External Ear Anthropometry of Healthy Turkish Young Adults.

PURPOSE: The aim of this study was to determine the external ear values in Turkish young adults with 2-dimensional photogrammetry. METHODS: One hundred males and 100 females aged between 18 and 25 years were included in the study. Individuals were photographed from both sides. Ear length (superaurel-subaurel, spa-sba ), ear width (preaurel-postaurel, pra-pa ), and the angle between the vertical axis of the auricle and the line between spa and sba (ear incline angle, eia ) were measured in these photographs. Also, auricular index ( pra-pa / spa-sba ×100) was calculated. RESULTS: The average values of the spa-sba, pra-pa , eia , and auricular index were found as 65.46±4.68 mm, 37.89±3.61 mm, 19.40±4.83 degrees, and 57.93±4.53 in males and 60.90±5.35 mm, 35.62±3.69 mm, 17.95±4.86 degrees, and 58.65±5.29 in females, respectively. While the values of spa-sba ( P =0.001 for the right side and P =0.001 for the left side), pra-pa ( P =0.001 for the right side and P =0.001 for the left side), and eia ( P =0.024 for the right side and P =0.041 for the left side) were statistically higher for males than females, there was no statistically significant difference between the sex and the auricular index ( P =0.404 for the right side and P =0.955 for the left side). Besides, there was no statistically significant difference between the sides for these 4 parameters ( P =0.760, 0.409, 0.225, and 0.521, respectively). CONCLUSION: The authors believe that the results obtained for Turkish young adults can be used as reference values, which can be used in the diagnosis, follow, or surgical treatment of many diseases, forensic procedures, and planning esthetic surgery procedures.

Radiologic Evaluation of the Fossa Navicularis on Dry Skull: A Comparative CBCT Study.

Fossa navicularis (FN) is defined as bony depression that is not always present and is located anterior to the foramen magnum and pharyngeal tubercle on the inferior aspect of the basilar part of the occipital bone. It has been reported that FN can create an infection spread path from the pharynx to the intracranial structures. Therefore, the diagnosis of this variation is important. Although cone beam computed tomography (CBCT) diagnostic accuracy has mostly been verified in detection and quantification particularly on human skulls, there is no study comparing morphometric measurements between direct measurement on the skull and CBCT measurement. The main object of this study is to evaluate the presence of FN on dry bones and CBCT images of the same dry skull and to examine the morphometric and morphological features of this formation. Thirty-two random craniums that were made available for this study that did not have any fractures or deformities of the cranial base were examined. The sagittal diameter, transverse diameter, and depth of the FN was measured both directly on dry skulls and radiologically on CBCT images of dry skull. In addition, the shape of FN (SFN) was determined. FN was detected in 10 (31.25%) of 32 craniums examined with both modalities. It was determined that sagittal diameter of the FN, transverse diameter of the FN, depth of the FN, and the shape of FN did not show a statistically significant difference between the 2 measurements. Unlike the literature, FN was investigated on dry bones both directly and in CBCT images in this study. In contrast to previously thought the FN may be smaller according to this findings, and this small variation can be detected with CBCT images. According to this findings, it can be said that morphometric evaluations on CBCT are accurate and reliable, and CBCT is a safe method for clinical diagnosis and treatment.

Lip Anthropometry of Healthy Turkish Young Adults.

ABSTRACT: The lips play an important role in evaluating and recognizing the craniofacial complex and our perception of facial beauty and attractiveness. The aim of this study was to evaluate the anthropometric measurements of the lips of Turkish young adults and to look for sexual dimorphism. Anterior view photographs were taken of 100 females and 100 males who volunteered to participate in the study. Seven landmarks were determined, stomion (st), sublabiale (sl), subnasale (sn), labiale superius (ls), labiale inferius (li), crista philtre (cp), and chelion (ch). Then, using these landmarks, lower lip height (st-sl), upper lip height (sn-st), philtrum length (sn-ls), upper vermilion height (ls-st), lower vermilion height (li-st), cutaneous lower lip height (li-sl), philtrum width (cp-cp), and mouth width (ch-ch) were measured. It was observed that there was a statistical difference between genders in the parameters of st-sl, sn-st, sn-ls, li-sl, and ch-ch (P = 0.001, for these parameters). Besides, using these distances, 6 anthropometric ratios (ls-st/li-st, sn-ls/ls-st, li-sl/li-st, sn-st/st-sl, cp-cp/ch-ch, and ls-li/ch-ch) were calculated. Among the ratios investigated, sn-ls/ls-st, li-sl/li-st, and cp-cp/ch-ch were statistically significantly larger in males compared females (P = 0.012, P = 0.002, and P = 0.001, respectively). We believe that the results obtained in this study regarding lip anthropometry will help determine the standard values that can be used for the Turkish population aged 18 to 25.

