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Tanaka M, Askar AEKA, Kumawat C, Arataki S, Komatsubara T, Taoka T, Uotani K, Oda Y. A Novel Technique for Basilar Invagination Treatment in a Patient with Klippel-Feil Syndrome: A Clinical Example and Brief Literature Review. Medicina (Kaunas) 2024; 60:616. [PMID: 38674263 PMCID: PMC11051808 DOI: 10.3390/medicina60040616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 03/21/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
Objectives and Background: To present a novel technique of treatment for a patient with basilar invagination. Basilar invagination (BI) is a congenital condition that can compress the cervicomedullary junction, leading to neurological deficits. Severe cases require surgical intervention, but there is debate over the choice of approach. The anterior approach allows direct decompression but carries high complication rates, while the posterior approach provides indirect decompression and offers good stability with fewer complications. Materials and Methods: A 15-year-old boy with severe myelopathy presented to our hospital with neck pain, bilateral upper limb muscle weakness, and hand numbness persisting for 4 years. Additionally, he experienced increased numbness and gait disturbance three months before his visit. On examination, he exhibited hyperreflexia in both upper and lower limbs, muscle weakness in the bilateral upper limbs (MMT 4), bilateral hypoesthesia below the elbow and in both legs, mild urinary and bowel incontinence, and a spastic gait. Radiographs revealed severe basilar invagination (BI). Preoperative images showed severe BI and that the spinal cord was severely compressed with odontoid process. Results: The patient underwent posterior surgery with the C-arm free technique. All screws including occipital screws were inserted into the adequate position under navigation guidance. Reduction was achieved with skull rotation and distraction. A follow-up at one year showed the following results: Manual muscle testing results and sensory function tests showed almost full recovery, with bilateral arm recovery (MMT 5) and smooth walking. The cervical Japanese Orthopedic Association score of the patient improved from 9/17 to 16/17. Postoperative images showed excellent spinal cord decompression, and no major or severe complications had occurred. Conclusions: Basilar invagination alongside Klippel-Feil syndrome represents a relatively uncommon condition. Utilizing a posterior approach for treating reducible BI with a C-arm-free technique proved to be a safe method in addressing severe myelopathy. This novel navigation technique yields excellent outcomes for patients with BI.
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Affiliation(s)
- Masato Tanaka
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama 702-8055, Japan; (A.E.K.A.A.); (C.K.); (S.A.); (T.K.); (T.T.)
| | - Abd El Kader Al Askar
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama 702-8055, Japan; (A.E.K.A.A.); (C.K.); (S.A.); (T.K.); (T.T.)
| | - Chetan Kumawat
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama 702-8055, Japan; (A.E.K.A.A.); (C.K.); (S.A.); (T.K.); (T.T.)
| | - Shinya Arataki
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama 702-8055, Japan; (A.E.K.A.A.); (C.K.); (S.A.); (T.K.); (T.T.)
| | - Tadashi Komatsubara
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama 702-8055, Japan; (A.E.K.A.A.); (C.K.); (S.A.); (T.K.); (T.T.)
| | - Takuya Taoka
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, Okayama 702-8055, Japan; (A.E.K.A.A.); (C.K.); (S.A.); (T.K.); (T.T.)
| | - Koji Uotani
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama 700-8558, Japan; (K.U.); (Y.O.)
| | - Yoshiaki Oda
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama 700-8558, Japan; (K.U.); (Y.O.)
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Ni J, Pei Y, Xu Z, Zhang B, Sun Z, Wu X, Liang L. Three-Dimensional Anatomy of the Hypoglossal Canal: A Plastinated Histologic Study. World Neurosurg 2023; 178:e362-e370. [PMID: 37482084 DOI: 10.1016/j.wneu.2023.07.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/16/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE To provide a precise description of the morphology and morphometry of the hypoglossal canal (HC) and its relationship with surrounding structures by using the epoxy sheet plastination technique. METHODS Thirty human cadaveric heads were plastinated into 5 sets of gross transparent plastination slices and 43 sets of ultrathin plastination sections. The HC were examined at both macro- and micro levels in these plastination sections and the reconstructed 3-dimensional visualization model. RESULTS The HC was an upward arched bony canal with a dumbbell-shaped lumen. According to the arched trajectory of its bottom wall, the HC could be divided into a medial ascending segment and a lateral descending segment. The thickness of the compact bone in the middle part of the HC was thinner than that at the intracranial and extracranial orifices. In 14 of 43 sides (32.6%), the posterior wall or the roof of the HC were disturbed by passing venous channels which communicated the posterior condylar emissary vein and the inferior petroclival vein. The trajectory of hypoglossal nerve in HC is mainly from anterosuperior to posteroinferior. The meningeal dura and the arachnoid extended into the HC along the hypoglossal nerve to form the dural and arachnoid sleeves and then fused with the nerve near the extracranial orifice of the HC. CONCLUSIONS Knowledge of the detailed anatomy of the HC can be helpful in avoiding surgical complications when performing surgery for lesions and the occipital condylar screw placement in this complex area.
