Comparison of craniometric measurements of New Zealand rabbit (Oryctolagus cuniculus L.) using three-dimensional scanner with digital calliper measurements: A methodological study.

As technology has developed in recent years, the use of three-dimensional (3D) scanners and printers has become widespread in the medical field. However, since this field is new, all kinds of methodological and experimental related studies gain importance. This study aimed to identify the differences between the calliper measurements by determining the craniometric data on the models constructed by scanning the crania of New Zealand Rabbits (Oryctolagus cuniculus L.), preferred as experimental animals, with a three-dimensional scanner. Therefore, a total of 12 New Zealand rabbits including 6 females and 6 males were used. After the crania that comprised the study material were macerated, they were subjected to 3D scanning. After the scanning process was completed, they were craniometrically measured both on the scanned models and by using a digital calliper. Analysis of the craniometric data of the 3D scanner showed that there was a difference between sexes at the level of p < 0.05 in widest length between the external acoustic meatus (WLBEAM), skull width and Foramen magnum height (FMH) parameters and cranial index data, and at the level of p < 0.001 in the largest nasal width (LNW) parameter. A statistical difference was found between sexes in frontal length, WLBEAM, LNW and FMH parameters and cranial index values in craniometric data collected with the digital calliper (p < 0.05). Consequently, the data collected in this study were found to be close to each other in both methods, suggesting that the 3D scanner may be used in morphometric studies.

Orbital shape in sheep and goats with sex and breed factors.

The purpose of this study was to identify the dimorphic structures of the orbita based on breed and sex factors through shape analysis across species. Additionally, the study aimed to ascertain the variability between the two species. A total of 86 (51 sheep-Akkaraman [Ak] and Morkaraman [Mk], 35 goats-Hair [Hr] and Honamli [Hm]) skulls were used in the study. It was decided to designate 36 landmarks to represent the orbit's edge. In the principal component analysis, 68 PCs were calculated. It was determined that PC1, PC2 and PC3 explained the total variance in morphology by 26.909%, 16.147% and 13.616%, respectively. According to the cross-validation results, the goats were grouped with 95% (Hm: 100%, Hr: 90%), while the sheep were grouped with 56% (Ak: 50%, Mk: 63%). Therefore, dimorphism among goat breeds on orbita shape was more pronounced compared to sheep. In the discriminant function analysis of the sex groups, Procrustes and Mahalanobis distance values in goats were 0.04425425 (p < 0.0001) and 5.3733 (p = 0.9550), in sheep 0.03513424 (p < 0.0001) and 7.1003 (p = 0.9414), respectively, was detected. According to the cross-validation results, in terms of sex, goats were correctly grouped at a rate of 74% (F: 73%; M: 75%) and sheep breeds were correctly grouped at a rate of 72% (F: 77%; M: 66%). Factors such as habitat selection, breeding behaviours and ecological environment may show anatomical differences within breeds as well as between breeds. Therefore, various measurement techniques are used to reveal these differences. As a result, it is thought that the study will contribute to many disciplines, especially taxonomy and zooarchaeology, by analysing the shape of the orbita of sheep and goat breeds, the domestication of which dates back to ancient times, and revealing the similarities and differences between species and according to sex.

Osteometric and topographic measurement of the skull and mandible of Siirt colored Mohair goat with three-dimensional (3D) modeling technique.

Siirt-colored Mohair goat is one of the breeds that contributed significantly to the existence of Mohair goats reared in Turkey. Morphological and morphometric characteristics of the Siirt-colored Mohair goat remained vague owing to a lack of studies. Recent advances in high-tech imaging have replaced conventional two-dimensional anatomical structures with three-dimensional (3D) models. In our study, morphometric features were determined by 3D modeling from computed tomography images obtained from the skull and mandibular bones of Siirt-colored Mohair goats. For this purpose, the skulls and mandibular bones of 20 Siirt-colored Mohair goats (10 females and 10 males) were used. The images were reconstructed with the help of a particular software program. The craniometric data were analyzed in terms of sexual dimorphism, and statistically significant difference was found in the A5, A18, and A31 measurement parameters (P<0.05) and Skull index (P<0.01) parameters. In the mandible measurements, there was a statistically significant difference between the sexes in C5, C10 measurement points (P<0.05), C2, C8, C12, C18, C21 measurement points (P<0.001) and surface area parameter (P<0.01). The morphometric data obtained is a resource in the fields of zoo archaeology, anatomy, forensics, anesthesia, surgery, and treatment.

