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1.
J Contemp Dent Pract ; 25(5): 453-458, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-39364844

RESUMEN

AIM: To evaluate the morphology of the mastoid process and its role in sex determination with the help of cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A retrospective study was conducted on 200 adults who were subjected to full FOV CBCT scans (100 males and 100 females). Eight parameters of the mastoid process were assessed for sex determination. The study measured eight parameters of the mastoid process, including mastoid length (ML), mastoid width, mastoid height (MH), intermastoidale distance (IMD), intermastoidale lateral surface distance (IMLSD), mastoid medial convergence angle, mastoid size (MS), and mastoid surface area (MSA). Data were recorded and statistically analyzed. RESULTS: Statistics revealed a significant value for MH (p < 0.001), IMD (p < 0.001), IMLSD (p < 0.001), MSA (p < 0.001), MS (p < 0.001), and ML (p = 0.032). A highly significant value was noted for MH (p < 0.001), IMD (p < 0.001), IMLSD (p < 0.001), MSA (p < 0.001), MS (p < 0.001), followed by ML, all of which were found to be greater in males. Out of the eight parameters, IMD was found to be the best sex determinant among all the eight parameters, with an accuracy of 70%. The study showed a significant difference between the mastoid process morphometric measurements for males and females. CONCLUSION: It can be concluded from the present study that IMD can be used as a good index for sex determination. The combined parameters that were found to be the most accurate were right MH, left ML, and IMLSD, with an accuracy of 75%. CLINICAL SIGNIFICANCE: The three-dimensional imaging techniques can contribute significantly towards disaster victim identification and sex determination in the fields of forensic odontology and anthropology. For the recognition of victims, sex determination becomes one of the most difficult parameters to assess. In such events, the mastoid process can become an important anatomical landmark for the estimation of sex. This is due to the condensed nature of the petrous bone and its protected position in the skull. How to cite this article: Ahmed J, Saha A, Muralidharan A, et al. Efficacy of Mastoid Morphometry in Sex Determination Using Cone-beam Computed Tomography: A Retrospective Analysis in Dakshina Kannada Population. J Contemp Dent Pract 2024;25(5):453-458.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Apófisis Mastoides , Determinación del Sexo por el Esqueleto , Humanos , Estudios Retrospectivos , Masculino , Tomografía Computarizada de Haz Cónico/métodos , Femenino , Apófisis Mastoides/diagnóstico por imagen , Apófisis Mastoides/anatomía & histología , Adulto , Determinación del Sexo por el Esqueleto/métodos , Persona de Mediana Edad , Adulto Joven
2.
World Neurosurg ; 186: e721-e726, 2024 06.
Artículo en Inglés | MEDLINE | ID: mdl-38616028

RESUMEN

OBJECTIVE: Neuronavigation systems coupled with previously reported external anatomical landmarks assist neurosurgeons during intracranial procedures. We aimed to verify whether the posterior auricularis muscle (PAM) could be used as an external landmark for identifying the sigmoid sinus (SS) and the transverse-sigmoid sinus junction (TSSJ) during posterior cranial fossa surgery. METHODS: The PAM was dissected in 10 adult cadaveric heads and after drilling the underlying bone, the relationships with the underlying SS and TSSJ were noted. The width and length of the PAM, and the distance between the muscle and reference points (asterion, mastoid tip, and midline), were measured. RESULTS: The PAM was identified in 18 sides (9 left, 9 right). The first 20 mm of the muscle length (mean 28.28 mm) consistently overlay the mastoid process anteriorly and the proximal half of the SS slightly posteriorly on all sides. The superior border was a mean of 2.22 mm inferior to the TSSJ and, especially when the muscle length exceeded 20 mm, this border extended closer to the transverse sinus; it was usually found at a mean of 3.11 mm (range 0.0-13.80 mm) inferior to the distal third of the transverse sinus. CONCLUSIONS: Superficial landmarks give surgeons improved surgical access, avoiding overexposure of deep neurovascular structures and reducing brain retraction. On the basis of our cadaveric study, the PAM is a reliable and accurate direct landmark for identifying the SS and TSSJ. The PAM could potentially be used for guiding the retrosigmoid approach.


