Suture-like pattern formation in the pterygospinous bridge of the human sphenoid bone

The paper presents an anatomical study involving rare variations in the pterygospinous bridges found in Mongolian skulls. These structures extend between the lateral pterygoid plate and the sphenoid spine. Particularly interesting is the division of these bridges into two distinct parts of the similar length. The junctions within these structures resemble morphological patterns characteristic for the plain and zigzag sutures, which articulate the cranial bones.

The surgical anatomy of the inferior alveolar nerve: a meta-analysis with clinical implications

BACKGROUND

The main goal of the present meta-analysis was to provide physicians, especially surgeons, with crucial data on the complete anatomy of the inferior alveolar nerve (IAN). It is hoped that our results may help reduce the rates of complications in procedures associated with this anatomical entity.

MATERIALS AND METHODS

Major online medical databases such as PubMed, Embase, Scopus, Web of Science, Google Scholar, and Cochrane Library were searched to gather all studies on IAN anatomy, including topography, morphology, and variations.

RESULTS

IAN mean thickness of the IAN in the mandibular angle area was set to 2.32 mm (LL: 1.82 ; HL: 2.78-). IAN mean thickness of the IAN in the mandibular body region was found to be 2.49 mm (LL: 2.02 ; HL: 2.98). The mean thickness of the IAN in the mental region was established at 1.70 mm (LL: 1.54 ; HL: 1.86). The mean distance from the IAN to the external (buccal) surface of the 1st molar was set to be 4.99 mm (LL: 3.84 ; HL: 6.13).

CONCLUSIONS

In conclusion, this is the most up-to-date and thorough analysis of the complete anatomy of the IAN. We provided morphometric data that present the spatial relationship of the IAN with numerous anatomical landmarks in the mandibular region. These include the ramus of the mandible, the first, second, and third molars, and the body of the mandible, among others. It is hoped that the results of the present meta-analysis may be a helpful tool for physicians, especially surgeons, performing various oral and maxillofacial procedures, such as third molar removal or IAN block anesthesia.

A morphological study on the sphenoid bone ligaments' ossification pattern

PURPOSE

The sphenoid bone (SB) extracranial ligaments (ECRLs) are the pterygoalar and pterygospinous ligaments (PTAL and PTSL) that are located at the SB lateral pterygoid plate, and inferior to the foramen ovale (FO). Their ossification may affect the mandibular nerve's distribution. The intracranial ligaments' (ICRLs) ossification (the caroticoclinoid ligament-CCLL, the anterior and posterior interclinoid ligaments-AICLL and PICLL) may impede the approaches to the sella. This study highlights the incidence of the ossified ECRLs and ICRLs location, their type (partial, or complete), considering laterality, gender, age, and ligaments' simultaneous presence.

METHODS

The sample consisted of 156 Greek adult dried skulls of both genders and variable age.

RESULTS

Ossified ligaments were identified in 57.05%, predominantly extracranially (42.31%, P = 0.003). ECRLs were predominantly identified unilaterally (30.13%, P < 0.001). The majority of the ossified ICRLs were predominantly identified in male skulls (31.1%, P = 0.048) and the majority of the ECRLs (52.8%, P = 0.028) were predominantly identified at the age of 60 years and above. The PTAL was the most ossified (32.69%), followed by the CCLL (24.36%), the PTSL (16.03%), the PICLL (6.41%), and the AICLL (4.49%).

CONCLUSIONS

Detailed knowledge of the SB morphology and ligaments' ossification extent is essential to improve the technique of the FO percutaneous approach, and sellar approaches, to minimize complications.

The venous plexus of Rektorzik - anatomo-clinical issues retrieved from the literature data

The venous plexus of Rektorzik is a network of small veins, which enlace outside the wall of the internal carotid artery while it traverses the petrous part of the temporal bone. The anatomical and clinical issues related to the communication between the plexus of Rektorzik and other cranial venous structures were discussed in this paper.