Commensal Microbiota Effects on Craniofacial Skeletal Growth and Morphology.

Microbes colonize anatomical sites in health to form commensal microbial communities (e.g., commensal gut microbiota, commensal skin microbiota, commensal oral microbiota). Commensal microbiota has indirect effects on host growth and maturation through interactions with the host immune system. The commensal microbiota was recently introduced as a novel regulator of skeletal growth and morphology at noncraniofacial sites. Further, we and others have shown that commensal gut microbes, such as segmented filamentous bacteria (SFB), contribute to noncraniofacial skeletal growth and maturation. However, commensal microbiota effects on craniofacial skeletal growth and morphology are unclear. To determine the commensal microbiota's role in craniofacial skeletal growth and morphology, we performed craniometric and bone mineral density analyses on skulls from 9-week-old female C57BL/6T germ-free (GF) mice (no microbes), excluded-flora (EF) specific-pathogen-free mice (commensal microbiota), and murine-pathogen-free (MPF) specific-pathogen-free mice (commensal microbiota with SFB). Investigations comparing EF and GF mice revealed that commensal microbiota impacted the size and shape of the craniofacial skeleton. EF versus GF mice exhibited an elongated gross skull length. Cranial bone length analyses normalized to skull length showed that EF versus GF mice had enhanced frontal bone length and reduced cranial base length. The shortened cranial base in EF mice was attributed to decreased presphenoid, basisphenoid, and basioccipital bone lengths. Investigations comparing MPF mice and EF mice demonstrated that commensal gut microbes played a role in craniofacial skeletal morphology. Cranial bone length analyses normalized to skull length showed that MPF versus EF mice had reduced frontal bone length and increased cranial base length. The elongated cranial base in MPF mice was due to enhanced presphenoid bone length. This work, which introduces the commensal microbiota as a contributor to craniofacial skeletal growth, underscores that noninvasive interventions in the gut microbiome could potentially be employed to modify craniofacial skeletal morphology. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Skull variation in different breeds sheep from Balkan countries.

The Balkan Peninsula region has a very diverse agricultural and livestock tradition, and almost every country has its own local breed of sheep. Different breeds of sheep and different breeding traditions, despite the small geographical distance, determine the morphological and morphometric variability among animal breeds. In this study, this morphological diversity among the skulls of sheep breeds of some countries in the Balkan region was examined by the geometric morphometric method. 2D images of 86 sheep skulls from five different countries were analyzed from the dorsal view.Sixteen landmarks were used. The Bardhoka and the Ivesi breed have the broadest distributions of skull shape amongst the sheep breeds. The Ruda sheep is the most morphologically conservative. The sheep from Turkey (Ivesi) and Kosovo (Bardhoka) seem to differ mainly from sheep from other Balkan countries. Bardhoka and Ruda differ most from each other (p < 0.0001). The next biggest differences were between Ivesi and Ruda (p < 0.0011) and between Bardhoka and Sharri sheep (p < 0.0016). The sheep breeds Dubska and Lara e Polisit differ the least from each other. Geometrics morphometric analysis is a useful tool to detect differences in the shape of the skull of different sheep breeds and can therefore be used successfully for taxonomic purposes.

Methods of forensic facial reconstruction and human identification: historical background, significance, and limitations.

Facial reconstruction is the most frequently used method for human identification in forensic examinations. It is a complex and time-consuming technique and an actively growing field with a wide array of applications. The methods of forensic facial reconstruction are helpful in those cases where other methods of identification are not applicable. Identification of the dead is always a challenging task for forensic teams in cases involving terrorists' attacks and mass disasters where the corpses are fragmented, decomposed, and skeletonized. In such cases, only the skeletal remains and few other clues are available to establish the identity of a person. The progress of facial reconstruction was initiated in the nineteenth century, reconstructing the facial profiles of some famous and rich people. Various novel techniques for facial reconstruction have been devised in the recent past. We conducted literature search, using databases PubMed, Scopus, Web of Science, and ScienceDirect for analyzing different methods developed and practiced till date for human facial reconstruction. We outline the brief history along with a discussion regarding the different methods of forensic facial reconstruction and their limitations. We also discuss future recommendations and preferences for further research in the field of forensic facial reconstruction and human identification.