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Affiliation(s)
- Jingyi Ni
- Grade 2020, School of Nursing, Anhui Medical University, Hefei, China
| | - Yazhi Pei
- Department of Anatomy, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Zhaoyang Xu
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Bo Zhang
- Department of Anatomy, School of Basic Medical Sciences, Anhui Medical University, Hefei, China; Human Brain Tissue Resource Center, Anhui Medical University, Hefei, China
| | - Zhengzheng Sun
- Department of Anatomy, School of Basic Medical Sciences, Anhui Medical University, Hefei, China; Human Brain Tissue Resource Center, Anhui Medical University, Hefei, China
| | - Xiao Wu
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Liang Liang
- Department of Anatomy, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.
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Chakraborty AR, Pelargos PE, Milton CK, Martin MD, Bauer AM, Dunn IF. Occipital condyle screw fixation after posterior decompression for Chiari malformation: Technical report and application. Surg Neurol Int 2021; 12:543. [PMID: 34877029 PMCID: PMC8645510 DOI: 10.25259/sni_26_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 09/15/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Surgical techniques for stabilization of the occipital cervical junction have traditionally consisted of screw-based techniques applied in conjunction with occipital plating and rods connected to subaxial instrumentation in the form of pars, pedicle, or lateral mass screws. In patients with type 1 Chiari malformation (CM-1) and evidence of occipital cervical junction instability who have undergone posterior decompression, the occipital condyle (OC) represents a potential alternative cranial fixation point. To date, this technique has only been described in pediatric case reports and morphometric cadaver studies. METHODS Patients underwent posterior fossa decompression for treatment of CM. Subsequently, patients received occipital cervical stabilization using OC screws. RESULTS Patients were successfully treated with no post-operative morbidity. Patient 2 was found to have pseudoarthrosis and underwent revision. Both patients continue to do well at 1-year follow-up. CONCLUSION Placement of the OC screw offers advantages over traditional plate-based occipital fixation in that bone removal for suboccipital decompression is not compromised by the need for hardware placement, screws are hidden underneath ample soft tissue in patients with thin skin which prevents erosion, and the OC consists of primarily cortical bone which provides for robust tricortical fixation. These cases demonstrate the novel application of the OC screw fixation technique to the treatment of occipital cervical junction instability in adult patients undergoing simultaneous posterior fossa decompression.
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Affiliation(s)
| | | | | | | | | | - Ian F. Dunn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
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Xu D, Peng Y, Li H, Wang Y, Ma W. The Feasibility of Anterior Occipital Condyle Screw for the Reconstruction of Craniovertebral Junction: A Digital Anatomical and Cadaveric Study of a Novel Technique. Int J Gen Med 2021; 14:5405-5413. [PMID: 34526809 PMCID: PMC8436257 DOI: 10.2147/ijgm.s332071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 08/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background Anterior occipital condyle screw (AOCS) could be a feasible alternative technique for occipitocervical fusion for reconstruction of craniovertebral junction. This study aimed to analyze the feasibility of AOCS. Methods The craniovertebral junction computed tomography (CT) scans of 40 adults were enrolled and imported into Mimics software. Then, the three-dimensional reconstruction digital model of craniovertebral junction was established to determine entry point, insertion angle, and screw’s trajectory. After AOCS insertion into ten human cadaver spine specimens, CT scans were performed to verify the location between screws and important structures. Results The optimal entry point was located caudally and medial to the ventral of occipital condyle. The optimal trajectory was in inclination angle (5.9°±3.4°) in the sagittal plane and divergence angle (26.7°±6.0°) in the axial plane with the screw length around 21.6±1.2mm. None of the screws invaded the hypoglossal canal and vertebral artery in any of the specimens. Conclusion AOCS fixation is a feasible, novel technique for anterior craniovertebral junction reconstruction, and it could be an effective alternative operation for anterior reconstruction with titanium mesh cage.