Asunto(s)
Puntos Anatómicos de Referencia , Cadáver , Senos Craneales , Humanos , Senos Craneales/anatomía & histología , Senos Craneales/cirugía , Puntos Anatómicos de Referencia/anatomía & histología , Fosa Craneal Posterior/anatomía & histología , Fosa Craneal Posterior/cirugía , Neuronavegación/métodos , Masculino , Femenino , Apófisis Mastoides/anatomía & histología , Apófisis Mastoides/cirugía , Procedimientos Neuroquirúrgicos/métodos , Anciano
3.
Oper Neurosurg (Hagerstown) ; 27(4): 475-484, 2024 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-38634695

RESUMEN

BACKGROUND AND OBJECTIVES: Access to the jugular fossa pathologies (JFPs) via the transmastoid infralabyrinthine approach (TI-A) using the nonrerouting technique (removing the bone anterior and posterior to the facial nerve while leaving the nerve protected within the fallopian canal) or with the short-rerouting technique (rerouting the mastoid segment of the facial nerve anteriorly) has been described in previous studies. The objective of this study is to compare the access to Fisch class C lesions (JFPs extending or destroying the infralabyrinthine and apical compartment of the temporal bone with or without involving the carotid canal) between the nonrerouting and the short-rerouting techniques. Also, some tailored steps to the nonrerouting technique (NR-T) were outlined to enhance access to the jugular fossa (JF) as an alternative to the short-rerouting technique. METHODS: Neuronavigated TI-A was performed using the nonrerouting, tailored nonrerouting, and short-rerouting techniques on both sides of 10 human head specimens. Exposed area, horizontal distance, surgical freedom, and horizontal angle were calculated using vector coordinates for nonrerouting and short-rerouting techniques. RESULTS: The short-rerouting technique had significantly higher values than the NR-T ( P < .01) for the exposed area (169.1 ± SD 11.5 mm 2 vs 151.0 ± SD 12.4 mm 2 ), horizontal distance (15.9 ± SD 0.6 mm vs 10.6 ± SD 0.5 mm 2 ), surgical freedom (19 650.2 ± SD 722.5 mm 2 vs 17 233.8 ± SD 631.7 mm 2 ), and horizontal angle (75.2 ± SD 5.1° vs 61.7 ± SD 4.6°). However, adding some tailored steps to the NR-T permitted comparable access to the JF. CONCLUSION: Neuronavigated TI-A with the short-rerouting technique permits wider access to the JF compared with the NR-T. However, the tailored NR-T provides comparable access to the JF and may be a better option for class C1 and selected class C2 and C3 JFPs.


Asunto(s)
Procedimientos Neuroquirúrgicos , Humanos , Procedimientos Neuroquirúrgicos/métodos , Foramina Yugular/cirugía , Apófisis Mastoides/cirugía , Apófisis Mastoides/anatomía & histología , Hueso Temporal/cirugía , Hueso Temporal/anatomía & histología , Oído Interno/cirugía , Oído Interno/anatomía & histología , Oído Interno/diagnóstico por imagen , Nervio Facial/anatomía & histología , Nervio Facial/cirugía
4.
J Craniofac Surg ; 35(5): 1572-1575, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38687087

RESUMEN

Mastoid emissary foramen transmitting mastoid emissary vein connects the posterior auricular vein with the sigmoid sinus. This foramen and so the mastoid emissary vein varies in prevalence, number, size and location, knowledge of which is essential for carrying out uneventful surgeries, especially retrosigmoid, mastoidectomy, and skull base surgeries. There is a paucity of literature on this foramen in the Indian context, so the study was done. The purpose of the study is to elaborate on the prevalence, number, size, and location of mastoid foramen in dry adult skulls. The study was conducted in the Department of Anatomy using 90 dry skulls of unknown age and sex, and prevalence, number, size, and location in these skulls were noted. The mastoid foramen was detected in 27.8% of skulls, with an incidence of 31.1% and 12.2% on right and left sides of skulls, respectively. The number of foramina ranged between 1 and 4. The mean diameter of this foramen was 0.9 mm, and the most frequent location was mastoid process. The detailed morphology and morphometry of mastoid foramen are of utmost use to neurosurgeons, ENT surgeons, radiologists, and vascular surgeons as it transmits mastoid emissary vein and meningeal branch of the occipital artery, which may be injured during various surgical procedures involving mastoid region and skull base causing catastrophic hemorrhage. In addition to this, mastoid emissary vein may be the source of thrombus, causing thrombus of sigmoid sinus creating helm of neurological complications.


Asunto(s)
Apófisis Mastoides , Humanos , Apófisis Mastoides/anatomía & histología , Cadáver , Masculino , Femenino , Adulto , Senos Craneales/anatomía & histología , Base del Cráneo/anatomía & histología
5.
J Craniofac Surg ; 35(5): 1568-1571, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38408324

RESUMEN

Nadbath facial nerve block is the most common procedure to anesthetize the facial nerve at stylomastoid foramen in intraocular surgeries, but it is associated with complications. Also, this foramen exhibits ethnic and racial variations with regard to its location. There is scanty literature describing the topographical location of this foramen. So, the study is carried out. The purpose of the study is to describe the topography of stylomastoid foramen from the surrounding landmarks so that Nadbath facial nerve block can be performed with minimum complications. The study was conducted using 80 adult dry skulls of unknown age and sex, and the distance of this foramen was measured from the tip, upper end, and lower end of the anterior border of the mastoid process and jugular foramen. The statistical analysis consisting of mean, SD, median, range mode, and t test was calculated. Mean distances of stylomastoid foramen from the upper end, the lower end of anterior border and tip of mastoid process and jugular foramen on right side were 1.5±0.16, 1.02±0.09, 0.84±0.09, and 0.49±0.06 cm and those on left side were 1.5±0.16, 1.02±0.09, 0.84±0.09, and 0.5±0.06 cm, respectively. The mode of these distances was 1.5, 1, 0.8, and 0.5, both on the right and left sides. The topographic information about stylomastoid foramen given in this study is useful to anesthetists to carry out Nadbath facial nerve block successfully with minimum complications.


