location of the PF in the skull of an adult human. Moreover, measure the distance amidst PF and the sagittal suture's midline to ascertain its clinical repercussions. 74 adult human skulls, without gross pathology, were observed for the PF's existence. The PF's and sagittal suture's midline distance were measured. According to the PF patterns of presence, five groups were distributed. Finally, specimens were photographed and subjected to statistical analysis. The PF was absent in 7 skulls (9.5 %). There were 9 skulls (12.2 %) exhibited central parietal foramen where the parietal foramen lies on the sagittal suture. 17 skulls (23 %) showed right unilateral parietal foramen, whereas 15 skulls (20.3 %) demonstrated left unilateral parietal foramen. The final 26 skulls (35.1 %) exhibited bilateral parietal foramen. This descriptive study supplies valuable information of PF variations, which is crucial for neurosurgeons in modifying surgical techniques and procedures to alleviate injury to PF-emerging structures such as emissary veins.

Los forámenes emisarios parietales (FEP) son pequeños orificios que se localizan entre los tercios medio y posterior de la superficie posterior del hueso parietal, cerca de la sutura sagital. Los FEP son estructuras importantes que protegen la vena emisaria parietal, que lo atraviesa. Durante los procedimientos de neurocirugía, el conocimiento de los forámenes parietales (FP) es crucial. Este trabajo tuvo como objetivo evaluar la presencia y ubicación del FP en el cráneo de hombres adultos, además, medir la distancia entre el FP y la línea mediana de la sutura sagital para conocer su repercusión clínica. Se examinaron 74 cráneos humanos adultos, sin patología grave, para determinar la existencia del FP. Se midió la distancia de la línea mediana de la sutura sagital y del FP. De acuerdo con los patrones de presencia del FP, se distribuyeron en cinco grupos. Finalmente, los especímenes fueron fotografiados y sometidos a análisis estadístico. El PF estaba ausente en 7 cráneos (9,5 %). Hubo 9 cráneos (12,2 %) que presentaban un PF central localizándose en la sutura sagital. 17 cráneos (23 %) presentaban un FP unilateral derecho, mientras que 15 cráneos (20,3 %) se observó un FP unilateral izquierdo. Los 26 cráneos restantes (35,1 %) exhibieron FP bilaterales. Este estudio descriptivo proporciona información valiosa sobre las variaciones del FP, que es fundamental para los neurocirujanos en el momento de modificar las técnicas y los procedimientos quirúrgicos para aliviar las lesiones de las estructuras emergentes del FP, como las venas emisarias.

Bilateral Inferior Alveolar Canal Variations Detected by Cone Beam Computed Tomography-Case Report.

Inferior alveolar canal (IAC) is an important anatomical landmark in dentistry. It is a bony canal in the mandible, one on each side and transmit inferior alveolar neurovascular bundle. However, it has been reported to have anatomical variations in its course. IAC is visible on radiographs and cone beam computed tomography (CBCT) has been identified as the one of the best methods to assess IAC preoperatively. An interesting case of IAC anatomy in a CBCT is presented here. There were accessory mandibular foramina, retromolar foramina on both sides, accessory mental foramen on the right side and lingual foramina in the midline as well as on the body of the mandible. The IAC was showing several branching within ramus as well as in the body of the mandible. This case report highlights the possible anatomical variations and importance of careful assessment of IAC in dental and maxillofacial procedures which can cause damage to the neurovascular bundle.

Morphometric analysis of foramen ovale, foramen spinosum, and foramen rotundum of human skull using computed tomography scan: a cross-sectional study.

There is limited literature of objective assessments of foramina of skull base using computed tomography (CT) scan. This study was carried out to analyze the dimensions of foramen ovale (FO), foramen spinosum (FS), and foramen rotundum (FR) using CT scan imaging of the human skull and their associations with sex, age, and laterality of the body. Materials and methods: A cross-sectional study was carried out in the Department of Radiodiagnosis and Imaging at BP Koirala Institute of Health Sciences (BPKIHS), Nepal using a purposive sampling method. We included 96 adult patients (≥18 years) who underwent CT scan of the head for any clinical indications. All those participants below 18 years, inadequate visualization or erosions of skull base foramina, and/or not consenting were excluded. Appropriate statistical calculations were done using the statistical package for social sciences (SPSS), version 21. The P-value of less than 0.05 was considered statistically significant. Results: The mean length, width, and area of FO was 7.79±1.10 mm, 3.68±0.64 mm, and 22.80±6.18 mm2, respectively. The mean length, width, and area of FS was 2.38±0.36 mm, 1.94±0.30 mm, and 3.69±0.95 mm2, respectively. Similarly, the mean height, width, and area of FR was 2.41±0.49 mm, 2.40±0.55 mm, and 4.58±1.49 mm2, respectively. The male participants had statistically significant higher mean dimensions of FO and FS (P<0.05) than the female participants. There were statistically insignificant correlations of dimensions of these foramina with age and between the left and right side of each foraminal dimensions (P>0.05). Conclusions: The sex-based difference in dimensions of FO and FS should be clinically considered in evaluating the pathology of these foramina. However, further studies using objective assessment of foraminal dimensions are required to draw obvious inferences.