Anatomical features of the mandibular canal and their clinical significance - review of literature

The clinical issues related to the anatomical variation of the mandibular canal have been extensively analyzed since the 19th century. Evolving dentistry techniques and advancements in the prosthetics forced to collect detailed information about anatomical variations of the mandibular canal due to its neurovascular content. Therefore, its radiographic imaging became an essential part of the oral surgery, in order to avoid complications resulted from an accidental damage of the mandibular canal.

Cranial diploic channels and their veins - a review of literature

The current paper is a review of the results attained in the past and current anatomical studies, aimed at understanding the variability and function of the diploic venous system of the human skull. The diploic veins can serve as transit for infections from the scalp to the structures contained within the cranial cavity via the emissary veins, due to their interconnections with the pericranial veins, meningeal veins and dural sinuses. Thereby this clinical aspect has also been discussed.

A micro-computed tomography study of the sinus tympani variation in humans

BACKGROUND

The posterior part of the tympanic cavity comprises a depression called the sinus tympani (ST). The said structure is of outmost importance, e.g. in surgical procedures involving the middle ear, as a pathology (microbial biofilm or cholesteatoma) present in this difficult to access location might hinder its effective treatment. The aim of the study was to evaluate anatomical variants of the ST in human adult petrous bones. For this purpose, three-dimensional (3D) models of the ST were recreated from micro-computed tomography (CT) scans of 44 dry petrous bone samples (19 female, 25 male), applying 3D Slicer, Meshmixer and MeshLab software.

MATERIALS AND METHODS

Anatomical variants of the ST were classified in terms of both shape and surface configuration. The internal configuration of the ST was classified as heterogeneous - containing small bony trabeculae and crests up to 1.0 mm in size, contrasting to homogeneous ST that characterizes a relatively smooth interior, or mere presence of minor depressions and mild folds. Female STs were more bowl-shaped (57.9%) than saccular (42.1%), and had heterogeneous surface configuration (52.6%) compared to homogeneous (47.4%). On the contrary, male STs were more saccular (52.0%) rather than bowl-shaped (48.0%), and predominantly had a heterogeneous surface (84.0%) over homogeneous (16.0%).

RESULTS AND CONCLUSIONS

A complex combination of ST features comprised of a saccular shape and heterogeneous surface occurred in 52.0% of males and in 15.8% of females (a statistically significant difference; p = 0.0254, Fisher's exact test) seems to be clinically important because of its potential negative implication on health outcomes after surgery in the case of, for example, cholesteatoma, and it may also favour chronic pathological processes.

A case of early obliteration of the sagittal suture without effect on cranial deformation

This paper describes a unique case of craniosynostosis in a female skull in which sagittal sutures were completely fused by adolescence. Despite sagittal synostosis, the skull was of normal shape and size. Regarding craniometric features, the synostotic normocephalic skull was markedly different than that of scaphocephalic skulls which typically result from premature obliteration of the sagittal suture.

A 3D model of the renal vasculature - a joined result of the corrosion casting technique, micro-CT imaging and rapid prototyping technology

Three-dimensional (3D) printed model of the renal vasculature shows a high level of accuracy of subsequent divisions of both the arterial and the venous tree. However, minor artifacts appeared in the form of oval endings to the terminal branches of the vascular tree, contrary to the anticipated sharply pointed segments. Unfortunately, selective laser sintering process does not currently permit to present the arterial, venous and urinary systems in distinct colors, hence topographic relationship between the vascular and the pelvicalyceal systems is difficult to attain. Nonetheless, the 3D printed model can be used for educational purposes to demonstrate the vast renal vasculature and may also serve as a reference model whilst evaluating morphological anomalies of the intrarenal vasculature in a surgical setting.

A computed tomography comprehensive evaluation of the ostium of the sphenoid sinus and its clinical significance

BACKGROUND

The purpose of this research was to evaluate the size of the sphenoid sinuses' ostia, the distance between them and the distance between the medial margin of the ostia and the median line in the Polish adult population.