Asunto(s)
Puntos Anatómicos de Referencia , Nervio Facial , Apófisis Mastoides , Bloqueo Nervioso , Humanos , Bloqueo Nervioso/métodos , Nervio Facial/anatomía & histología , Apófisis Mastoides/anatomía & histología , Cadáver , Adulto , Masculino , Femenino , Hueso Temporal/anatomía & histología
6.
Am J Forensic Med Pathol ; 45(1): 51-62, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-38039501

RESUMEN

ABSTRACT: Previous studies on the sexual dimorphism of the mastoid triangle have typically focused on linear and area measurements. No studies in the literature have used mastoid air cell system volume measurements for direct anthropological or forensic sex determination. The aims of this study were to investigate the applicability of mastoid air cell system volume measurements and mastoid triangle measurements separately and combined for sex estimation, and to determine the accuracy of sex estimation rates using machine learning algorithms and discriminant function analysis of these data. On 200 computed tomography images, the distances constituting the edges of the mastoid triangle were measured, and the area was calculated using these measurements. A region-growing algorithm was used to determine the volume of the mastoid air cell system. The univariate sex determination accuracy was calculated for all parameters. Stepwise discriminant function analysis was performed for sex estimation. Multiple machine learning methods have also been used. All measurements of the mastoid triangle and volumes of the mastoid air cell system were higher in males than in females. The accurate sex estimation rate was determined to be 79.5% using stepwise discriminant function analysis and 88.5% using machine learning methods.


Asunto(s)
Apófisis Mastoides , Determinación del Sexo por el Esqueleto , Masculino , Femenino , Humanos , Apófisis Mastoides/diagnóstico por imagen , Apófisis Mastoides/anatomía & histología , Determinación del Sexo por el Esqueleto/métodos , Antropología Forense/métodos , Análisis Discriminante , Aprendizaje Automático
7.
Neurosurg Rev ; 47(1): 4, 2023 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-38062247

RESUMEN

INTRODUCTION: We aimed to investigate the morphological features of the artery that traverse the sigmoid sinus's lateral surface and to discuss this structure's clinical relevance. METHODS: Ten sides from five cadaveric Caucasian heads were used for gross anatomical dissection to investigate the morphological features of the sigmoid sinus artery (SSA), and additional five sides were used for histological observation. RESULTS: The SSA was found on eight out of ten sides (80%). The mean diameter of the SSA was 0.3 mm. The mean distance from the tip of the mastoid process to the artery was 20.3 mm. Histological observation identified extradural and intradural courses of SSA. The intradural course was further categorized into protruding and non-protruding types. In the protruding type, the SSA traveled within the dura but indented into the bone, making it more or less an intraosseous artery. In the non-protruding type, the SSA traveled within the dura but did not protrude into the bone but rather indented into the lumen of the SS. In all sections, both intradural and extradural courses were identified simultaneously. CONCLUSIONS: When the mastoid foramen is observed, it does not always only carry an emissary vein but also an artery. The SSA could be considered a "warning landmark" during bone drilling for the transmastoid approach.


Asunto(s)
Senos Craneales , Cráneo , Humanos , Cráneo/anatomía & histología , Senos Craneales/cirugía , Apófisis Mastoides/cirugía , Apófisis Mastoides/anatomía & histología , Arterias , Duramadre/cirugía , Cadáver
8.
Sci Prog ; 106(2): 368504231178382, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37262004