Evaluation of the Cranial Aperture of the Optic Canal on Cone-Beam Computed Tomography Images and its Clinical Implications for the Transcranial Approaches.

OBJECTIVE: This study aimed to investigate morphometric properties of the cranial aperture (CA) of the optic canal. METHODS: Cone-beam computed tomography images of 400 individuals (200 males and 200 females) aged 37.32 ± 15.87 years were retrospectively examined to assess the morphometry and morphology of the CA. RESULTS: The height and width of CA were found as 4.22 ± 0.74 mm and 7.27 ± 1.15 mm, respectively. The distances between the CA and the midsagittal line, the anterior and lateral boundaries of the anterior skull base were measured as 5.77 ± 1.32 mm, 64.97 ± 6.36 mm, and 41.00 ± 4.05, respectively. The angle of the optic canal in the sagittal plane was measured as 7.57° ± 3.95°, whereas in the horizontal plane as 38.96° ± 4.36°. The aperture shape was defined as the tear-drop (413 foramina, 51.62%), triangular (180 foramina, 22.50%), oval (158 foramina, 19.75%), round (30 foramina, 3.75%), and polygonal (19 foramina, 2.38%). CONCLUSIONS: The authors observed that the diameters, and angulations of the CA may change relative to gender and the shape. The anatomic features of CA are important for the positioning of the patient's head, the choice of the appropriate surgical approach or equipment, and the detection of anatomical landmarks during interventions. In this context, our dataset may be beneficial for surgeons helpful as a reference for radiological evaluations.

Change in the Location of the Optic Strut Relative to the Anterior Clinoid Process Pneumatization.

OBJECTIVE: This study aimed to peruse the alteration of the position of the optic strut (OS) according to the anterior clinoid process (ACP) pneumatization. METHODS: This retrospective study conducted on cone-beam computed tomography images of 400 patients with a mean age of 36.49±15.91 years. RESULTS: Anterior clinoid process length, width, and angle were measured as 10.56±2.42 mm, 5.46±1.31 mm, and 42.56±14.68 degrees, respectively. The tip of ACP was measured as 6.60±1.50 mm away from the posterior rim of OS. In the 631 sides (78.87%) did not have ACP pneumatization. In the cases with ACP pneumatization, three different configurations were identified as follows: Type 1 in 71 sides (8.87%), Type 2 in 56 sides (7%), and Type 3 in 42 sides (5.23%). Relative to ACP, the location of OS was determined as follows: Type A in 29 sides (3.64%), Type B in 105 sides (13.12%), Type C in 344 sides (43%), Type D in 289 sides (36.12%), and Type E in 33 sides (4.12%). The spread of data related to the attachment site of OS according to the presence or absence of ACP pneumatization showed that the location of OS was affected by ACP pneumatization ( P <0.001). In ACPs with pneumatization, the frequency of OS position relative to ACP was found as follows: Type A in none of sides (0%), Type B in 8 sides (7.6%), Type C in 53 sides (15.4%), Type D in 88 sides (30.4%), and Type E in 20 sides (60.6%). CONCLUSIONS: The main finding of this study was that the location of OS relative to ACP was affected by ACP pneumatization. In ACPs with pneumatization, OS was located more posteriorly compared with ACPs without pneumatization.

The muscular branching patterns of the ulnar nerve in fetal forearms.