Evaluation of the normal craniocervical junction craniometry in 137 asymptomatic patients / Evaluación de la craneometría de la unión craneocervical normal en 137 pacientes asintomáticos

SUMMARY: To our best knowledge, most of the craniometric studies on the normal craniocervical junction (CCJ), are still poorly studied and based on measurements taken from plain radiographs. In this study, the authors conducted a craniometric evaluation of the CCJ in a population without known CCJ abnormalities. The purpose of the study was to assess the normal CCJ craniometry based on measures obtained from CT scans. The authors examined 137 consecutive CCJ CT scans obtained in patients evaluated at their hospital for treatment of non-CCJ conditions between 2018 and 2019. Twelve craniometrical dimensions were conducted, including the relation of the odontoid with the cranial base, the atlantodental interval (ADI), the clivus length, and the clivus-canal angle (CCA).

Hasta donde sabemos, aun son escasos y pocos los estudios craneométricos respecto a la unión craneocervical normal (UCCN) y estos se basan en mediciones tomadas de radiografías simples. En este estudio, realizamos una evaluación craneométrica de la UCCN en una población sin anomalías conocidas. El propósito del estudio fue evaluar la craneometría UCCN normal en función de las medidas obtenidas de las tomografías computarizadas. Los autores examinaron 137 tomografías computarizadas UCCN consecutivas obtenidas en pacientes evaluados en su hospital para el tratamiento de condiciones no UCCN entre los años 2018 y 2019. Se realizaron doce dimensiones craneométricas, incluida la relación del proceso odontoides con la base del cráneo, el intervalo atlantodental (ADI), la longitud del clivus y el ángulo clivus-canal (CCA).

Ancestry estimation in forensic anthropology: accuracy of the AncesTrees software in a Brazilian sample.

The objective of this study is to analyze the accuracy and applicability of the AncesTrees software with respect to a set of cranial measurements of a Brazilian sample consisting of 114 identified skulls from two osteological collections, predominantly composed of European (n = 59), African (n = 35), and admixed individuals (n = 20). Twenty-four different craniometric measurements are performed and input to AncesTrees via two algorithms, one of which is used in three configurations, with different ancestral groups integrated in the model. The software exhibits superior performance in the estimation of European individuals, reaching 73% accuracy, compared with 66% in the African individuals. Those individuals classified as admixed produce a variety of ancestral classifications, mainly European. Overall, the most accurate combination of AncesTrees is obtained using ancestralForest with only the European and African groups integrated into the algorithm, where the accuracy reaches 70%. The applicability of this software to a specific population is fragile because of the high admixing load, making it necessary to create a more representative anthropometric database of the Brazilian people. Key points: Ancestry estimation methods are seldom validated in Brazil.AncesTrees performed poorly on our sample, with a maximum accuracy of 70%.Brazil's highly mixed population hinders ancestry estimation.Mixed individuals (pardos) are predominantly classified as Europeans.The insertion of Brazilian metric data into the AncesTrees database would produce better results.

Correlation between facial measurements and vertical dimension of occlusion among Tunisian populations: An anthropometric study.

Background. Establishing an accurate occlusal vertical dimension (OVD) is a crucial clinical step during full-mouth rehabilitation. Various techniques have been suggested to evaluate OVD, but none of them is practically reliable, and each one has its shortcomings. The correlation between facial proportions and the lower third of the face is a reliable method but needs to be verified in many ethnic groups. Therefore, this study aimed to determine the correlation between OVD and various facial measurements in a Tunisian ethnic group. Methods. A cross-sectional study was conducted between November 2020 to January 2021. The participants were randomly selected from dental students, dental surgeons, and the patients referring to the University Dental Clinic for dental treatments. Seven facial measurements were clinically recorded using a digital caliper. The correlation between OVD and facial measurements was analyzed using Spearman's coefficient and linear regression analysis. Results. A total of 201 dentate participants (134 females and 67 males) were included in the study. The mean OVD in male subjects was higher (67.60±4.49) compared to female subjects (60.72±3.84). The total facial height was positively correlated with OVD in both genders. OVD was statistically correlated with the height of the upper lip. This correlation was highly significant in males while it was weak in the female group. Conclusion. Facial proportions and linear equations are non-invasive, simple, and reliable methods to predict OVD, especially in males.

An endoscope-assisted craniometric cadaveric study for the brain stem and the cisternal segment of the trochlear nerve.