RESUMEN

OBJECTIVES: This study aimed to determine mastoid emissary canal's (MEC) and mastoid foramen (MF) prevalence and morphometric characteristics on cone-beam computed tomography (CBCT) images to underline its clinical significance and discuss its surgical consequences. METHODS: In the retrospective analysis, two oral and maxillofacial radiologists analyzed the CBCT images of 135 patients (270 sides). The biggest MF and MEC were measured in the images evaluated in MultiPlanar Reconstruction (MPR) views. The MF and MEC mean diameters were calculated. The mastoid foramina number was recorded. The prevalence of MF was studied according to gender and side of the patient. RESULTS: The overall prevalence of MEC and MF was 119 (88.1%). The prevalence of MEC and MF is 55.5% in females and 44.5% in males. MEC and MF were identified as bilateral in 80 patients (67.20%) and unilateral in 39 patients (32.80%). The mean diameter of MF was 2.4 ± 0.9 mm. The mean height of MF was 2.3 ± 0.9. The mean diameter of the MEC was 2.1 ± 0.8, and the mean height of the MEC was 2.1 ± 0.8. There is a statistical difference between the genders (p = 0.043) in foramen diameter. Males had a significantly larger mean diameter of MF in comparison to females. CONCLUSION: MEC and MF must be evaluated thoroughly if the surgery is contemplated. Radiologists and surgeons should be aware of mastoid emissary canal morphology, variations, clinical relevance, and surgical consequences while operating in the suboccipital and mastoid areas to avoid unexpected and catastrophic complications. CBCT may be a reliable imaging diagnostic technique.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Apófisis Mastoides , Humanos , Masculino , Femenino , Apófisis Mastoides/diagnóstico por imagen , Apófisis Mastoides/anatomía & histología , Estudios Retrospectivos , Tomografía Computarizada de Haz Cónico/métodos , Prevalencia , Relevancia Clínica
9.
Homo ; 74(1): 45-54, 2023 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-36920118

RESUMEN

Five cranial nonmetric traits for sex estimation for sex estimation are classified by score according to geometry. The population of origin is one of the factors influencing cranial nonmetric traits. Moreover, among the five cranial traits, the robust traits for estimating sex varied across population. The aim of this study is to suggest the most useful method for sex estimation and demonstrate the need of a suitable method for each population. One-hundred thirty-five three-dimensional skull images from 21st century Korean autopsy cadavers were evaluated using the ordinal scoring system of five cranial nonmetric traits as outlined in Buikstra & Ubelaker (1994). All scores of each trait were analyzed by linear discriminant and decision tree analyses for sex estimation. The frequency of each trait was analyzed and compared to populations from other studies. The accuracy for both sexes was 88.1% by discriminant analysis and 90.4% by decision tree. The traits with the highest accuracy were the glabella and mastoid process in both discriminant analysis and decision tree. Sex estimation in modern Korean cadavers using the cranial nonmetric method was shown to be highly accurate by both discriminant analysis and decision tree. When comparing the pattern of frequency scores in this study with those of other populations, the pattern of trait scores for estimating sex was different for each population, even among populations in the same Asian region, which suggests the need for methods suited for specific populations.


Asunto(s)
Pueblos del Este de Asia , Determinación del Sexo por el Esqueleto , Cráneo , Tomografía Computarizada por Rayos X , Femenino , Humanos , Masculino , Antropología Forense/clasificación , Antropología Forense/métodos , Hueso Frontal/anatomía & histología , Hueso Frontal/diagnóstico por imagen , Imagenología Tridimensional/métodos , Apófisis Mastoides/anatomía & histología , Apófisis Mastoides/diagnóstico por imagen , Determinación del Sexo por el Esqueleto/métodos , Cráneo/anatomía & histología , Cráneo/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Autopsia , Cadáver
10.
Surg Radiol Anat ; 45(1): 55-63, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36520166

RESUMEN

PURPOSE: During retrosigmoid craniotomy, the mastoid emissary vein (MEV) can be a source of considerable bleeding during the operation, especially when the larger diameter MEV or sigmoid sinus is torn. In this study, we evaluated the relevant structure of the MEV for their anatomy and applied the data in surgery to summarize their clinical significance. METHODS: The posterior craniocervical regions of 15 silicon-injected Chinese human cadaver specimens were dissected to expose the MEV and adjacent structures. Fifty-one patients who were scheduled to undergo retrosigmoid craniotomy were selected. All patients underwent preoperative routine CT of the head. The relevant data were collected on cadaveric anatomy and CT. Eventually, all patients underwent retrosigmoid craniotomy and the MEV was observed during the operation. RESULTS: In cadaver specimens, the prevalence of the MEV was 90.0%. It originated from the middle and lower parts of the posterior wall of the sigmoid sinus and extended in the posterior direction in the mastoid process, usually having 1-2 external openings (86.7%) and only 1 internal opening. The intraosseous courses of the MEV were classified as straight and curved. The straight type accounted for 57.9%, and the curved type for 42.1%. The mean diameter of the MEV was 1.84 ± 0.85 mm, and the straight length of the MEV inside the mastoid process was 11.93 ± 3.58 mm. In 16.7% and 6.7% of all cadaver specimens, the MEV diameter was greater than 2.5 and 4 mm, respectively. In 51 patients (bilateral), routine head CT scan showed the MEV in 49.0% of the patients, and the MEV diameter was greater than 2.5 and 4 mm, respectively, in 17.6% (18/102) and 3.9% (4/102) of the cases. During surgery (unilateral) in the 51 patients, 48 had the MEV and 3 had no MEV. None of the patients had sigmoid sinus tears or massive bleeding. CONCLUSION: In the process of retrosigmoid craniotomy, detailed anatomical knowledge of the MEV, well-planned CT scan, and meticulous microsurgical techniques are key for successful operation, which can reduce the occurrence of complications.