MATERIALS AND METHODS

The analysis was undertaken as a retrospective study of 296 computed tomography (CT) scans of patients (147 females, 149 males) with no comorbidities in their sphenoid sinuses. The paranasal sinuses were investigated by using Spiral CT Scanner (Siemens Somatom Sensation 16), in the option Siemens CARE Dose 4D, without administering any contrast medium. Having obtained transverse planes, multiplans reconstruction tool was used in order to glean sagittal and frontal planes.

RESULTS

The average size of both sphenoid sinuses ostia was 0.31 cm for both genders (for females ranging from 0.1 to 0.5 cm and from 0.1 to 0.6 cm for males). The mean distance between both sphenoid sinuses ostia was 0.6 cm for both genders (the range for females was 0.1-1.4 cm, whereas 0.1-1.8 cm for males). The average distance between the medial margin of the ostium and the median line was 0.32 cm for both genders (0.31 cm for females in the range of 0-0.9 cm and 0.32 cm for males in the range of 0-1 cm).

CONCLUSIONS

Intraoperative identification of the sphenoid sinus ostia might prove difficult and their inadequate excision could lead to potential iatrogenic complications, hence detailed anatomical descriptions are still warranted in specific populations in order to perform safe and effective procedures.

Anatomical variations of the superficial ulnar artery: case series observed on historical specimens prepared by Ludwik Karol Teichmann

BACKGROUND

In this report we present a series of cases representing variant origin and course of the ulnar artery, namely the superficial ulnar artery, observed during the review of collection of historical specimens prepared in the 19th century by the prominent Polish anatomist Ludwik Karol Teichmann and his collaborators, exhibited in the Anatomy Museum of Jagiellonian University Medical College.

RESULTS

Three distinct variants of the superficial ulnar artery were found on anatomical specimens of the upper limb with arteries injected by using Teichmann's method. In case No. 1, the superficial ulnar artery originated from the brachial artery slightly above the interepicondylar line of the humerus. This aberrant vessel gave off the common interosseous artery in the upper half of the cubital fossa and then ran superficially to the bicipital aponeurosis and over the muscles arising from the medial epicondyle of the humerus. The cases No. 2 and 3 involved two similar variants of the superficial artery in which the common interosseous artery arose from the radial artery. In the unique case No. 4, the superficial ulnar artery arose from the radial artery.

CONCLUSIONS

The superficial ulnar artery shows diverse anatomy regarding its topography and blood supply territory. Orthopedic, hand, and plastic surgeons should be aware of anatomic variations of the SUA both in planning and in conducting surgeries of the upper limb.

Duplication of the inferior vena cava: evidence of a novel type IV

Anatomical variations of the inferior vena cava, including the double inferior vena cava or isolated left inferior vena cava, are uncommon and of great clinical importance. Inferior vena cava variations signify predisposition to deep vein thrombosis and may complicate retroperitoneal surgeries including abdominal aortic surgery. Failure to recognize such variations may predispose a patient to life- threatening complications. This prospective anatomical study assessed 129 cadavers for variations of the inferior vena cava. One of the 129 cadavers (0.78%) possessed a double inferior vena cava and none (0%) possessed an isolated left inferior vena cava. The left-sided inferior vena cava was of a larger diameter than that of the right-sided inferior vena cava - opposite of what would be seen in a Type III duplication. Therefore, this observation expands the three-type classification system to include a Type IV duplication.

Bilateral duplication of the abducens nerve - case study

The abducens nerve is characterized by a long intracranial course and complex topographical relationships. Anatomical knowledge may help to understand both the etiology and clinical symptoms of abducens nerve palsy. Typically, the single trunk of the abducens nerve travels on both sides. However, occasionally different variants of unilateral or bilateral duplications of the abducens nerve may be observed. The presented paper is a detailed anatomical description of bilateral duplication of the abducens nerve, with atypical appearance of the nerve in the cavernous sinus and normal distribution within the lateral rectus muscle on both sides of one cadaver. On the right side both trunks of the abducens nerve fused within the subarachnoid space and pierced the dura mater together. On the left side both trunks of the duplicated abducens nerve pierced the dura mater separately, entered the petrous apex separately and fused just below the petrosphenoidal ligament. Within the cavernous sinus the nerve divided once again into two filaments, which reunited into one trunk a er crossing the horizontal segment of the intracavernous part of internal carotid artery. The orbital segments of the abducens nerve showed a typical course on both sides. Duplication of the abducens nerve is anatomical variation which should be taken into account during diagnostic and surgical procedures performed within the petroclival region and cavernous sinus.