OBJECTIVE: We aimed to present our findings systematically by examining the muscular branching patterns of the ulnar nerve (UN) in the forearms of fetuses. METHODS: This study was conducted on the 52 forearms of 26 formalin-fixed fetal cadavers with gestational ages varying between 19 and 37 weeks. The anatomical dissection was performed by using stereomicroscope with × 8 magnification. The numbers of muscular branches leaving UN and their order of leaving main nerve were noted down. The findings were classified according to the muscles they reached, and branching typing was done. RESULTS: It was found that a total of 2-6 muscular branches left UN to reach flexor carpi ulnaris (FCU) and flexor digitorum profundus (FDP). UN was classified by separating into five main types according to the number of muscular branches, and these types were classified into 16 different branching patterns according to the order of branches leaving from the main trunk and going to FCU and FDP. The pattern where two branches left UN was classified as Type I (n = 6), three branches left was classified as Type II (n = 18), four branches left was classified as Type III (n = 24), five branches left was classified as Type IV (n = 3), and six branches left was classified as Type V (n = 1). Martin-Gruber connection occurred in 17 (32.7%) fetal forearms. CONCLUSION: We believe that the information that UN can demonstrate different branching patterns on the forearm can help the surgeons to prevent complications that may develop in potential nerve injury during the selection and transfer of relevant branch.

The Confusion of Determining the Landmark in the Craniofacial Soft Tissue Analyzes: Nasion or Sellion?

ABSTRACT: In the literature, most of the craniofacial anthropometric landmarks found on both bones and soft tissue have been clearly defined and widely used. However, it seems that few landmarks such as nasion are generally often set incorrectly. Therefore, in this study, it was aimed to examine the nasion and sellion in the dry bones and to review the definitions of each landmarks. A total of 41 adult skulls, whose nasofrontal region was not deformed and whose age, gender and ethnic origin were not known, were examined. It was found that nasion and sellion are at the same point in 24 of the 41 (58.54%) bones examined, and that in 17 of them (41.46%), sellion is below the nasion. In the bones where the sellion is below the nasion, the average distance between each two landmarks was determined as 4.53 ±â€Š0.95 mm. Consequently, we think that it is not possible to determine nasion in the indirect craniofacial soft tissue analyzes, and it would be better to use sellion as a reference landmark instead of nasion.

Craniofacial Anthropometry of Healthy Turkish Young Adults: Outer Canthal, Inner Canthal, Palpebral Fissure, and Interpupillary Distances.

ABSTRACT: This study aims to examine the values of the orbital region in Turkish young adults by the two-dimensional photogrammetry. Anthropometric measurements of the eye and eyelid-related parameters were taken from 100 female and 100 male volunteer Turkish young adults, ranging in age from 18 to 25 years. Endocanthion (en), exocanthion (ex), and pupil (p) were identified on the photograph and the distances between these points were measured with the ImageJ program. The average values of the en-en, ex-en (R), ex-en (L), p-p, and ex-ex were found as 32.92 ±â€Š2.84, 32.48 ±â€Š2.06, 32.22 ±â€Š2.01, 65.32 ±â€Š3.77, and 97.75 ±â€Š5.09 mm, respectively. There were statistically significant differences between the genders in all parameters. Although there are many studies examining these parameters, comprehensive studies are needed in different populations and in many cases. In this study, we believe that the results obtained for Turkish young adults can be used as reference values.

Craniofacial Anthropometry of Healthy Turkish Young Adults: Analysis of Head and Face.

ABSTRACT: The aim of this study was to evaluate the craniofacial anthropometric measurements of Turkish young adults between the ages of 18 and 25. Anterior view and side profile photographs were taken of 100 females and 100 males who volunteered to participate in the study and had no craniofacial anomalies, history of facial trauma, or history of orofacial surgery. Thirteen landmarks on the face and head were chosen, and these landmarks were identified on the photographs. Then, using these landmarks, a total of 19 distance measurements were made, 16 from the anterior view, and 3 from the side profile. There were statistically significant differences between the sexes in 13 parameters: 2 parameters (t-n and ft-ft) being higher in females and 11 parameters (v-n, v-t, t-gn, sn-gn, n-gn, st-gn, sl-gn, fz-fz, z-z, tr-tr and go-go) being higher in males. Also, 7 facial anthropometric ratios were calculated. There were statistically significant differences between the genders in all ratios. The literature reveals that craniofacial anthropometric measurements have been performed on many different populations and that there are numerous differences between the results of the studies conducted. We are of the opinion that the results obtained in this present study will contribute to the literature by helping to determine the standard values for the Turkish population between the ages of 18 and 25, which can be used in diagnosis, treatment and postoperative evaluation in areas such as forensic science, orthodontics, clinical genetics, maxillofacial surgery, and plastic surgery.