Asunto(s)
Apófisis Mastoides , Cráneo , Humanos , Apófisis Mastoides/diagnóstico por imagen , Apófisis Mastoides/cirugía , Apófisis Mastoides/anatomía & histología , Cráneo/anatomía & histología , Venas Yugulares/anatomía & histología , Senos Craneales/diagnóstico por imagen , Senos Craneales/cirugía , Cadáver
11.
Morphologie ; 107(357): 252-258, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36503869

RESUMEN

OBJECTIVE OF THE STUDY: This study aimed to quantify the area of the mastoid triangle (MT) and assess potential morphometric differences between males and females. PATIENTS: The sample consisted of 244 dry human skulls, with biological sex known based on genetic analysis, collected from a medicolegal osteological database from Central-Western Brazil. MATERIALS AND METHODS: The study was observational, analytical, and cross-sectional. The skulls were analyzed using Heron's equation to calculate the area of the MT. The landmarks connecting each of the sides of the triangle were: Porion (Po)>Mastoidale (Ma)>Asterion (Ast). Morphometric references were calculated and compared based on sex. RESULTS: The area of the MT was nearly 14% larger in males compared to females (p<0.05). The mean MT area for the right and left sides of males were 684.11±93.25mm2 and 668.94±111.95mm2, respectively. In females, the mean MT for the right and left sides were 588.93±91.09mm2 and 582.88±102.98mm2, respectively. Right and left side measurements were significantly different (p<0.05), except for Po-Ast (p=0.232). CONCLUSION: Morphometric features regarding the MT were slightly different between males and females. Application of the MT as a dimorphic tool should be adjuvant. Moreover, this tool should be considered carefully, especially because the sex-based differences were statistically significant, but discrete between males and females.


Asunto(s)
Apófisis Mastoides , Caracteres Sexuales , Femenino , Humanos , Masculino , Cefalometría , Estudios Transversales , Apófisis Mastoides/anatomía & histología , Cráneo
12.
Folia Morphol (Warsz) ; 82(4): 909-920, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36385426

RESUMEN

BACKGROUND: The main objective of the present study was to analyse the morphological variations of the air spaces of the temporal bone, that is, the pneumatized and air-filled spaces of the temporal bone cavities. MATERIALS AND METHODS: A total of 99 sides were analysed. Temporal bone pneumatic spaces (TBPS) were defined as the free spaces inside the cavities of the temporal bone filled with air, excluding the volume of the structures present in the investigated region. Total volumes of TBPS were calculated as the sum of total volumes of mastoid air cells (MAC), tympanic cavity (TC), and external auditory canal (EAC). Analyses were performed considering the general population and the female and male subgroups. RESULTS: The overall results obtained on Polish population were set as follows: the median total volume of TBPS was demonstrated at 7882.58 mm3 (lower quartile [LQ]: 6200.56 mm3; higher quartile [HQ]: 10393.16 mm3). The median volume of MAC was set at 5813.05 mm3 (LQ: 4224.94 mm3; HQ: 8181.81 mm3). The median of the total volume of the EAC was demonstrated at 1294.36 mm3 (LQ: 1099.68 mm3; HQ: 1627.84 mm3). CONCLUSIONS: In the present study, the morphometric properties of the temporal bone cavities were analysed. The results showed that the total volume of the MAC was, on average, lower in women than in men. This should be taken into account when performing procedures on the mastoid, such as mastoidectomies. It is hoped that the results of this study can help reduce potential surgical complications associated with otological procedures.


Asunto(s)
Hueso Temporal , Tomografía Computarizada por Rayos X , Humanos , Masculino , Femenino , Hueso Temporal/anatomía & histología , Apófisis Mastoides/anatomía & histología , Oído Medio , Conducto Auditivo Externo
13.
Odovtos (En línea) ; 24(2)ago. 2022.
Artículo en Inglés | LILACS, SaludCR | ID: biblio-1386597

RESUMEN

Abstract This study aimed to investigate the possibility of age and sex determination using bimastoid diameter with cone-beam computed tomography (CBCT). This retrospective study investigated 100 female and 100 male patients aged 18-83 years (mean age: 45.55±16.28 years). To measure bimastoid diameter, the appropriate image was chosen from sagittal, coronal, and axial images of CBCT in which the measurement points could be best detected. The distance between the points of the mastoid process was measured using three-dimensional coronal reconstruction. The mean bimastoid breadth was 106.12±6.22mm. The bimastoid diameter in male cases was higher than that in female cases (110.69±4.53mm vs. 101.65±4.00mm). There was no significant difference in bimastoid breadth with advancing age. For sex determination, morphometric measurements of bimastoid diameter ensured a high rate of dimorphism in the Turkish subpopulation. CBCT morphometric analysis may be reliable and convenient for evaluating sex and may be recommended to compare population data.