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Affiliation(s)
- Dingli Xu
- Department of Orthopedics, The Affiliated Hospital of Medical School, Ningbo University, Ningbo, Zhejiang, People's Republic of China
| | - Yujie Peng
- Department of Spine, Ningbo No.6 Hospital, Ningbo, Zhejiang, People's Republic of China
| | - Haojie Li
- Department of Spine, Ningbo No.6 Hospital, Ningbo, Zhejiang, People's Republic of China
| | - Yang Wang
- Department of Spine, Ningbo No.6 Hospital, Ningbo, Zhejiang, People's Republic of China
| | - Weihu Ma
- Department of Spine, Ningbo No.6 Hospital, Ningbo, Zhejiang, People's Republic of China
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Wan M, Zong R, Xu HL, Qiao GY, Tong HY, Shang AJ, Yin YH, Yu XG. Feasibility of occipital condyle screw placement in patients with Chiari malformation type I: a computed tomography-based morphometric study. Acta Neurochir (Wien) 2021; 163:1569-1575. [PMID: 33462712 DOI: 10.1007/s00701-021-04714-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND The occipital condyle (OC) screw is an alternative technique for occipitocervical fixation that is especially suitable for revision surgery in patients with Chiari malformation type I (CMI). This study aimed to investigate the feasibility and safety of this technique in patients with CMI. METHODS The CT data of 73 CMI patients and 73 healthy controls were retrospectively analyzed. The dimensions of OCs, including length, width, height, sagittal angle, and screw length, were measured in the axial, sagittal, and coronal planes using CT images. The OC available height was measured in the reconstructed oblique parasagittal plane of the trajectory. RESULTS The mean length, width, and height of OCs in CMI patients were 17.79 ± 2.31 mm, 11.20 ± 1.28 mm, and 5.87 ± 1.29 mm, respectively. All OC dimensions were significantly smaller in CMI patients compared with healthy controls. The mean screw length and sagittal angle were 19.13 ± 1.97 mm and 33.94° ± 5.43°, respectively. The mean OC available height was 6.36 ± 1.59 mm. According to criteria based on OC available height and width, 52.1% (76/146) of OCs in CMI patients could safely accommodate a 3.5-mm-diameter screw. CONCLUSIONS The OC screw is feasible in approximately half of OCs in CMI patients. Careful morphometric analyses and personalized surgical plans are necessary for the success of this operation in CMI patients.
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Ramos-Dávila EM, Meléndez-Flores JD, Álvarez-Pérez R, Barrera-Flores FJ, Martínez-Cobos MC, Pinales-Razo R, Quiroga-Garza A, Zarate-Garza P, Sanchez-Gomez A, Guzman-Lopez S, Elizondo-Omaña RE. Occipital condyle screw fixation viability according to age and gender anatomy: A computed tomography-based analysis. Clin Neurol Neurosurg 2020; 200:106358. [PMID: 33223342 DOI: 10.1016/j.clineuro.2020.106358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the Occipital condyle morphology in an all-age population of Northeastern Mexico, and determine age and gender related changes for surgical viability. METHODS A total of 175 consecutive HRCT scans were included and divided into 5 age groups. The condylar length, width, height, sagittal angle, anterior, posterior and medial intercondylar distances, and intercondylar angle of the OC were measured. RESULTS Mean condylar length, width, and height in total population were 20.58 mm, 9.42 mm, and 9.02 mm, respectively. Differences were observed in most morphometric parameters when comparing age groups. Significant intergender differences in total population were observed in most parameters, when individualizing each age group the height remained significant in all. The group with the least height measurement was aged 5-9 years, this however, could allow the OC screw (≥6.5 mm) placement. CONCLUSION Differences in most morphometric parameters of OC were observed between age groups and gender, particularly patients with 5-9 years. However, all groups presented a minimum height that allows the placement of a standard screw. A preoperative imaging study is always recommended due to the variability and complexity of the region.