External Nose Anthropometry of Healthy Turkish Young Adults.

ABSTRACT: Although many studies in the literature examine distances and angles about the nose, there are no clear standard values for different races and ethnic groups. The aim of this study is to determine the anthropometric measurement standards related to the external nose in Turkish young adults between the ages of 18 and 25. The subjects participating in this study were 100 female and 100 male volunteers. Six landmarks (nasion, subnasale, pronasale, alar, subalar and maxillofrontale) on the nose were chosen, and these landmarks were identified on the photographs. Then, using these landmarks, a total of seven distances (nose height, dorsum of nose length, distance between the subnasale and pronasale, nose width, right nostril floor width, left nostril floor width and root of nose width) and four angles (nasofrontal, nasofacial, nasomental and nasolabial angles) measurements were made. There were statistically significant differences between gender in nine parameters. One parameter (nasofrontal angle) is higher in females, and seven parameters (nose height, dorsum of nose length, nose width, right nostril floor width, left nostril floor width, root of nose width and nasofacial angle) are higher in males. It is accepted that distances and angles about the nose differ according to race and ethnicity. The authors believe that the results obtained in this study will help determine the standard values that can be used for the Turkish population between the ages of 18 and 25.

Evaluation of attitudes and opinions of medical faculty students against the use of cadaver in anatomy education and investigation of the factors affecting their emotional responses related thereto.

INTRODUCTION: The encounter with the cadaver is one of the few experiences that have a profound effect on the educational life of the medical students. The objective of this study was to investigate medical student's attitudes and opinions towards the use of cadaver in anatomy education, as well as the factors affecting the emotional reactions they demonstrate in their repeated encounter with the cadaver. MATERIAL AND METHODS: Before the study, ethics committee approval for the study was obtained from the Gaziantep University Clinical Researches Ethical Committee (decision date and number: 2016/40). Two different questionnaires were administered to 351 students who participated in the study. Questionnaire-I was administered before the student's first encounter with the cadaver, whereas Questionnaire-II was administered twice, one after student's first encounter with the cadaver and the other after student's fifth encounter with the cadaver. RESULTS: The females got significantly more excited before their first encounter with the cadaver, and that they felt more fear and more sadness for the cadaver (p = 0.001, p = 0.002, and p = 0.019, respectively). On the other hand, the males felt significantly readier to see the cadaver (p = 0.002). It was found that statements of emotional shock, excitement, sadness, and fear coming from the participants decreased significantly after their fifth encounter with the cadaver (p = 0.028, p = 0.001, p = 0.048, and p = 0.039, respectively). CONCLUSION: Repeated encounters with cadavers were found to have reduced the negative emotions felt by the students, but have negatively affected the thoughts of the students in respect of donating their bodies.

Radiologic evaluation of the fossa navicularis: incidence, morphometric features, and clinical implications.

INTRODUCTION: The aim of this study was to determine the incidence and morphometric and morphological characteristics of fossa navicularis (FN) on cone beam computed tomography (CBCT) images of healthy adults MATERIALS AND METHODS: CBCT images of 900 individuals (450 males, 450 females, over the age of 18) admitted to Gaziantep University, Dentistry Faculty were retrospectively examined. The incidence and shape of FN were determined. Transverse diameter (TDFN), sagittal diameter (SDFN), depth in transverse section (DFNT), depth in sagittal section (DFNS), and the shortest distance between the deepest point of FN and intracranial cavity (FNI) were measured. RESULTS: FN was detected in 122 (59 males and 63 females) of 900 (13.56%) CBCT images. No statistically significant difference was observed between gender and the incidence of FN. SDFN, TDFN, DFNS, DFNT and FNI were measured as 4.04 ± 1.71, 4.28 ± 1.34, 1.79 ± 0.68, 2.34 ± 0.85, and 6.76 ± 2.23 mm, respectively. Besides, FN was described as oval in 95 of 122 (77.87%) cases, while as round in 27 (22.23%) cases. CONCLUSIONS: The incidence of FN is rare; however, it may be responsible for serious consequences by causing infections from the nasopharynx to the intracranial cavity. As far as we know, the distance between the deepest point of FN and the intracranial cavity was measured for the first time in the literature with this study.