Resumen Este estudio tuvo como objetivo investigar la posibilidad de determinar la edad y el sexo utilizando el diámetro bimastoideo con tomografía computarizada de haz cónico (CBCT). Este estudio retrospectivo investigó a 100 mujeres y 100 hombres de entre 18 y 83 años (edad media: 45,55±16,28 años). Para medir el diámetro bimastoideo, se eligió la imagen adecuada de las imágenes sagital, coronal y axial de CBCT en las que los puntos de medición se podían detectar mejor. La distancia entre los puntos del proceso mastoideo se midió mediante reconstrucción coronal tridimensional. La amplitud media del bimastoide fue de 106,12± 6,22mm. El diámetro del bimastoide en los casos masculinos fue mayor que en los casos femeninos (110,69±4,53 mm frente a 101,65±4,00mm). No hubo diferencias significativas en la amplitud del bimastoide con la edad. Para la determinación del sexo, las mediciones morfométricas del diámetro bimastoide aseguraron una alta tasa de dimorfismo en la subpoblación turca. El análisis morfométrico CBCT puede ser confiable y conveniente para evaluar el sexo y puede recomendarse para comparar datos poblacionales.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Tomografía Computarizada de Haz Cónico , Apófisis Mastoides/anatomía & histología , Determinación de la Edad por el Esqueleto , Determinación del Sexo por el Esqueleto
14.
World Neurosurg ; 157: e364-e373, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34673238

RESUMEN

BACKGROUND: Occipital artery (OA)-posterior inferior cerebellar artery (PICA) bypass is a challenging procedure and is not frequently performed owing to the difficulty of OA harvest. To facilitate harvest, the intersection between the sternocleidomastoid and splenius capitis (the OA triangle) is used as the anatomical landmark to identify the OA segment that carries the highest risk of damage. This clinical study aimed to demonstrate efficacy and safety of OA harvest using this landmark. METHODS: The study included 18 patients who underwent OA harvest using the OA triangle as a landmark for treatment of vertebral artery and PICA aneurysms. Patients were retrospectively evaluated for safety and patency of OA after harvest and OA-PICA bypass. RESULTS: Of 18 patients with ruptured and unruptured vertebral artery and PICA aneurysms, 13 (72.2%) underwent OA-PICA bypass and 5 (27.8%) did not undergo bypass. The OA was completely harvested without damage in all patients. After harvest, the OA was patent in 17 patients (94.4%) and was occluded in 1 patient owing to vasospasm; this patient then underwent recanalization resulting in good patency of the OA-PICA bypass. The patency rate of the OA-PICA bypass was 100%. CONCLUSIONS: The OA triangle, which is the anatomical landmark of the proximal end of the transitional segment of the OA, facilitated OA harvest using the distal-to-proximal harvest technique with safety and good patency. To the best of our knowledge, this is the first study of OA harvest in clinical cases.


Asunto(s)
Puntos Anatómicos de Referencia/cirugía , Aneurisma Intracraneal/cirugía , Apófisis Mastoides/cirugía , Músculos Paraespinales/cirugía , Esternón/cirugía , Arteria Vertebral/cirugía , Adulto , Anciano , Puntos Anatómicos de Referencia/anatomía & histología , Revascularización Cerebral/métodos , Femenino , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Masculino , Apófisis Mastoides/anatomía & histología , Persona de Mediana Edad , Posicionamiento del Paciente/métodos , Estudios Retrospectivos , Esternón/anatomía & histología , Cirugía Asistida por Video/métodos
15.
Acta Otolaryngol ; 141(8): 742-748, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34380359

RESUMEN

BACKGROUND: Predicting the prognosis of early-onset otitis media with effusion (OME) in children is difficult. OBJECTIVES: To investigate the prognostic factors of OME in children undergoing tympanostomy at 1 year of age. MATERIAL AND METHODS: We examined 66 children (123 ears) followed up to 6 years of age. OME prognosis was determined by a history of re-tympanostomy at the last examination. We retrospectively analysed the prognostic factors based on the duration of first ventilation tube (VT) placed, history of otorrhea, asthma, adenoidectomy, and mastoid air cell system (MACS) size at 1 year before tympanostomy and at 3 years. RESULTS: While 25 ears underwent re-tympanostomy (group 1), 98 did not (group 2). The mean duration of VT placed was 21 months and 25, and the mean MACS size at 3 years was 314 mm2 and 441, respectively, in the corresponding groups. MACS size at 3 years was significantly smaller in group 1 than in group 2. The combination of MACS size at 3 years and duration of VT placed showed the best value of area under the curve. CONCLUSION AND SIGNIFICANCE: The most probable prognostic factor was the combination of the MACS size at 3 years and duration of VT placed.


