Assessment of the Anterior Clinoid Process and Optic Strut in Chiari Malformation Type I: A Computed Tomography Study.

Objective This study aimed to evaluate morphological features of the anterior clinoid process (ACP) and the optic strut (OS) in Chiari malformation Type I (CM-I). Methods The study universe consisted of computed tomography images of 41 CM-I patients and 45 normal subjects. Comparison of the parameters for CM-I and the control group was performed with the Student's t -test. A " p < 0.05" was accepted as the significance level. Results ACP length was smaller in CM-I than the control group ( p < 0.001). In contrast to ACP length, ACP angle ( p < 0.001), OS length ( p = 0.022), and the distance between ACP and OS ( p = 0.020) were found greater in CM-I in comparison to the control group ( p < 0.05). ACP width ( p = 0.233) and OS width ( p = 0.376) were similar in both groups. ACP pneumatization in CM-I group was found as 12.20%, whereas in the control group as 8.90%. Two different types about the pneumatization were identified in CM-I group (Type 1: 4.9% and Type 2: 7.3%), whereas three different types in the control group (Type 1: 3.3%, Type 2: 4.4%, and Type 3: 1.1%). Relative to ACP, three different types about OS position were identified in CM-I group (Type C: 31.70%, Type D: 64.60%, and Type E: 3.70%) and the control group (Type C: 7.80%, Type D: 64.40%, and Type E: 27.80%). Conclusion Shorter ACP, wide-angled ACP, longer OS, and more anteriorly located OS were found in CM-I group compared with the normal group. Our findings showed that the pneumatization of ACP was not affected by CM-I.

Anatomical features of the sphenoid ridge in the pediatric population.

PURPOSE: To describe the relation of the sphenoid ridge (SR) with the surrounding anatomical structures in healthy children when approaching the anterior and middle fossae. METHODS: Computed tomography of 180 pediatric patients (90 males / 90 females), aged 1-18 years were included the study. The size of the lesser wing (LW) and the distances of the LW to certain landmarks were measured. RESULTS: The LW length was 28.48 ± 8.15 mm. The LW widths at the midline and the midpoint and lateral point of the SR were 7.78 ± 1.74 mm, 2.84 ± 0.81 mm, and 1.91 ± 0.64 mm, respectively. The distance between the midpoint of the SR and the crista galli was 28.22 ± 5.56 mm, and the distance between the crista alaris and internal auditory meatus was 51.73 ± 5.79 mm. The linear function was calculated as y = 18.748 + 1.024 × age for SR length, y = 6.046 + 0.182 × age for the midline width of SR, y = 2.367 + 0.050 × age for the midpoint width of SR, y = 1.249 + 0.069 × age for the crista alaris width, y = 21.727 + 0.683 × age for the distance between the SR midpoint and the crista galli, and y = 43.614 + 0.855 × age for the distance between the crista alaris and internal auditory meatus. CONCLUSION: All measured parameters increased irregularly with advancing age. Furthermore, our regression equations representing the growth dynamics of SR may be used to estimate these parameters.

Topographic Anatomy and Pneumatization of the Posterior Clinoid Process in Chiari Type I Malformation.

OBJECTIVE: This study aimed to examine pneumatization and topographic location of the posterior clinoid process (PCP) in Chiari type I malformation (CIM) for skull base approaches. METHODS: Computed tomography images of 52 (23 males/29 females) CIM subjects aged 23.87 ± 16.09 years and 71 (26 males/45 females) healthy subjects aged 42.48 ± 21.48 years constituted the study universe. RESULTS: The distances of PCP to the foramen magnum (P = 0.037), superior orbital fissure (P < 0.001), foramen rotundum (P < 0.001), and foramen ovale (P < 0.001) were smaller, but the distance of PCP to the crista galli (P = 0.038) was greater in CIM patients, compared with normal subjects. In CIM, the fusion between PCP and the anterior clinoid process was observed in 9 sides (8.70%), while in controls it was observed in 12 sides (8.50%). PCP pneumatization was observed in 40 sides (38.50%) in CIM patients, while it was observed in 28 sides (19.70%) in normal subjects. These data displayed that PCP pneumatization was affected by CIM (P < 0.001). CONCLUSIONS: The distances of PCP to the crista galli and foramen magnum indicate the anterior fossa length and the posterior fossa depth, respectively; thus CIM patients have a longer anterior fossa and a shallow posterior fossa. In addition, the distances of PCP to the superior orbital fissure, foramen rotundum, and foramen ovale indicate the middle fossa width; hence CIM patients have less middle fossa width than normal individuals. CIM patients have an approximately 50% higher PCP pneumatization rate, and this may increase the risk of complications such as cerebrospinal fluid fistula during the application of posterior clinoidectomy.