Contribution of 3D printing technology for craniofacial surgery

This article summarizes technical aspects of preparing printable 3D anatomical models created from radiological data (CT, MRI) and discusses their usefulness in surgery of the human skull. Interdisciplinary approach to the capabilities of the 3D printers, and the materials used for manufacturing 3D objects oriented on replicating anatomical structures has created new possibilities for simulating and planning surgical procedures in clinical practice settings.

Printable 3D model of the sella turcica region including the interclinoid bridge

The objective of the study was to create a printable 3D model of the sellar region of the sphenoid bone for demonstrating anatomical variant of the osseous bridging between anterior and posterior clinoid processes. Three-dimensional reconstruction of the middle cranial fossa along with 3D printed model, allow for accurate depicting position of the interclinoid bridge with reference to other basicranial structures.

3 D printed replica of the human temporal bone intended for teaching gross anatomy

The anatomy of the human temporal bone is complex and, therefore, poses unique challenges for students. Furthermore, temporal bones are frequently damaged from handling in educational settings due to their inherent fragility. This report details the production of a durable physical replica of the adult human temporal bone, manufactured using 3D printing technology. The physical replica was printed from a highly accurate virtual 3D model generated from CT scans of an isolated temporal bone. Both the virtual and physical 3D models accurately reproduced the surface anatomy of the temporal bone. Therefore, virtual and physical 3D models of the temporal bone can be used for educational purposes in order to supplant the use of damaged or otherwise fragile human temporal bones.

A concise survey on 3D modeling in the science of anatomy

This report provides a concise overview of the rendering and utilization of three-dimensional models in the field of anatomy. Anatomical three-dimensional virtual models are widely used for educational purposes, preoperative planning, and surgical simulations because they simply allow for interactive three-dimensional navigation across the human organs or entire body. Virtual three-dimensional models have been recently fabricated as accurate replicas of the anatomical structures thanks to advances in rapid prototyping technology.

Fusion between the median and musculocutaneous nerve: A case study

The musculocutaneous nerve (C5-C7) is a terminal branch of the lateral cord of the brachial plexus and provides motor innervation to the anterior compartment of arm muscles. Both the musculocutaneous and median nerve may show numerous anatomical variations. Keeping in mind possible aberrations in the course of the upper limb nerves may increase the safety and success rate of surgical procedures. The presented report is a detailed anatomical study of the fusion between the median and musculocutaneous nerve, supplemented by intraneural fascicular dissection. In the presented case, the musculocutaneous nerve was not found in its typical location in the axillary cavity and upper arm during the preliminary assessment. However, a careful intraneural fascicular dissection revealed that musculocutaneous nerve was fused with the median nerve and with its lateral root; Those nerves were surrounded by a common epineurium, however they were separable. The muscular branch to the biceps brachii muscle arose from the trunk (fascicular bundle) dissected out from the median nerve and corresponding to the musculocutaneous nerve. Such variation may be of utmost clinical importance, especially during reconstructions of the brachial plexus or its branches.

Sphenoid bone and its sinus - anatomo-clinical review of the literature including application to FESS

Authors paid attention to anatomy and clinical implications which are associated with the variations of the sphenoid sinus. We discuss also anatomical structure of the sphenoid bone implementing clinical application of this bone to different invasive and miniinvasive procedures (i.e. FESS).