Asunto(s)
Apófisis Mastoides/anatomía & histología , Ventilación del Oído Medio , Otitis Media con Derrame/cirugía , Edad de Inicio , Área Bajo la Curva , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Modelos Logísticos , Masculino , Pronóstico , Curva ROC , Reoperación/estadística & datos numéricos , Estudios Retrospectivos , Factores de Riesgo , Factores de Tiempo
16.
Int. j. morphol ; 39(4): 1068-1073, ago. 2021. ilus, tab, graf
Artículo en Inglés | LILACS | ID: biblio-1385462

RESUMEN

SUMMARY: Human identification involving mutilation, advanced decomposition, and skeletonized materials is a challenge for professionals in forensic medicine and dentistry. This study was aimed at a morphometric analysis of the mastoid and bimastoid triangles to determine sex in a Brazilian population. The sample included 80 human skulls (34 females and 46 males; age: 18 to 60 years) from individuals with death certificates. Linear measurements (mm) of the mastoid process - right (n=3) and left (n=3) - and the opisthion- bimastoid (n=3) triangles were taken (digital caliper) by two previously trained researchers. Three cranial points - asterion, porion and process - were determined for the right and left mastoid triangle and three others - (1) opisthion and (2) right and (3) left mastoid - for the bimastoid triangle. Heron's formula was used to calculate the area of the triangles assessed. Data were submitted to the Shapiro- Wilk normality test, followed by the unpaired Student's t test or the Mann-Whitney U test, depending on the data distribution verified in the normality test (GraphPad Prism 5.01; p<0.05). The ROC curve was used to measure the accuracy of the variables toward sex determination. The opisthion-bimastoid triangle showed high accuracy and significant differences in all the variables assessed and thus was considered a potential element for sex determination in the Brazilian population assessed.


RESUMEN: La identificación humana que comprende la mutilación, descomposición avanzada y materiales esqueletizados, es un desafío para los profesionales de la medicina forense y de la odontología. Este estudio tuvo como objetivo un análisis morfométrico de los triángulos mastoideo y bimastoideo para determinar el sexo en una población brasileña. La muestra incluyó 80 cráneos humanos (34 mujeres y 46 hombres; edad: 18 a 60 años) de sujetos con certificado de defunción. Se tomaron las medidas lineales (mm) del proceso mastoides - derecha (n = 3) e izquierda (n = 3) - y los triángulos opistion-bimastoide (n = 3) (caliper digital) por dos investigadores previamente entrenados. Se determinaron tres puntos craneales - asterion, porion y proceso mastoides - para el triángulo mastoideo derecho e izquierdo y otros tres - (1) opistion y (2) proceso mastoides derecho e izquierdo - para el triángulo bimastoideo. Se utilizó la fórmula de Heron para calcular el área de los triángulos evaluados. Los datos se analizaron con la prueba de normalidad de Shapiro-Wilk, seguida de la prueba t de Student para datos no apareados o la prueba U de Mann-Whitney, según la distribución de datos verificada en la prueba de normalidad (GraphPad Prism 5.01; p <0.05). La curva ROC se utilizó para medir la precisión de las variables hacia la determinación del sexo. El triángulo opistion-bimastoide mostró una alta precisión y diferencias significativas en todas las variables evaluadas, por lo que se consideró un elemento probable para la determinación del sexo en la población brasileña evaluada.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Cefalometría , Determinación del Sexo por el Esqueleto , Apófisis Mastoides/anatomía & histología , Brasil , Caracteres Sexuales , Medicina Legal
17.
Homo ; 72(2): 113-127, 2021 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-33846705

RESUMEN

3D analysis of skeletal volumes has become an important field in digital anthropology studies. The volume of the mastoid process has been proposed to display significant sexual dimorphism, but it has a complex shape and to date no study has quantified the full mastoid volume for sex estimation purposes. In this study we compared three different ways to isolate the volume of the mastoid process from digital 3D models of dry crania, and then evaluated the performance of the three different volume definitions for sex estimation purposes. A total of 170 crania (86 male, 84 females) excavated from five medieval Croatian sites were CT-scanned and used to produce 3D stereolitographic models. The three different isolation techniques were based on various anatomical landmarks and planes, as well as the anatomy of the mastoid process itself. Measurements of the three different mastoid volumes yielded different accuracies and precisions. Interestingly, anatomical structures were sometimes more useful than classical landmarks as demarcators of mastoid volume. For all three volume definitions, male mastoid volumes were significantly larger than female volumes, in both relative and absolute numbers. Sex estimation based on mastoid volume showed a slightly higher precision and better accuracy (71% correct classifications) than visual scoring techniques (67%) and linear distance measurements (69%) of the mastoid process. Sex estimation based on cranial size performed even better (78%), and multifactorial analysis (cranium size + mastoid volume) reached up to 81% accuracy. These results show that measurements of the mastoid volume represent a promising metric to be used in multifactorial approaches for sex estimation of human remains.