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Affiliation(s)
| | | | - Ricardo Álvarez-Pérez
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Hospital Universitario "Dr. José Eleuterio González", Department of Radiology and Imaging, Monterrey, Mexico.
| | | | - Maria C Martínez-Cobos
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Hospital Universitario "Dr. José Eleuterio González", Department of Radiology and Imaging, Monterrey, Mexico.
| | - Ricardo Pinales-Razo
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Hospital Universitario "Dr. José Eleuterio González", Department of Radiology and Imaging, Monterrey, Mexico.
| | | | - Patricio Zarate-Garza
- Human Anatomy Department, Faculty of Medicine, Universidad Autónoma, Monterrey, Mexico.
| | - Arnulfo Sanchez-Gomez
- Human Anatomy Department, Faculty of Medicine, Universidad Autónoma, Monterrey, Mexico.
| | - Santos Guzman-Lopez
- Human Anatomy Department, Faculty of Medicine, Universidad Autónoma, Monterrey, Mexico.
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Hassler KR, Jamshidi R, Vail SJ, Connell MJ, Chundu K, Lettieri SC, Feiz-Erfan I. Atlanto-Occipital Transarticular Screw Fixation for the Treatment of Traumatic Occipitocervical Instability in the Pediatric Population. World Neurosurg 2020; 140:e81-6. [PMID: 32344140 DOI: 10.1016/j.wneu.2020.04.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Atlanto-occipital transarticular screw fixation (AOTSF) has rarely been reported for fixation of the craniovertebral junction (CVJ). METHODS A retrospective chart review of all pediatric patients (less than 18 years of age) with an attempt of AOTSF for fixation of traumatic CVJ instability was conducted. RESULTS A total of 4 patients (2 boys and 2 girls; ages 2, 3, 5, and 8 years) who suffered from acute traumatic CVJ instability managed during 2007-2018 underwent an attempted AOTSF. In 2 patients, this method was technically successful. In the other 2 instances, we were not able to engage the screw into the occipital condyle. These were converted to standard occipital plate, rod, and screw fixation. All were placed in a halo subsequently for a minimum of 3 months. Three patients were fused at last follow-up (range, 17-48 months). One patient after successful AOTSF did not fuse. There were no surgical complications or revision procedures. CONCLUSIONS AOTSF was feasible in half of pediatric patients suffering from traumatic CVJ instability. Therefore, intraoperative salvage options and strategies should be on hand readily. In the pediatric population, where bony anatomy may pose challenges to fixation, this technique may offer a viable first-line option in selected cases, despite the overall modest success rate.
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Abstract
Occipitocervical instability is a life threatening and disabling disorder caused by a myriad of pathologies. Restoring the anatomical integrity and stability of the occipitocervical junction (OCJ) is essential to achieve optimal clinical outcomes. Surgical stabilization of the OCJ is challenging and technically demanding. There is a paucity of options available for anchorage in the cephalad part of the construct in occipitocervical fixation systems due to the intricate topography of the craniocervical junction combined with the risk of injury to the surrounding anatomical structures. Surgical techniques and instrumentation for stabilizing the unstable OCJ have undergone several modifications over the years and have primarily depended on occipital squama-based fixations. At present, the occipital-plate-screw-rod construct is the most commonly adopted technique of stabilizing the OCJ. In certain distinct scenarios like posterior fossa craniectomy (absence of occipital squama for screw placement), malignancy and infection of occipital squama (poor screw purchase in the diseased occipital bone) and in revision surgery for failed occipitocervical stabilization, occipital plate-based instrumentation is not feasible. To overcome these difficulties, recently, a novel technique of occipitocervical stabilization, using the occipital condyle (OC) as the cephalad anchor, namely the direct occipital condyle screw (OCS) fixation was described. Several cadaveric and biomechanical studies have suggested that OCSs are feasible options as additional augmentative anchors in a standard occipital plate-screw-rod construct or as salvage cephalad anchors in previous failed occipital-plate-screw-rod constructs. The OCS placement technique has a steep learning curve. We have done a review of the techniques of OCS fixation and have described the indications, biomechanical and technical considerations, preoperative planning, surgical technique, complications, advantages and limitations of OCS based occipitocervical fixation.