Rediscovered identity of the scaphocephalic skull housed in the museum of the Department of Anatomy of the Medical College of the Jagiellonian University

A personal data referring to the scaphoid skull housed in the Department of Anatomy of the Jagiellonian University, Medical College was established thanks to reviewing 19th century literature performed by Dr. Soficaru. We received information that the skull had belonged to an adult man who was a carpenter, born at Cracow. The original anthropometrical study of this skull was performed by prof. Kopernicki 19th century.

The pterygoalar bar: A meta-analysis of its prevalence, morphology and morphometry

PURPOSE

The pterygoalar (PA) bar is a bony bridge resulting from the partial or complete ossification of a PA ligament. The aim of this meta-analysis was to systematically analyze and provide the most comprehensive data on the prevalence, morphology and topographical anatomy of the PA bar.

MATERIALS AND METHODS

A comprehensive search of the major electronic databases (PubMed, Embase, ScienceDirect, SciELO, BIOSIS, and Web of Science) was conducted in order to identify relevant studies. Studies reporting the prevalence, side of occurrence, gender dimorphism and morphometry of the PA bar were included in the current study.

RESULTS

A total of 25 articles (n = 16,168 subjects) were included in the meta-analysis. The overall pooled prevalence of the complete PA bar was 4.4% (95% CI: 3.0-6.0) and of the incomplete was 8.4% (95% CI: 4.6-13.3). The PA bar was most often observed unilaterally, on the left side. Analysis of geographical subgroups revealed considerable differences, with the lowest prevalence rates in Europe for both incomplete and complete PA bars.

CONCLUSIONS

Considering the prevalence and anatomical characteristics of the PA bar, caution is recommended while planning or performing transfacial needle approach to the foramen ovale and when considering a differential diagnosis for nerve compression or entrapment syndromes.

Estimating age at death from an archaeological bone sample – a preliminary study based on comparison of histomorphometric methods

The estimation of age at death is one of the most fundamental biological parameters, determined on skeletal remains in anthropological context. That is why, there is a constant need to improve applied methods. Histomorphometry, which uses microscopic analysis of bone tissue is suggested to be one alternative method. In general, this technique is based on measurements and the determination of the number and density of basic bone structural units, osteons. Osteon density is found to be related with age of the individual. The main goal of this research was to compare results of determined age at death, on the basis of ribs histology, comes from methods proposed by different authors. We analyzed ground cross sections of ribs from archeological origin. The presented methodology is simple in use and effective. Four different methods were tested (Stout and Paine 1992; Cho et al. 2002; Kim et al. 2007; Bednarek et al. 2009). The obtained age results were compared with each other as well as related to the age estimated by standard macroscopic method used in anthropology. Bednarek’s method is recognized to be the most supportive for anthropological analyzes. Methodological issues connected with grinding methodology and results interpretation are also presented. Hypothesis about interpopulation as well as histological and dimorphic differences were confirmed.

Visual perception of the osseous labyrinth rendered from micro-CT scans of the petrous bone

Grayscale images comparing to the color images may have less of visual information necessary for easy recognition of the anatomical structures. Although micro-CT scanners deliver images of ultra-high resolution, application of false-colors to the rendered structures enhance their visual perception and allow for quick delineation between them and surrounding bony matrix. This paper presents differences of imaging of the osseous structures of the inner ear labyrinth using pseudo-color volume rendering in contrast to grayscale volume rendering of the micro-CT data. Applied procedures of image processing improved significantly delineation between the bony matrix surrounding the cochlea and vestibule rendered in the pseudo-colors than in grayscale.

Ossification of the petrosphenoid ligament - a case study

The current study presents a case in which a human skull revealed a partially ossified petrosphenoid ligament. The ossified ligament appears as a hooked bony trabecula emerging below the right posterior clinoid process. Another bony trabecula arises from the petrous apex and runs towards the clivus. Both trabecula face each other but do not fuse, having a small gap between their tips. Their positions clearly indicate that they must have formed an overhang above the abducens nerve. Therefore, they should be considered a part of the walls of Dorello's canal, which is a conduit for the abducens nerve and associated vascular structures.