Asunto(s)
Apófisis Mastoides , Determinación del Sexo por el Esqueleto , Croacia , Femenino , Antropología Forense , Humanos , Masculino , Apófisis Mastoides/anatomía & histología , Apófisis Mastoides/diagnóstico por imagen , Caracteres Sexuales , Cráneo/anatomía & histología , Cráneo/diagnóstico por imagen
18.
World Neurosurg ; 147: 257-267, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33685030

RESUMEN

There are many approaches to the cerebellopontine angle, all of which involve different degrees of disruption of the normal anatomy. The retromastoid craniotomy has stood the test of time for the efficiency, panoramic exposure, and flexibility it provides while allowing excellent control over the vital cerebrovascular structures including the brainstem. This approach allows the surgeon not to get distracted by how to get there but instead to focus on what to do when he or she is there. Herein, I discuss the nuances of this simple approach with its "extended" variations.


Asunto(s)
Ángulo Pontocerebeloso/cirugía , Craneotomía/métodos , Ángulo Pontocerebeloso/anatomía & histología , Potenciales Evocados Auditivos del Tronco Encefálico , Humanos , Monitorización Neurofisiológica Intraoperatoria , Apófisis Mastoides/anatomía & histología
19.
Surg Radiol Anat ; 43(6): 909-915, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33459837

RESUMEN

OBJECTIVE: The main objective of this study was to define and verify anatomo-sonographic landmarks for ultrasound-guided injection of botulinum toxin into the longissimus capitis (LC) and splenius cervicis (SC) muscles. METHODS AND RESULTS: After a preliminary work of anatomical description of the LC and SC muscles, we identified these muscles on two cadavers and then on a healthy volunteer using ultrasound and magnetic resonance imaging (MRI) to establish a radio-anatomical correlation. We defined an anatomo-sonographic landmark for the injection of each of these muscles. The correct positioning of vascular glue into the LC muscle and a metal clip into the SC muscle of a fresh cadaver as verified by dissection confirmed the utility of the selected landmarks. DISCUSSION: For the LC muscle, the intramuscular tendon of the cranial part of the muscle appears to be a reliable anatomical landmark. The ultrasound-guided injection can be performed within the cranial portion of the muscle, between the intra-muscular tendon and insertion into the mastoid process at dens of the axis level. For the SC muscle, the surface topographic landmarks of the spinous processes of the C4-C5 vertebrae and the muscle body of the levator scapulae muscle seem to be reliable landmarks. From these, the ultrasound-guided injection can be carried out laterally by transfixing the body of the levator scapulae. CONCLUSION: The study defined two cervical anatomo-sonographic landmarks for injecting the LC and SC muscles.


Asunto(s)
Puntos Anatómicos de Referencia , Toxinas Botulínicas/administración & dosificación , Músculos del Cuello/inervación , Músculos Paraespinales/inervación , Tortícolis/tratamiento farmacológico , Anciano , Cadáver , Vértebras Cervicales , Femenino , Voluntarios Sanos , Humanos , Inyecciones Intramusculares/métodos , Masculino , Apófisis Mastoides/anatomía & histología , Apófisis Mastoides/diagnóstico por imagen , Músculos del Cuello/diagnóstico por imagen , Músculos del Cuello/efectos de los fármacos , Músculos Paraespinales/diagnóstico por imagen , Músculos Paraespinales/efectos de los fármacos , Tendones/anatomía & histología , Tendones/diagnóstico por imagen , Ultrasonografía Intervencional , Adulto Joven
20.
Auris Nasus Larynx ; 48(5): 841-845, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33468351

RESUMEN

OBJECTIVE: Körner's septum is a dense bony lamina dividing the mastoid cavity into superficial squamous and deeper petrosal portions at the level of antrum. In this study, we aimed at investigating the association of the Körner's septum with the length of the Cog process and the volume of anterior epitympanic recess (AER), using the 3-dimensional reconstruction models based on high resolution computed tomography sections of the temporal bone. METHODS: Using OsiriX software for MacOS (version 3.8.1, Pixmeo), we measured the volumes from three- dimensional models of anterior epitympanic recess. Anterior epitympanic recess volumes and Cog process lengths of the temporal bones with and without Körner's septum were compared. RESULTS: Cog process length was significantly higher, and AER volume was significantly lower in patients with Körner's septum compared to the patients without. (p < 0.001). Additionally, Cog process length was significantly (p = 0.008), negatively, but weakly (rho= -0.24) correlated with AER volume. CONCLUSION: Temporal bones with Körner's septum had a longer Cog process and a smaller AER.


Asunto(s)
Variación Anatómica , Apófisis Mastoides/diagnóstico por imagen , Adolescente , Adulto , Estudios de Casos y Controles , Oído Medio/anatomía & histología , Oído Medio/diagnóstico por imagen , Femenino , Humanos , Imagenología Tridimensional , Masculino , Apófisis Mastoides/anatomía & histología , Apófisis Mastoides/patología , Persona de Mediana Edad , Tamaño de los Órganos , Hueso Temporal/anatomía & histología , Hueso Temporal/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto Joven
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