Background and purpose: This study analyzed the relationship of trochlear nerve with neurovascular structures using craniometric measurements. The study was aimed to understand the course of trochlear nerve and minimize the risk of injury during surgical procedures. Methods: Twenty trochlear nerves of 10 fresh cadavers were studied bilaterally using endoscopic assistance through the view afforded by the lateral infratentorial-supracerebellar, and the combined presigmoid-subtemporal transtentorial approaches. Trochlear nerves were exposed bilaterally taking seven parameters into consideration: the distance between the cisternal segment of trochlear nerve and vascular structures (superior cerebellar artery/SCA; posterior cerebral artery/PCA), the origin of the trochlear nerve in the brain stem, the angle in the level of tentorial junction, length, diameter, and length of nerve in the cisternal segment. Results: We identified the brain stem and cisternal segments of the trochlear nerve. The lateral infratentorial supracerebellar approach allowed the exposure of the cisternal segments (crural and ambient cisterns), including the origin of the nerve in the brain stem. The combined presigmoid-subtemporal transtentorial approaches provided visualization of the cisternal segment of the nerve and the free edge of the tentorium. In this study, the mean length and width of the trochlear nerve in the cisternal segment were 30.3 and 0.74 mm, respectively. Length of the trochlear nerve from its origin to its dural entrance was 37.2 mm, tentorial dural entrance angle of the trochlear nerve and exit angle of the trochlear nerve from the brain stem were 127.0 degrees and 54 degrees, PCA to trochlear nerve in mid ambient cistern and SCA to trochlear nerve in mid ambient cistern were 7.3 mm and 6.8mm. Conclusion: Trochlear nerve is vulnerable to injury during the surgical procedures. Therefore, it is necessary to have a sufficient knowledge of the anatomy of cisternal segment and its relationship with adjacent neurovascular structures. The anatomical and craniometric data can be helpful in middle and posterior fossa surgery in minimizing the potential injury of the trochlear nerve.

Phrenology's frontal sinus problem: An insurmountable obstruction?

Whereas some of Gall's critics were quick to assail his organology as materialistic and fatalistic, others questioned his methods and scientific assumptions, especially his craniological tenets. The idea that the skull does not faithfully reflect the features of small, underlying brain areas was repeatedly brought up in the scientific debates. Critics pointed to the frontal sinuses above the eye orbits as evidence for the interior and exterior plates of the cranium not being in parallel-hence, for several or many phrenological organs being unknowable. This article traces the origins of the frontal sinus arguments and how Gall, Spurzheim, and later phrenologists responded to it. It reveals how the two sides fought and remained divided about the significance of the sinuses throughout the nineteenth century-that is, on whether the frontal sinus "problem" was an insurmountable obstacle or one that was merely an inconvenience.

Golden ratio for the foramen magnum on CT images: a morphological and morphometrical study / Proporción áurea para el foramen magnum en imágenes de TC: un estudio morfológico y morfométrico

SUMMARY: The foramen magnum (FM) is a transition zone between the spine and skull. There is a study in the literature showing the golden ratio (4.62) and harmony between both FM and the anteroposterior and transverse diameters of the skull. The aim of this study is to examine the existence of this ratio on CT images and to investigate whether this ratio changes according to the FM shape types. In this study, 402 adult CT images belonging to the Turkish population were examined. Maximum cranial length (MCL), maximum cranial width (MCW) and the FM length (FML) and FM width (FMW) were measured. The different shapes of the FM were macroscopically classified. The number and incidence of each type in the studied skull was registered. In the 402 CT images used in the study, 12 FM shapes were detected. Three of the shape types observed in our study have not been reported in the literature until now, and were found in our study for the first time. In addition, our data supported that by using the ratio of 4.62, there was a great harmony between the skull and FM. The results obtained from the research show that there is a ratio of 4.62 between the basic cranial measurements and FM dimensions in all shapes except triangular shape. It is thought that repeating the calculated coefficients over more different FM shapes will contribute to the effectiveness of the proposed golden ratio.

RESUMEN: El foramen magno (FM) es una zona de transición entre la columna y el cráneo. Existe un estudio en la literatura que muestra la proporción áurea (4,62) y la armonía entre el FM y los diámetros anteroposterior y transversal del cráneo. El objetivo de este estudio fue examinar la existencia de esta relación en las imágenes de TC e investigar si esta relación cambia según los tipos de forma del FM. Se examinaron 402 imágenes de TC de adultos pertenecientes a la población turca. Se midieron la longitud craneal máxima, el ancho craneal máximo y la longitud del FM y la anchura del FM. Las diferentes formas del FM se clasificaron macroscópicamente. Se registró el número e incidencia de cada tipo en el cráneo estudiado. En las 402 imágenes de TC utilizadas en el estudio, se detectaron 12 formas de FM. Tres de los tipos de formas observados en nuestro estudio no se han reportado en la literatura consultada describiéndose por primera vez. Además, nuestros datos respaldaron que al usar la proporción de 4,62, había una armonía importante entre el cráneo y el FM. Los resultados obtenidos de la investigación muestran que existe una relación de 4,62 entre las medidas craneales básicas y las dimensiones de la FM en todas las formas excepto en la triangular. Se cree que la repetición de los coeficientes calculados en más formas de FM diferentes contribuirá a la eficacia de la proporción áurea propuesta.