The transversoclasiotome: a novel instrument for examining the vertebral artery.

Opening the foramen transversarium of the cervical vertebrae is necessary for accessing the vertebral vessels. There are no specialist tools for cutting the anterior lamina of the transverse processes, and alternatives lead to questionable results. A novel tool, the transversoclasiotome, is described and tested. The literature and patent databases were systematically reviewed. A blueprint of the transversoclasiotome was created, and the prototype was tested through autopsy on ten fresh-frozen cadavers within our Body Donation Program. The transversoclasiotome consists of two delicate branches mounted as a scissor, one a cutting jaw and the other a knocker with a rounded tip, both angled 30° to the principal axis. The jaws shut, facing each other in parallel. The cutting jaw corresponds to a slit on the knocker profile without protruding beyond it even when entirely closed. It acts by cutting and wedging. The testing autopsies demonstrated its suitability for its purpose, with an adequate response to the pressure exerted on the bone lamina. The section cut cleanly, without sliding off while closing on the bone. The vertebral vessels were not injured either during instrument insertion or cutting. Their morphological features are described. The transversoclasiotome has been proven appropriate for sectioning the anterior lamina of transverse processes of the cervical vertebrae. It meets the needs of clinical anatomy in teaching and training clinicians or surgeons, forensic clinical anatomy during medico-legal investigation, and research.

Comprehensive microsurgical anatomy of the middle cranial fossa: Part I-Osseous and meningeal anatomy.

The middle cranial fossa is one of the most complex regions in neurosurgery and otolaryngology-in fact, the practice of skull base surgery originated from the need to treat pathologies in this region. Additionally, great neurosurgeons of our present and past are remembered for their unique methods of treating diseases in the middle fossa. The following article reviews the surgical anatomy of the middle fossa. The review is divided into the anatomy of the bones, dura, vasculature, and nerves-in two parts. Emphasis is paid to their neurosurgical significance and applications in skull base surgery. Part I focuses on the bony and dural anatomy.

Morphometric and topographic evaluations of principal nutrient foramina of the ilium.

BACKGROUND: Nutrient arteries pass through the nutrient foramina and reach the spongious part or medullary cavity of the bones. The arterial blood supply and nutrient foramina of the ilium have not been well described in the literature. The aim of this study is to define the numbers and localizations of nutrient foramina of the ilium on the internal surface in accordance with the pelvic brim, as well as the external surface, and furthermore the distances between these foramina with certain anatomical landmarks. METHODS: This study was performed on 57 dry hip bones. The foramina on the external and internal surfaces of the ilium were evaluated separately. The external surface of the ilium was divided into 4 regions in accordance with the gluteal lines to determine the localizations of the nutrient foramina. The foramina on the internal surface were evaluated according to whether they were above or below the pelvic brim. The diameters of the foramina and their nearest distances to certain anatomical landmarks were measured. Furthermore, the risk area of the region above the pelvic brim was determined. RESULTS: : The foramina that were found on the external surface of the ilium were distributed mainly between anterior and inferior gluteal lines (42 foramina-37.17%) and below the inferior gluteal line (57 foramina-50.44%). On the internal surface, 54 nutrient foramina were found above the pelvic brim and 81 were found below. DISCUSSION: The localizations and configurations of all nutrient foramina on the ilium were evaluated morphometrically for the first time.

[Assessment of the local blood supply when femoral neck fracture occurs:advances in the anatomy research and its clinical application].

The stability of internal fixation of femoral neck fractures can be obtained through surgical techniques, the configuration of screws and bone grafting, etc. However, the blood supply injury caused by fractures could not be completely reversed by the current medical management. Hence, the comprehensive evaluation of the residual blood supply of the femoral neck, to perioperatively avoid further iatrogenic injury, has become a hotspot. The anatomy of the extraosseous blood supply of the femoral neck has been widely reported, while its clinical application mostly involved the assessment of the medial circumflex femoral artery and retinacular arteries. However, further studies are needed to explore the prognosis of patients with these artery injuries, with different degrees, caused by femoral neck fractures. Direct observations of nutrient foramina in vivo are not possible with current clinical technologies, but it is possible to make reasonable preoperative planning to avoid subsequent femoral head necrosis based on the distribution features of nutrient foramina. The anatomy and clinical application studies of the intraosseous blood supply focused on the junction area of the femoral head and neck to probe the mechanism of femoral head necrosis. Thus, the intraosseous blood supply of other regions in the femoral neck remains to be further investigated. In addition, a blood supply evaluation system based on a three-level structure, extraosseous blood vessels, nutrient foramina, and intraosseous vascular network, could be explored to assist in the treatment of femoral neck fractures.