Massa intermedia in adults: incidence, dimension, location and clinical importance.

PURPOSE: This retrospective magnetic resonance imaging investigation aimed to obtain information related to the anatomy of the massa intermedia (MI) in an adult population. METHODS: The work conducted on MRI views of 1058 (539 males and 519 females) healthy adult samples aged with 48.93 ± 17.63 years. Initially, the presence or absence of MI was noted, and then if present, its numbers and location in the third ventricle were recorded. Its horizontal (HDMI) and vertical (VDMI) diameters were measured on MRI views, while the cross-sectional area (CSAMI) was calculated using its diameters. RESULTS: MI was missing in 2.6% (27 cases) of 1058 adult samples. Six subjects (0.6%) had a double MI. HDMI, VDMI and CSAMI were measured as 4.83 ± 1.01 mm, 4.86 ± 0.98 mm, and 19.11 ± 7.23 mm2, respectively. MI size did not show a significant alteration from 19 up to 49 years, but then its size distinctly decreased between 50 and 60 years. After age 60, MI dimension did not display an important change. MI was settled in the antero-superior quadrant in 929 cases (90.63% of 1025 subjects), in the postero-superior quadrant in 22 cases (2.15%), in the antero-inferior quadrant in 32 cases (3.12%), in the postero-inferior quadrant in 8 cases (0.78%), and in the central part in 34 cases (3.32%). CONCLUSIONS: The size, position and incidence of MI were not affected by sex, and its position and incidence were not affected by adult age periods. In adults, MI size demonstrated a significant decrease in the middle age.

Anatomic Features of the Interthalamic Adhesion in the Pediatric Population.

OBJECTIVE: The main goal of this retrospective study was to examine the morphology of the interthalamic adhesion (ITA) in normal children aged between 1 and 18 years. METHODS: The study universe consisted of magnetic resonance images of 180 healthy pediatric subjects (age, 9.50 ± 5.20 years, sex, 90 girls and 90 boys). The cross-sectional area (CSA), vertical diameter (VD), and horizontal diameter (HD) of the ITA were measured and in addition, its location was noted. RESULTS: HD, VD, and CSA of the ITA were measured as 8.47 ± 1.64 mm, 7.59 ± 1.57 mm, and 52.06 ± 18.51 mm2, respectively. HD did not change from infancy until postpubescence, but then significantly decreased (P < 0.001). VD increased up to early childhood but then did not alter until the end of prepubescence. After that period, it decreased in postpubescence (P < 0.001). CSA tended to decrease in an irregular pattern according to pediatric age periods (P < 0.001). The ITA was located at the anterosuperior quadrant in 138 individuals (76.70%), at the anteroinferior quadrant in 7 individuals (3.90%), and the center of the lateral wall of the third ventricle in 35 individuals (19.40%). Linear functions were calculated as y = 9.490-0.107 × age (years) for HD, y = 8.453-0.091 × age (years) for VD, and y = 63.559-1.211 × age (years) for CSA. CONCLUSIONS: ITA size irregularly decreases with advancing age from 1 to 18 years. Our calculated linear functions, showing the growth dynamics of the ITA by pediatric ages, may be helpful in estimating its dimension.

Interthalamic Adhesion: Can it be used to Diagnose Idiopathic Intracranial Hypertension?