Micro-CT study of the dehiscences of the tympanic segment of the facial canal

PURPOSE

To depict the anatomy of the tympanic segment of the facial canal using a 3D visualization technique, to detect dehiscences, and to evaluate their frequency, location, shape, and size.

METHODS

Research included 36 human temporal bones (18 infant and 18 adult samples) which were scanned using a Nanotom 180N device. The final resolution of the reconstructed object was 18 µm. Obtained micro-CT data were subsequently processed by the volume rendering software.

RESULTS

The micro-CT study allowed for the 3D visualization of the tympanic segment of the facial canal and detects dehiscences in the studied material in both infants and adults. Most of the dehiscences (66.7 %) involved the inferior wall of the tympanic segment in infants as well as in adults, and were located above and backward to the oval window. The most frequent dehiscence shape was elliptic (66.7 % in infants; 50 % in adults). Furthermore, we observed dehiscences of fusiform and trapezoidal shape in infants. Length of the dehiscences in most cases ranged from 0.5 to 1.4 mm (50 % in infants; 75 % in adults).

CONCLUSIONS

Volumetric reconstructions demonstrated the course of the tympanic segment of the facial canal and its relationship with the tympanic cavity. Knowledge about the size and location of any dehiscence within the tympanic segment of the facial canal is necessary due to the surgical significance of this region. If a dehiscence occurs, there is an increased risk of injury to the facial nerve during the operations or spread of inflammation from the middle ear.

Morphology, topography and clinical signi cance of the jugular foramen

The paper describes morphological variants of the jugular foramen of the human skull and discusses the reasons for its frequent asymmetry. Bilateral disproportions between the anteroposterior and mediolateral diameters of the jugular foramina were analyzed. We established that the jugular foramen is extremely narrow when its anteroposterior diameter is less than 5.0 mm. When the mediolateral diameter exceeds 20.0 mm, then the foramen exhibits extreme widening.

3D visualization of the intratemporal course of the facial canal using computed micro-tomography

The current study presents high resolution reconstructions showing the course of the facial canal within the temporal bone and visualizes the spatial orientation of the subsequent segments of the facial canal. 3D reconstructions of the facial canal were created from micro-CT data obtained from the right and left human temporal bones of an adult individual of the male sex. For this purpose, volume and surface rendering was applied. 3D models of the facial canal and adjacent osseous structures comprehensively revealed its intricate course and depicted the spatial orientation of its subsequent segments: labyrinthine, tympanic and mastoid. The labyrinthine segment of the facial canal was clearly displayed in the horizontal plane whereas the tympanic and mastoid segments were entirely visible in the sagittal plane, which lines up along the long axis of the petrous part of the temporal bone.

Comparison of volumetric reconstructions obtained from CT and micro-CT scans of the petrous bone

is study presents effects of volumetric reconstructions of the petrous bone anatomy obtained from image data delivered by the medical CT scanner (Optima CT 660) and micro-CT scanner (Nanotom 180N) used in biological and technical applications. Although most of the osseous structures of the ear were visible in the subsequent serial CT scans delivered by the computed tomography system (Optima CT 660), their composition into volume was not satisfactory for viewing as a three-dimensional reconstruction. Micro-CT imaging of the anatomical structures of the petrous bone performed by the Nanotom 180N device was considerably superior to the medical computed tomography and the reconstructed anatomical structures presented a high level of accuracy and very realistic appearance.

Three-dimensional model of the skull and the cranial bones reconstructed from CT scans designed for rapid prototyping process

This paper presents the effects of building mesh models of the human skull and the cranial bones from a series of CT-scans. With the aid of computer so ware, 3D reconstructions of the whole skull and segmented cranial bones were performed and visualized by surface rendering techniques. The article briefly discusses clinical and educational applications of 3D cranial models created using stereolitographic reproduction.