The importance of volume and area fractions of cerebellar volume and vermian subregion areas: a stereological study on MR images.

PURPOSE: Age, gender, and body size are important factors which are affecting the cerebellar volume (CV). Many neurological diseases lead changes in CV. The aim of this study is to measure CV and the total intracranial volume (TIV) for both genders on magnetic resonance images (MRI), to calculate the CV/TIV volume fraction, and also to determine the normal values that can be regarded clinically significant by determining the total vermis area and vermian subregion areas (V1, V2, and V3). METHODS: In this retrospective study, MR images (without any pathological findings) of 200 individuals (100 female, 100 male) between the ages of 20-40 were used. CV and CV/TIV volume fractions, vermian subregion areas, and area fractions were calculated by using the Stereoinvestigator 8.0 (Microbrightfield, USA) software. The volumetric calculations were performed by the point counting method according to the Cavalieri principle, which is one of the volume calculation methods in stereology. Total CV, TIV, cerebellar vermis areas (V1, V2, and V3), and total cerebellum area were measured separately for both groups. RESULTS: The volume of cerebellum was 120.53 ± 11.1 cm3 in males, 105.99 ± 11.2 cm3 in females, TIV was 1304.99 ± 91.7 cm3 in males and 1155.15 ± 85.7 cm3 in females. CV and TIV were statistically higher in males (p = 0.001, p = 0.001 respectively). It was observed that the differences between the genders in terms of CV/TIV disappeared (p = 0.679). The total vermis area was 11.59 ± 1.3 cm2 in males and 10.85 ± 1.3 cm2 in females. V1 area, V3 area, and the total vermis area were found statistically higher in males (p = 0.05, p = 0.006, p = 0.007 respectively). It was determined that the area fraction of V2 was higher in females when the fractions of V1, V2, and V3 to the total vermis area were examined (p = 0.03). CONCLUSION: We believe that the normal values of CV, TIV, and vermian subregion areas, determined by stereological method, will contribute to the diagnosis and the treatment plan of the clinical pathological evaluations in adults and children.

The anatomical and radiological evaluation of the Vidian canal on cone-beam computed tomography images.

INTRODUCTION: The aim of this study is to explore the anatomy of the Vidian nerve to elucidate the appropriate surgical approach based on preoperative cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS: The Vidian canal and its surrounding structures were morphometrically evaluated retrospectively in CBCT images of 400 cases by the Planmeca Romexis program. The types of the Vidian canal were determined and seven parameters were measured from the images. RESULTS: Three types of the Vidian canal according to the relationship with the sphenoid bone were found as follows: the Vidian canal totally protruded into the sphenoid sinus (19.75%), partially protruded into sphenoid sinus (44.37%) and embedded inside bony tissue of the body of sphenoid bone (35.87%). The position of the Vidian canal was medial (34.62%), on the same line (55.12%) and lateral (10.25%) to the medial plate of the pterygoid process. The distance between the Vidian canal and the vomerine crest, the mid-sagittal plane, the round foramen, the palatovaginal canal, and the superior wall of the sphenoid sinus, the length of the Vidian canal and the angle between the Vidian canal and the sagittal plane was found to be 16.69 ± 2.14, 13.80 ± 2.00, 8.88 ± 1.60, 5.83 ± 1.37, 23.98 ± 2.68, 13.29 ± 1.71 mm and 25.78° ± 3.68° in males, 14.62 ± 1.66, 11.43 ± 1.28, 8.51 ± 1.63, 5.78 ± 0.57, 22.37 ± 2.07, 12.91 ± 1.26 mm and 23.43° ± 3.07° in females, respectively. CONCLUSIONS: Our results may assist with proper treatment for surgical procedures around the Vidian canal with a high success rate and minimal complications. Therefore, the results obtained in this study contribute to the literature.

Morphometric evaluation and clinical implications of the greater palatine foramen, greater palatine canal and pterygopalatine fossa on CBCT images and review of literature.