OBJECTIVE: This retrospective study aimed at determining the dimension of the interthalamic adhesion (ITA) in patients with the idiopathic intracranial hypertension (IIH) for assisting in preoperative radiologic diagnosis. METHODS: The study universe consisted of magnetic resonance images of 20 patients with IIH (age: 22.70 ± 4.04 years, sex: 14 females and 6 males) and 20 normal subjects (age 22.30± 2.94 years, sex: 14 females and 6 males). To determine the morphology of ITA, its height (vertical diameter) and width (horizontal diameter) were measured on the coronal and axial planes, respectively. RESULTS: The height and width of ITA in IIH were measured as 2.58 ± 0.71 mm (range: 1.40-4.20 mm) and 2.73 ± 0.77 mm (range: 1.70-4.40 mm), respectively. Its height and width in controls were measured as 4.99 ± 1.04 mm (range: 2.70-6.30 mm) and 4.92 ± 1.11 mm (range: 2.60-6.50 mm), respectively. ITA height and width in IIH was significantly smaller compared with controls (P < 0.001). For an arbitrary cutoff of 3.85 mm, the sensitivity of the height of ITA was 85% with 95% specificity. For an arbitrary cutoff of 4.45 mm, the sensitivity of the width of ITA was 75% with 100% specificity. CONCLUSIONS: The height and width of ITA are approximately 50% smaller in IIH than controls; therefore alterations in the dimension of ITA may be a valuable radiologic sign for the diagnosis of IIH.

Analysis of the Prechiasmatic Sulcus in Chiari Malformation Type I.

OBJECTIVE: To assess morphologic features of the prechiasmatic sulcus (PS) in Chiari malformation type I (CM-I). METHODS: Computed tomography images were obtained in patients with CM-1 (mean age: 21.26 ± 16.46 years; sex: 25 females and 17 males) and 58 healthy control subjects (mean age: 28.12 ± 22.60 years; sex: 29 females and 29 males). The following parameters were measured to determine the anatomy of the PS: planum length, sulcal length, sulcal angle (SA), and interoptic distance. Considering sulcal length and SA measurements, 4 types of PS were identified: narrow-steep-groove (NSG), narrow-flat-groove (NFG), wide-steep-groove, and wide-flat-groove. RESULTS: SA was greater in the CM-I group (32.80 ± 18.21°) compared with the control group (23.05 ± 14.53°) (P = 0.004), but the other parameters were similar in both groups. Distribution ranking of PS types was as follows: NFG (31%) > NSG (26.20%) > wide-steep-groove (23.80%) > wide-flat-groove (19%) in the CM-I group; wide-flat-groove (37.90%) > wide-steep-groove (20.70%) = NFG (20.70%) = NSG (20.70%) in the control group. Distribution rate of PS types relative to both groups showed that the classification system was not affected by CM-I (P = 0.226). CONCLUSIONS: SA value was approximately 25% greater in the CM-I group than in the control group; thus, CM-I patients had more vertical groove. The percentage of narrow-type (NSG + NFG) PS in the CM-I group was higher than in the control group.

Sternocleidomastoid Muscle in Fetuses: Classification, Morphometric Analysis, and Clinical Significance.

PURPOSE: This study aimed to examine variations and morphometric properties of the sternocleidomastoid muscle (SCM) in fetuses in terms of infancy and early childhood surgeries. MATERIALS AND METHODS: Neck regions of 27 fetuses (mean age: 23.30±3.40 wk, sex: 11 boys and 16 girls) fixed with 10% formalin were dissected bilaterally. Photographs of the dissected fetuses were taken in the standard position. Morphometric measurements, such as length, width, and angle, were performed on the photographs using the ImageJ software. In addition, the origin and insertion of SCM were detected. Taking into account the studies in the literature, a classification consisting of 10 types associated with the origin of SCM was carried out. RESULTS: No statistically significant difference was observed in the parameters in terms of side and sex ( P >0.05), except from the linear distance between the clavicle and motor point where the accessory nerve enters SCM (20.10±3.76 for male, 17.53±4.05 for female, P =0.022). Two-headed SCM (Type 1) was detected in 42 out of 54 sides. Two-headed clavicular head (Type 2a) was detected on 9 sides, and 3-headed (Type 2b) on 1 side. A 2-headed sternal head (Type 3) was detected on 1 side. A single-headed SCM (Type 5) was also detected on 1 side. CONCLUSION: Knowledge related to variations of the origin and insertion of fetal SCM may be helpful in preventing complications during treatments of pathologies such as congenital muscular torticollis in early period of life. Moreover, the calculated formulas may be useful to estimate the size of SCM in newborns.