Blood vessels of the shin - anterior tibial artery - anatomy and embryology - own studies and review of the literature

Injuries of the lower leg are rather frequent in every day orthopedic routine. Process of healing takes quite a long time and is commonly dependent on the proper vasculature. e study was carried out on 50 human lower legs obtained during autopsies. The anatomy of the vascular system of the leg was studied using classical anatomical dissection methods. Based also on literature we have reviewed the current knowledge on the vascularization of the lower leg and its embryological background.

Anatomy of the fundus of the internal acoustic meatus - micro-computed tomography study

The aim of this paper was to present micro-computed tomography (micro-CT) high resolution images of the fundus of internal acoustic meatus (FIAM) and characterise the normal appearance of its singular areas which are places of passage of numerous anatomical structures. By using micro-CT we obtain detailed volume rendering images presenting topography of the FIAM in 3-dimensional (3D) space. We figured out that 3D reconstructions obtained from micro-CT scans can precisely demonstrate all areas of the FIAM (facial nerve area, cochlear area, superior and inferior vestibular areas, singular foramen). Application of this technique allows finding out new anatomical structures like the foramen of the transverse crest, which is not described in literature. Hence, we estimated the size of each area of the FIAM by measuring their minimal and maximal diameter. In the studied material we did not find out any statistically significant difference between mean diameters calculated for infant and adult individuals.

Improved reliability for fractal dimension calculation of the vascular imprints on the cranial vault mapped with topographical correction

We presented a novel approach to studies of the vascular grooves located on the inner surface of the cranial vault. A three-dimensional vision system that acquired the endocranial surface topography was used for this purpose. The acquired data were used to generate images showing the branching pattern of the middle meningeal artery. Fractal dimension was used to characterize and analyze branching pattern complexity. We discussed the usefulness of the latter method and indicated difficulties and potential errors connected to the fractal dimension application. The technique introduced for recording traits of the object surface appears to be helpful in anatomical study of morphological variation of dural vascularization. It may also be applicable in paleoneurological research based on analysis of the cranial remnants. Fractal dimension should be used carefully as a method sensitive to many aspects of data acquisition and processing.

Application of the temporal bone for sex determination from the skeletal remains

This paper presents state of current knowledge on possibilities and accuracy of sex determination from the temporal bone. Experimental and comparative studies performed on temporal bones derived from different human populations allowed to verify to what extend this bone is valuable source of information on sex of individual. It was figured out that the temporal bone can be used for this purpose and the size of the mastoid process is considered to be one of the best sex discriminator.

Destruction of the craniofacial skeleton in the child caused by an orbital tumor

PURPOSE

The aims of this paper are to describe the morphological alterations within an infant craniofacial skeleton caused by an orbital tumor and present how the bone reacts in contact with a spreading tumor mass.

METHODS

A study was performed on the dry skull of a child at the age of approximately 2 years. Morphological alterations of the craniofacial skeleton were analysed by visual inspection, and the intracranial cavity was examined with the aid of a digital camera. Subsequently, the skull was examined using computed tomography.

RESULTS

The skull was identified as having unilateral symptoms of orbital destruction caused by a malignant tumor, probably retinoblastoma or rhabdomyosarcoma. The left orbit and surrounding bones showed extensive malformation caused by the invading tumor. Profound deformities were also observed in the nasal cavity, which was partially occluded by the collapsed medial wall of the left orbit. The tumor extended to the wall of the orbit, spread out of the orbit, penetrated to the anterior cranial fossa, and probably invaded the brain.

CONCLUSIONS

Extensive pathological cranial destruction and possible metastases to inner organs suggest that the orbital tumor was the cause of death. Anatomical alterations observed in the craniofacial skeleton indicate a highly aggressive character of the orbital tumor.