A study of 285 cases of cranial vault suture closure in Chinese adults.

PURPOSE: To examine the presence and characteristics of cranial vault suture closure in Chinese adults and to explore whether craniosacral therapy (CST) manipulation is rational from the anatomical perspective. METHODS: Anthropological non-metric observation and craniometry were used to study 285 dry skull specimens of Chinese adults. RESULTS: A total of 91 specimens with closed extracranial sutures were observed, with an occurrence rate of 31.93%. Based on the mode of closure, there were 32 cases of single type closure, with sagittal suture closure predominating with 20 cases (21.98%); 59 cases of composite closure, with a partial closure of coronal suture + sagittal suture + lambdoid suture predominating with 26 cases (28.57%). In terms of the degree of closure, there were 13 cases (14.28%) of sagittal suture grade 0 closure and 78 cases (85.72%) of grade 1 - 4 closure; 34 cases (37.36%) of coronal suture grade 0 closure and 57 cases (62.64%) of grade 1 - 4 closure; 47 cases (51.65%) of lambdoid suture grade 0 closure and 44 cases (48.35%) of grade 1 - 4 closure. The segment and degree of coronal suture closure (46, 80.7%) and lambdoid suture (31, 70.45%) were mostly left-right symmetrical. The bone surfaces on either side of the cranial vault sutures are embedded in each other, forming a rough, complex and interlocking bone-suture-bone structure. CONCLUSION: This study observed the closure of the cranial vault suture, summarized its characteristics, and explored the irrationality of the CST manipulation. The anatomical characteristics of the cranial suture dictate that manipulation cannot push the cranial suture at will.

Extracranial guiding structures for navigation to specific topographical sectors of the equine neopallium: an anatomical investigation performing three-dimensional distance measurements in adult warm-blooded horses.

BACKGROUND: This basically anatomical study focuses on two items; firstly, the establishment of a system for the cartographic subdivision of the neopallium; secondly, the topographical correlation of extracranial landmarks and intracranial sites on the neopallium. MATERIALS AND METHODS: The surface of the neopallium was subdivided into 15 sectors with reference to a newly introduced pattern of Primary Sulci. The topographical link between extracranial landmarks and certain intracranial sites (i.e. neopallium sectors) was elaborated by using a simple stereotactic device and a computer-assisted measurement device. Measurements were performed between points on the head's outer surface and on the isolated brain. RESULTS AND CONCLUSIONS: The introduction of an anatomical three-dimensional coordinate system was an essential key issue for this investigation. This setting facilitated the measurements and calculations of the so-called indirect distances that were characterised by their alignment along the three orthogonal axes (x, y, z) of the anatomical coordinate system. The inter-individual comparison (16 adult horses [Equus caballus]) of the indirect distances revealed that each sector centre lay within a distinct morphometric residence area. The measured and calculated data also showed that each sector centre could be assigned to its proper extracranial landmark that - in comparison with other landmarks - was best suited for the optimal allocation of the sector centre point.

Automatic Segmentation of Bone Selective MR Images for Visualization and Craniometry of the Cranial Vault.