Location of the Tympanic Nerve Relative to the Round and Oval Windows.

BACKGROUND: The aim of the study was to measure the distance of the tympanic nerve to the oval window and round window niche in adult cadavers for evaluating its usability as an anatomical landmark during middle ear-related surgeries, including stapedotomy and cochleostomy, and for preventing its iatrogenic damage during surgical practices such as otosclerosis surgery and cochlear implantation. METHODS: The middle ears of 10 adult cadavers aged 74.70 ± 14.56 years were bilaterally dissected with the help of an endoscope and microscope to measure the distance of tympanic nerve to round window niche and oval window. RESULTS: Tympanic nerve was found as 1.60 ± 0.86 mm (range, 0-3.11 mm) and 1.55 ± 0.38 mm (range, 1.04-2.20 mm) away from round window niche and oval window, respectively. In relation to the quantitative values of these 2 distances, neither right-left nor male-female significant differences were determined (P > .05). Tympanic nerve was observed in all temporal bones. In terms of the shape and twigs of tympanic nerve, extreme variations among cadaveric temporal bones were determined. Tympanic nerve-round window niche distance between 0-1 mm was defined as type 1 (20%), between 1 and 2 mm as type 2 (45%), between 2 and 3 mm as type 3 (30%), and between 3 and 4 mm as type 4 (5%). CONCLUSION: Tympanic nerve may be vulnerable at round window niche- or oval window-related surgeries (e.g., cochleostomy).

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.

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.

Arnold Kirkpatrick Henry (1886-1962) and his eponym (Master Knot of Henry): a narrative review.

PURPOSE: The aims of this review were to form a more precise description for Master Knot of Henry (MKH), and to modify classifications related to interconnections between flexor hallucis longus (FHL) and flexor digitorum longus (FDL) for showing all configurations in the literature. METHODS: A literature search was performed in main databases to obtain information related to anatomical definitions and variations of MKH. The search was carried out using the following keywords: "Master Knot of Henry", "Chiasma plantare", "Flexor hallucis longus" and "Flexor digitorum longus". Information extracted from the studies was: sample size, numerical values, classifications, variation types, incidence of types, anatomical definitions of MKH, year of publication, and type of study. RESULTS: This study proposes that MKH should be defined as the intersection territory where FDL crosses over FHL in the plantar foot. The postchiasmatic plantar area located at distal to MKH (the narrow space between MKH and the division of FDL) should be termed as the triangle of Henry. Moreover, the classification systems showing different configurations related to interconnections situated at Henry's triangle were updated as eight types to present all forms in the literature. CONCLUSION: Our definitions may assist in determining the precise anatomical boundaries of MKH, and thus facilitate the use of MKH as a surgical landmark. In addition, our modified classification systems covering all variations in the current literature may be helpful for surgeons and anatomists to understand formations of the triangle of Henry, and the long flexor tendons of the lesser toes.

Ischiofemoral space dimensions for ischiofemoral impingement: is it different in children?

OBJECTIVE: This study intended to analyze alterations in ischiofemoral space (IFS) dimensions in normal children between the ages of 1 and 18 years for the ischiofemoral impingement. MATERIALS AND METHODS: This study retrospectively focused on computed tomography images of 360 hips of 180 (90 boys and 90 girls) pediatric subjects (mean age: 9.50 ± 5.20 years, range: 1-18 years) without any hip disorders to measure IFS, femoral neck angle (FNA), and ischial angle (IA). RESULTS: Mean IFS, FNA, and IA were measured as 14.64 ± 7.24 mm, 34.61 ± 11.47°, and 131.52 ± 4.22°, respectively. IFS increased in children aged between 1 and 18 years, whereas FNA and IA decreased. IFS was similar in infancy and early childhood periods but then increased up to postpubescent period. FNA decreased proportionally from birth, whereas IA decreased in an irregular pattern. Linear functions were detected as y = 3.451 + 1.178 × years for IFS, as y = 48.555 - 1.468 × years for FNA, and as y = 132.535 - 0.107 × years for IA. CONCLUSION: Our findings indicate that IFS tends to increase in size with age during childhood but decreases with further aging. Therefore, age-specific values for IFS, FNA, and IA may be beneficial for clinicians and radiologists for the diagnosis of ischiofemoral impingement.