INTRODUCTION: The pterygopalatine fossa (PPF) infiltration is performed to reduce blood flow during endoscopic sinus surgery and septorhinoplasty, as well as to control posterior epistaxis and provide regional anesthesia in dental procedures. PPF infiltration performed with consideration of the morphometrics of greater palatine foramen (GPF), greater palatine canal (GPC) and PPF would increase the success of the procedure and reduce the risk of complications. The aim of this study is to investigate the GPF, GPC, lesser palatine foramen (LPF), lesser palatine canal (LPC) and PPF morphology via the images obtained by CBCT, to provide information for interventional procedures. MATERIALS AND METHODS: GPF, GPC, LPF, LPC and PPF were morphometrically evaluated retrospectively in CBCT images of 75 female and 75 male cases by Planmeca Romexis program. The 19 parameters were measured on these images. RESULTS: These parameters were evaluated statistically. The comparison of these parameters by genders revealed significant differences in distances between GPC-PC, PC-IOF, LPC-GPF, GPF-MS in the coronal and transverse planes, the distance between GPF and the occlusal plane of the teeth, GPF-PNS, GPF-IF and TD-GPF, and in the area of GPF. The number of LPF was found ranging from 1 to 5. CONCLUSION: Our results may help to insert to needle properly for application of maxillary nerve block with a high success rate and minimal complication. We recommend that the needle should be inserted 14-15 mm lateral to the midsagittal plane, 19-20 mm over the occlusal plane of the teeth and on the same line with the third molar teeth. For PPF infiltration through the GPF, the needle should be pushed forward 28 mm upward at 66° angle on the transverse plane and 14°-15° angle on the vertical plane.

Comparison of the Gonial Angle With Age and Gender Using Cone-Beam Computed Tomography Images.

Introduction The mandible is one of the most important bones used in gender determination in forensic medicine and anthropology. In literature, there are many studies examining the relationship between the gonial angle on the mandible and gender. However, these studies reported different results. This study aimed to measure the gonial angle with cone-beam computed tomography (CBCT) images and investigate the relation of this angle with age and gender. Materials and methods CBCT images of 235 dentate individuals (111 males and 124 females) aged between seven and 77 years were evaluated. The individuals examined were categorized into four age groups: 7-19 years (group I), 20-39 years (group II), 40-59 years (group III), and 60-77 years (group IV). The gonial angle was measured bilaterally in all individuals. Results The mean age of the males was 41.70 ± 19.14, and the mean age of the females was 39.47 ± 17.90 years. There was no statistically significant difference between the ages based on gender (p = 0.356). It was observed that there was a statistical difference between the gonial angle and gender in groups II and III. There was no correlation between age and gonial angle in all groups. Conclusion The results obtained in this study and the comparison of these results with the literature clearly show that it is currently not possible to clearly express the relationship between the gonial angle and both age and gender. For this reason, we believe that conducting further studies evaluating both the gonial angle and the relationship between the gonial angle and other anatomical structures on a larger sample can yield more meaningful results.

Patterns of motor branching of the musculocutaneous nerve in human fetuses and clinical significance.

The purpose of this morphologic study is to investigate the course and the branching pattern of motor branches of musculocutaneous nerve (MCN) in human fetuses. Twenty upper limbs (10 right, 10 left) of spontaneously aborted formalin-fixed fetuses were dissected under a stereomicroscope to determine motor branches for the biceps brachii and brachialis and the communicating branches between the MCN and median nerve (MN). The MCN entered the proximal and middle part of coracobrachialis in 13/20 and 5/20 of arms, respectively, and the remaining 2/20 did not pierce coracobrachialis. The communication between MCN and MN was observed in 5/20 of the arms and detected only in the distal part of the coracobrachialis. The most frequently observed innervation is the type wherein a single branch to biceps brachii, which bifurcated for supplying the short and long heads (12/20). For the innervation of brachialis, the most frequent type was a single branch from the main trunk of the MCN (15/20). During the dissections, the distance between the acromion and the emerging point of the motor branches was measured. The mean distance between the acromion and the emerging point of the all motor branches for biceps brachii in all types of specimens was 33.8 ± 6.1% of acromion-lateral epicondyle length and for brachialis was 50.6 ± 11.5% of acromion-lateral epicondyle length. The data of the MCN variations in the human fetus may be useful for the clinicians and pediatric surgery.