Occipital spurs on lateral cephalometric radiographs: morphologic and morphometric features

An Anatomorphometric Study of Occipital Spurs and Their Association With Dental Occlusion

Background and objective The occipital spur (OS) can be described as an abnormal elongation of the external occipital protuberance (EOP); its etiology is multifactorial and may involve biomechanical, immunological, and/or genetic factors. This study aimed to determine the frequency and characteristics of elongated EOP or OS as well as the relationship of OS with occlusion in a group of Turkish dental patients. Materials and methods Lateral cephalometric radiographs of 1925 patients taken in 2022 were retrospectively analyzed. The frequency, types, and dimensions of OS were determined based on gender and age groups. Molar occlusion and incisal bite were also evaluated. Results Of the 1925 patients, 679 were males and 1246 were females. The mean age of the cohort was 18.17 ±5.03 years (range: 4-61). OS was detected in 483 (25.1%) patients and was more common in males (p<0.001); 133 (27.5%) of the OSs were flat, 247 (51.1%) crest, and 103 (21.3%) spin type. The incidence of OS increased depending on age groups (p<0.001). There was no statistically significant association between OS presence and molar occlusion (p>0.05). However, a statistically significant association was observed between anterior incisal bite (p=0.001) and OS presence. There was a statistically significant difference in terms of OS sizes in males and females; the sizes of OS were larger in males than in females (length: p<0.05, base and thickness: p<0.001). Conclusions The frequency of OS was quite high in our cohort; it was more common and of larger size in males and older age groups. The most common type was the crest type. While there was no statistically significant association between OS frequency and molar occlusion, there was a significant relationship with incisal bite. The frequency of OS was highest in people with anterior crossbite.

Enlarged occipital spur and craniofacial morphology: a cephalometric analysis

OBJECTIVE

This cross-sectional study aimed to investigate the association between the occipital spur length and craniofacial morphology in individuals with occipital spur (OS).

METHODS

The study included cephalometric images from 451 individuals (196 females, 255 males, age range was 9-84 years). The spur length and craniofacial characteristics were evaluated using cephalograms. Based on spur length, subjects were divided into two groups: the OS group (N = 209) and the enlarged occipital spur (EOS) group (N = 242). Descriptive statistics, Independent T-test, Mann-Whitney U test, chi-square test, Kruskal-Wallis test, and age- and sex-based stratified analyses were performed. The level of significance was set at p < 0.05.

RESULTS

Males had significantly larger spur length than females. Spur length was shorter in individuals under 18 than the groups over 18. After adjusting for gender and age, ramus height, mandibular body length, effective length of maxilla, effective length of mandible, anterior cranial base length, posterior cranial base length, anterior facial height, posterior facial height, facial height index, and lower anterior facial height had statistically significant differences between OS group and EOS group.

CONCLUSIONS

Males exhibit greater spur length than females. Patients under 18 had a shorter spur length than adults. Linear craniofacial measurements were found to be greater in subjects with EOS than the individuals with OS. The craniofacial growth and development of an individual might be associated with EOS. The causal relationship between EOS and craniofacial development requires further longitudinal studies.

Correlation of the external occipital protuberance with venous sinuses: a magnetic resonance imaging study

PURPOSE

To date, no study has explored the external occipital protuberance (EOP) using neuroimaging modalities. This study aims to characterize them using magnetic resonance imaging (MRI).

METHODS

A total of 96 patients underwent thin-sliced, post-contrast MRI. The sagittal images were analyzed.

RESULTS

In 97%, the EOPs were delineated as a focal external protrusion of the midline region of the occiput with varying morphologies. In 89% of 93 patients with identifiable EOPs, parts of the intracranial dural sinuses were found to lie just below the inion, the most prominent point of the EOP. The most frequently targeted dural sinus was the confluence of sinuses that was found in 57%, followed by the superior sagittal sinus. In 16%, a bony foramen and transmitting vessel were detected in the EOP, connecting between the diploic channels and the subcutaneous veins. Furthermore, in 33%, bony foramina and transmitting venous structures were identified in the region just below the EOPs, connecting between the diploic channels and the subcutaneous veins.

CONCLUSIONS

The intracranial dural venous sinus is located just below the EOP with a high probability. Most bony foramina in the EOP and midline suboccipital region may transmit veinous structures connecting to the diploic channel.