Cochleo-facial corridor to the vestibule and fundus of the internal auditory canal through oval window: a minimal invasive and cochlea sparing approach.

PURPOSE: This cadaveric work aimed to test the effectiveness of a modified surgical corridor (ExpTSA: expanded transcanal supracochlear approach) developed for anatomic cochlear preservation in selected vestibular schwannoma patients necessitating to perform cochlear implantation for appropriate cases to achieve the best outcome. METHODS: The ears of 10 cadavers (at mean age 75.70 ± 13.75 years, range 45-92 years) were dissected from the external auditory canal (EAC) to the internal auditory canal by ExpTSA under the guidance of a microscope and endoscope. All stages of the surgical process were recorded step by step and evaluated morphometrically. RESULTS: The vestibular base was successfully reached in all ears without damaging the cochlear morphology and facial nerve. The vestibular base was 23.33 ± 2.02 mm away from the entrance (external orifice) and 10.26 ± 1.33 mm from the exit (internal orifice) of EAC. The oval window and vestibular base were measured to be 2.94 ± 1.05 mm and 5.87 ± 1.24 mm deep from the facial nerve, respectively. The normal areas of the oval window, the exit and entrance of EAC were found as 2.90 ± 0.81 mm2, 42.52 ± 13.66 mm2, and 110.73 ± 25.32 mm2, respectively. After ExpTSA procedure, the areas of the oval window (11.04 ± 2.83 mm2), the exit (122.45 ± 20.41 mm2) and entrance (167.49 ± 30.94 mm2) of EAC were expanded approximately 280%, 188%, and 50%, respectively. CONCLUSION: The ExpTSA may be performed for accessing to the vestibule and fundus of IAC for tumor removal of intravestibular schwannoma patients (with or without fundus involvement) with unserviceable hearing, preserving the cochlear morphology.

Development of the Geniculate Ganglion in Human Fetuses.

AIM: To present the quantitative development of the geniculate ganglion (GG) in foetal cadavers. MATERIAL AND METHODS: This study focused on 60 temporal bones of 30 (15 female and 15 male) foetuses aged 18?30 weeks of gestation (mean age, 22.83 ± 3.49 weeks) to measure the length, width and area of the GG. RESULTS: According to gestational weeks and months, the ganglion length (1.21 ± 0.41 mm), width (1.03 ± 0.28 mm) and area (1.24 ± 0.61 mm < sup > 2 < /sup > ) did not change. In terms of sexes or sides, ganglion dimensions were not significantly different. Positive correlation was found between the length and width (p=0.033, r=0.276), between the length and area (p < 0.001, r=0.762) and between the width and area (p < 0.001, r=0.622). Linear functions were calculated for the ganglion area (y=0.355 + 0.039 × weeks), length (y=0.636 + 0.025 × weeks) and width (y=0.634 + 0.017 × weeks). CONCLUSION: The ganglion size did not change in foetal cadavers aged 18?30 weeks of gestation. This finding may be important for anatomists and embryologists in performing morphometric studies and understanding the development of the GG and for neurootologists and neurosurgeons in achieving greater success in skull base surgeries.

Anatomical Evaluation of the Foramen Magnum on Cone-Beam Computed Tomography Images and Review of Literature.