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Affiliation(s)
- Aju Bosco
- Assistant Professor in Orthopedics and Spine Surgery, Orthopedic Spine Surgery Unit, Institute of Orthopedics and Traumatology, Madras Medical College, Chennai, India
| | - Ilyas Aleem
- Department of Orthopedic Surgery, University of Michigan, 2912 Taubman Center, Ann Arbor, MI, USA
| | - Frank La Marca
- Professor of Neurological Surgery, Henry Ford Health System, Jackson, MI, USA
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Kirnaz S, Gerges MM, Rumalla K, Bernardo A, Baaj AA, Greenfield JP. Occipital Condyle Screw Placement in Patients with Chiari Malformation: A Radiographic Feasibility Analysis and Cadaveric Demonstration. World Neurosurg 2020; 136:470-8. [PMID: 32204299 DOI: 10.1016/j.wneu.2020.01.150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/15/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Patients who undergo decompression surgery for Chiari malformation frequently require occipitocervical fixation. This is typically performed with occipital plates, which may cause intracranial injuries due to multiple fixation points. We undertook this study to assess the feasibility of occipital condyle (OC) screw placement as an alternative method of occipitocervical fixation in this patient population. METHODS Using a cadaveric model with navigational assistance, we performed the complete surgical procedure for occipitocervical fixation with OC screws. We then performed a morphometric analysis using measurements from computed tomography scans of 49 patients (32 adult, 17 pediatric) who had undergone occipitocervical fusion with instrumentation following decompression surgery for Chiari malformation. Bilateral morphometric data were analyzed for the adult and pediatric subgroups separately, as well as for the overall group. RESULTS The surgical procedure was successfully performed in the cadaveric model, demonstrating the feasibility of the proposed method. Ninety-eight OCs were studied in the morphometric analysis, and 80 (81.6%) met our eligibility criteria for OC screw placement. However, in 14.1% of adult OCs and 26.5% of pediatric OCs studied, placement of condylar screws would have been challenging or unsafe, according to our criteria. CONCLUSIONS Our findings suggest that OC screws provide a useful option for occipitocervical fixation in a substantial proportion of patients with Chiari malformation. However, rigorous preoperative analysis would be essential to identify appropriate candidates for this technique and exclude those in whom it should not be attempted. Additional study is warranted.
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Gumussoy I, Duman SB. Morphometric analysis of occipital condyles using alternative imaging technique. Surg Radiol Anat 2019; 42:161-169. [PMID: 31549198 DOI: 10.1007/s00276-019-02344-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/14/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE The occipital condyles (OCs) are crucial anatomical structures in the cranial base. To our knowledge, there is no cone beam computed tomography (CBCT)-based study on the morphometric analysis of OCs. The aim of this study was to evaluate the morphometric analysis of OCs using CBCT. METHODS CBCT images of 200 OCs from 100 patients of which 39 males and 61 females in the age group of 18-67 years were included in the study population. Linear and angular measurements of OCs were performed. RESULTS The average OC width, length, height, sagittal angle, and effective height were 10.3 ± 1.3 mm, 19.6 ± 2.0 mm, 9.1 ± 1.4 mm, 7.4 ± 1.7 mm, and 35.3 ± 5.2 mm. Condylar width and sagittal angle measurements were found significantly different between the right and left sides; and were not found significant difference between the right and left sides in the measurements of condylar height, length, and effective height. Also the average intercondylar anterior distance (ICAD), intercondylar posterior distance (ICPD), distance between the basion and the anterior apex of the occipital condyle (B-AAOC), distance between the basion and posterior apex of the occipital condyle (B-PAOC), distance between the opisthion and anterior apex of occipital condyle (O-AAOC), and distance between the opisthion and posterior apex of occipital condyle (O-PAOC) were 20.9 ± 1.5 mm, 44.0 ± 2.0 mm, 12.3 ± 1.9 mm, 34.5 ± 4.2 mm, 29.8 ± 1.7 mm, and 27.0 ± 2.1 mm. There was not significant difference in the morphometric measurements among age groups. All morphometric measurements showed a significant difference depending on gender. CONCLUSIONS The morphometric evaluation of OCs may be effectively examined using CBCT. Linear and angular measurements data of OCs in the present study may be used as a reference database for future morphometric and surgical investigations.
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Affiliation(s)
- Ismail Gumussoy
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Sakarya University, Sakarya, Turkey.
| | - Suayip B Duman
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, İnonu University, Malatya, Turkey
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