Volume rendering of the tympanic cavity from micro-CT data

The current study presents volumetric reconstruction of the tympanic cavity obtained from micro-CT scans which pixel size was 18 μm. Thanks to this, osseous components of the tympanic cavity were shown in high optical resolution, causing that their morphological appearance was clearly demonstrated. Particular attention was paid on imaging the medial wall of the tympanic cavity, because its structures are of clinical importance. In this respect we showed spatial relationship between the promontory, the oval window, the round window and other minute structures like the pyramidal eminence, subiculum and ponticulus. Hence, application of the microcomputed tomography allowed to visualize abnormal osseous formation located within the tympanic cavity, which potentially could interrupt normal movement of the auditory ossicles.

The scaphocephalic skull of an adult male

The paper presents abnormal craniofacial morphology of an adult male afflicted with premature closure of the sagittal suture. The skull is well preserved and there are no visible traits of surgical management which would be aimed to correctcranial deformation. In consequence of the restricted cranial development, some diameters of the skull were significantly altered. Basically, cranial vault morphology fits apparently to the scaphocephaly, whereas the basic ranium and viscerocranium are altered only in minor degree.

Micro-computed tomography study of the abnormal osseous extensions of sella turcica

The paper presents anatomical considerations on the abnormal ossification, which occurred around the dorsum of the sella turcica in the human skull of the female individual. Probably the morphological alterations of the sellar region were associated with extensive heterotopic ossification of the dura mater attached to the dorsum of the sella turcica and the posterior clinoid processes. The analysis of gray values of the voxels representing the areas of abnormal ossification indicated on variation in bone density in the entire sample. We have established that the highest mineralisation of bony tissue occurred in the marginal parts of the osseous extensions deriving from the posterior clinoid processes. The ossified parts of dura mater attached to the posterior clinoid processes showed significantly higher content of the hydroxyapatite (1.9 g/cm3) than the dorsum of the sella turcica (1.0 g/cm3).

Contemporary views on the ossification of the ligamenta flava

The ligamenta flava, together with the vertebral lamina, form the posterior wall of the spinal canal. Since they are located immediately adjacent to the nerve structures of the spinal cord, every pathology that involves hypertrophy produces neurological disturbances as a result. One of the most common reasons for hypertrophy of the ligamenta flava is heterotopic ossification. The main regions of the world where this disorder occurs are the Asian countries, especially Japan, but there are increasing numbers of such cases in other populations. The most important causes of the formation of ectopic osseous tissue in the vicinity of the ligamenta flava are thought to be mechanical stress and genetic predisposition. Treatment is mostly limited to surgical procedures. The present study is a review of the current state of our knowledge concerning the ossification of the ligamenta flava, the sequelae of this pathology, and the treatment methods.

Validation of the Polish language version of the SF-36 Health Survey in patients suffering from lumbar spinal stenosis

INTRODUCTION AND OBJECTIVE

Patient-reported outcome (PRO) questionnaires have become the standard measure for treatment effectiveness after spinal surgery. One of the most widely used generic PROs is the SF-36 Health Survey. The aim of this study was to specifically focus on validating the SF-36 Health Survey to confirm that the tool is an acceptable and psychometrically robust measure to collect HRQoL data in Polish patients with spinal stenosis.

MATERIALS AND METHODS

Patients were eligible if they were above 18 years of age and had been qualified for spine surgery of the lumbar region due to either discopathy or non-traumatic spinal stenosis. All patients filled-in the Polish version of the SF-36 and a demographic questionnaire. Standard validity and reliability analyses were performed.

RESULTS

192 patients (83 women--43.2%) agreed to take part in the study (mean age: 57.5±11.4 years). In 47 patients (24.5%), using MRI, ossification of the ligamenta flava were found. Cronbach's alpha coefficients showed positive internal consistency (0.70-0.92). Interclass correlations for the SF-36 ranged from 0.72-0.86 and proved appropriate test-retest reliability. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen.

CONCLUSIONS

The Polish version of the SF-36 is a reliable and valid tool for measuring HRQoL in patients with spinal stenosis. It can be recommended for use in clinical and epidemiological settings in the Polish population. However, caution is warranted when interpreting the results of the 'role limitations due to physical health problems' and the 'role limitations due to emotional problems' scales because of floor and ceiling effects.