Background and objective The morphology and morphometry of the foramen magnum (FM), which provides a passageway to vital neurological structures that relay information to and from the brain and spinal cord, are significant for many surgical approaches and applications. It was aimed to investigate the morphometric and morphological features of the FM on the cone-beam computed tomography (CBCT) images and to review the literature in detail. Methods CBCT images of 400 individuals (200 males, 200 females, aged between 18 and 65) were evaluated by Planmeca Romexis Viewer. The length, width, perimeter, and area of the FM were examined and samples were classified according to shape. Also, the FM index (FMI) was calculated. Results The mean values of the length, width, and perimeter were found to be 36.75±2.50 mm, 32.55±2.93 mm, and 108.35±7.50 mm, respectively. The area of FM was found to be 941.81±128.26 mm2, 946.83±127.39 mm2, and 895.76±123.50 mm2 with Planmeca Romexis Viewer, Radinsky formula, and Teixeira formula, respectively. All parameters were significantly larger in males than females. There was no correlation between age and these parameters. Also, seven shapes were determined for FM, and the most common shape was oval. FM index was evaluated according to the Martin and Saller classification. It was found that 16.5% of the cases belonged to the narrow, 16% belonged to the medium, and 67.5% to the large FM index. There was no correlation between age and FM index. Conclusion Morphometric and morphological features of the FM located in the craniovertebral junction (CVJ), which is a highly complex area, are variable. Surgical procedures and approaches in this region are essential due to the high mortality rate. For this reason, anatomical structures in these regions should be well known before surgery. The quantitative data presented in this study, which made a detailed literature comparison, may assist in surgical procedures around the FM and the planning of these procedures.

Growth Pattern of the Tympanic Ring in Human Fetuses.

OBJECTIVES: The study aimed to display the growth pattern of the tympanic ring in fetal cadavers of 20-30 weeks of gestation. METHODS: In the study, 32 temporal bones of 16 fetuses (8 males, 8 females) of 24.62 ± 3.44 weeks of gestation were dissected to measure the height (TRH), width (TRW), and perimeter (TRP) of the annulus, and the width (TNW) of the opening part of the annulus at the level of the tympanic notch. RESULTS: The TRH, TRW, TRP, and TNW were measured as 8.25 ± 1.04 mm, 7.64 ± 1.08 mm, 24.93 ± 3.40 mm, and 4.01 ± 0.91 mm, respectively. The parameters were similar at the seventh and eighth months of gestation; therefore, there was no variation from the seventh month. Linear function was calculated as y = 1.328 + 0.281 x weeks (P < .001) for the TRH, y = 1.284 + 0.258 x weeks (P < .001) for the TRW, y = 3.367 + 0.876 x weeks (P < .001) for the TRP, and y = -0.603 + 0.188 x weeks (P < .001) for the TNW. CONCLUSION: The parameters (TRH, TRW, TRP, and TNW) did not alter from the seventh month in utero. The linear functions (which represent the growth pattern of the parameters) of the tympanic ring may be useful for ear professionals to guess the annulus diameters, and to diagnose growth retardation and probable congenital anomalies in utero during sonographic imaging.

Morphological features of the chiasma tendinum and its relation with surface landmarks and pulleys: a cadaveric study.

AIM: Chiasma tendinum (Camper's chiasm) is of great importance in the delicate movements and stability of the fingers and takes place poorly in the literature. This study aims to reveal the morphometric details of the chiasma tendinum in relation with pulleys and other relevant structures. MATERIALS AND METHODS: Palm and 2nd to 5th fingers of 10 (6 male, 4 female) formalin fixed cadavers were used bilaterally. After determining the superficial reference points on the fingers, the skin and the tendon sheath were incised, and then measurements of chiasma tendinum and related tendons were performed. The measurements were analyzed with respect to fingers, genders, and sides. Finally, the types of chiasma tendinum were identified and then grouped as symmetrical, asymmetrical, and pseudo chiasm. RESULTS: Pulley and chiasma tendinum positions were correlated with finger length (p < 0.01). Pulley lengths were significantly less in females. Asymmetrical chiasma tendinum types were found in 45% of the fingers. In most comparisons, values for fifth finger were significantly different than that of other fingers and chiasma tendinum types differed according to fingers and gender. The case of no fiber exchange was observed only in the 5th finger in 15%. CONCLUSION: Findings related to the prediction of location of the pulleys and chiasma tendinum according to the superficial signs, awareness of cases where one of the two arms of the flexor digitorum superficialis is extremely thin and no fiber exchanges that may be risk factors for spontaneous tendon rupture may help provide more accurate approaches in relevant clinical applications.

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.