Clinical anatomy of coronoid foramina of mandible and review of its implications in maxillofacial surgery.

INTRODUCTION: A foramen in the coronoid process of the human mandible is a recently identified anatomic variant. The authors in this script aim at presenting a detailed assessment of the coronoid foramen terming it as '''foramen of Nyer' (FN) based on the person first identifying it. METHODS: Mandibular cone beam computed tomography scans from a total of 2168 patients were evaluated on a prospective and retrospective scale for confirmation of the coronoid foramen after first identification over a panoramic radiograph. RESULTS: The coronoid foramen was found and confirmed in 96 (4.4%) patients. This script identifying the coronoid foramina of mandible becomes requisite research as a foundation for further analysis due to the scarcity of literature on this recent find. DISCUSSION: This anatomical-radiological study aims to explore the variant foramina using cone beam computed tomography while determining its prevalence and evaluating its variability in terms of unilateral, bilateral, or gender predilection and propose the significance of this unique anatomic finding. CLINICAL CONSEQUENCES: The lack of information about the presence of such variant foramina may lead to emergence of clinical morbidities such as increased risk of intra osseous hemorrhage and tumor spread due to presence of accessory blood vessels.

Morphometric study and anatomical variation with its incidence of foramina transversaria on the lower cervical vertebrae / Estudio morfométrico y variación anatómica con la incidencia de forámenes transversos en las vértebras cervicales inferiores

SUMMARY: Anatomical variation of the foramina transversaria (FT) is associated with vertebral neurovascular symptoms and can cause complications after lower spine surgery, especially cervical pedicle screw (CPS) insertion. FT variation has been documented and classified in various populations, as this information can help increase cervical stability in subaxial vertebral surgery. Although the morphometry of the upper cervical spine in Thai populations has been reported, there have yet been no studies examining the features of FT. The FT of dried cervical spines (C3-C7; left and right side; n = 107, male = 53 and female = 54) were examined for morphological variation, and their anteroposterior (AP) and transverse (T) diameters were measured using a digital vernier caliper. Morphometric data and variations were compared by sex and lateral side. It was that the C3-C6 FT in both sexes were round, and the C7 FT was elliptical with an oblique right side. FT diameters did not differ significantly by sex except for the AP diameters of C6-C7 and for T diameters of C4 and C7. The left AP diameters of C3-C6 were significantly longer than the right, as were the T diameters of C4 and C7 FT. Additionally, T diameter was significantly longer than that of the AP, except that of the left C6 in male spines, which did not differ from the AP. Most FT examined were round. These findings should be considered in the provisional diagnosis of vertebral neurovascular symptoms caused by FT variation as well as that of neurovascular damage after cervical pedicle screw placement.

La variación anatómica del foramen transverso (FT) se asocia con síntomas neurovasculares vertebrales y puede causar complicaciones después de la cirugía de columna cervical inferior, especialmente la inserción de tornillos pediculares cervicales (TPC). La variación del FT se ha documentado y clasificado en varias poblaciones, ya que esta información puede ayudar a aumentar la estabilidad cervical en la cirugía vertebral subaxial. Aunque se ha informado sobre la morfometría de la columna cervical superior en poblaciones tailandesas, aún no se han realizado estudios que examinen las características de FT. Se examinó la variación morfológica del FT de vértebras cervicales secas (C3-C7; lado izquierdo y derecho; n = 107, hombres = 53 y mujeres = 54), y se midieron sus diámetros anteroposterior (AP) y transverso (T) usando un pie de metro digital. Se compararon datos morfométricos y variaciones por sexo y lado. Los FT de C3-a C6 en ambos sexos eran redondos, y el FT C7 era elíptico con el lado derecho oblicuo. Los diámetros del FT no difirieron significativamente por sexo excepto para los diámetros AP de C6- C7 y para los diámetros transversos de C4 y C7. Los diámetros AP izquierdos de C3-C6 eran significativamente más largos que los del lado derecho, al igual que los diámetros transversos de C4 y C7. Además, el diámetro transverso fue significativamente mayor que el AP, excepto el C6 izquierdo en las vértebras de hombres, que no difirió del AP. La mayoría de los FT examinados eran redondos. Estos hallazgos deben ser considerados en el diagnóstico provisional de síntomas neurovasculares vertebrales causados por la variación del FT, así como en el de daño neurovascular tras la colocación de tornillos pediculares cervicales.