RATIONALE AND OBJECTIVES: Solid-state MRI has been shown to provide a radiation-free alternative imaging strategy to CT. However, manual image segmentation to produce bone-selective MR-based 3D renderings is time and labor intensive, thereby acting as a bottleneck in clinical practice. The objective of this study was to evaluate an automatic multi-atlas segmentation pipeline for use on cranial vault images entirely circumventing prior manual intervention, and to assess concordance of craniometric measurements between pipeline produced MRI and CT-based 3D skull renderings. MATERIALS AND METHODS: Dual-RF, dual-echo, 3D UTE pulse sequence MR data were obtained at 3T on 30 healthy subjects along with low-dose CT images between December 2018 to January 2020 for this prospective study. The four-point MRI datasets (two RF pulse widths and two echo times) were combined to produce bone-specific images. CT images were thresholded and manually corrected to segment the cranial vault. CT images were then rigidly registered to MRI using mutual information. The corresponding cranial vault segmentations were then transformed to MRI. The "ground truth" segmentations served as reference for the MR images. Subsequently, an automated multi-atlas pipeline was used to segment the bone-selective images. To compare manually and automatically segmented MR images, the Dice similarity coefficient (DSC) and Hausdorff distance (HD) were computed, and craniometric measurements between CT and automated-pipeline MRI-based segmentations were examined via Lin's concordance coefficient (LCC). RESULTS: Automated segmentation reduced the need for an expert to obtain segmentation. Average DSC was 90.86 ± 1.94%, and average 95th percentile HD was 1.65 ± 0.44 mm between ground truth and automated segmentations. MR-based measurements differed from CT-based measurements by 0.73-1.2 mm on key craniometric measurements. LCC for distances between CT and MR-based landmarks were vertex-basion: 0.906, left-right frontozygomatic suture: 0.780, and glabella-opisthocranium: 0.956 for the three measurements. CONCLUSION: Good agreement between CT and automated MR-based 3D cranial vault renderings has been achieved, thereby eliminating the laborious manual segmentation process. Target applications comprise craniofacial surgery as well as imaging of traumatic injuries and masses involving both bone and soft tissue.

Estudio dimensional de los puntos craneométricos mediosagitales en cráneos de población chilena / Dimensional study of midsagital craneometric points in skulls of Chilean population

RESUMEN: La utilidad de los puntos craneométricos en neurocirugía radica en la estudiada relación que poseen con las estructuras encefálicas y vasculares que subyacen, siendo relevantes al momento de planificar y realizar diversos abordajes y disminuir la morbilidad asociada. A pesar de esto, hasta el momento no se disponen de datos publicados de las distancias de estos puntos craneométricos en población chilena. Se utilizaron 45 cráneos secos de cadáveres adultos. Se realizaron mediciones de las distancias superficiales entre diversos puntos craneométricos mediosagitales. La distancia superficial promedio entre nasion y bregma fue de 12,71 cm; entre bregma y lambda, 12,34 cm; entre lambda e inion, 6,64 cm; entre inion y opistocranio, 5,16 cm; entre lambda y opistocráneo, 3,88 cm y entre inion y opistion, 5,16 cm. Se encontraron diferencias estadísticamente significativas (p<0,05) entre el grupo estudiado con datos obtenidos de la literatura en las distancias nasion-bregma, bregma-lambda, lambda-opistocranio. Las distancias entre los distintos puntos craneométricos en cráneos de población chilena fueron caracterizadas en el presente estudio existiendo algunas diferencias con los datos de la literatura que deben ser considerados en el contexto de la práctica quirúrgica relacionada.

Mastoid and opisthion-bimastoid triangles for sex determination in a Brazilian sample / Triangulos mastoideo y opistión-bimastoideo para la determinación del sexo en una muestra brasileña

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.

Distinguishing craniomorphometric characteristics and severity in metopic synostosis patients.

The decision about which metopic synostosis patients should undergo surgery remains controversial. Multiple measures for radiographic severity have been developed in order to determine the optimal criteria for treatment. The aim of this study was to perform an extensive craniomorphometric analysis of patients who underwent surgery for metopic synostosis to validate and compare the various severity scales developed for this non-syndromic craniosynostosis. A comparative morphometric analysis was performed using computed tomography scans of preoperative metopic synostosis patients (n=167) and normal controls (n=44). Measurements included previous and newly developed metopic severity indices. Volumetric and area analyses were used to determine the degree of anterior cranial area and potential volume restrictions. Of the severity indices measured, the frontal angle, endocranial bifrontal angle (EBF), adjusted EBF (aEBF), anterior cranial fossa angle, horizontal cone angle, and bitemporal/biparietal distance ratio were significantly different in the metopic subjects relative to controls overall. However, metopic index, orbital rim angle, foramen ovale distance, and cranial volume exhibited no significant difference from controls. Only the frontal angle and aEBF correlated with the changes in anterior cranial dimensions observed in metopic synostosis. In conclusion, the frontal angle and aEBF provide the most accurate measures of severity in metopic synostosis.

Combined unilateral coronal-lambdoid suture synostosis: surgical outcome of suturectomy and postoperative helmet therapy.

INTRODUCTION: Nonsyndromic, multi-suture craniosynostosis is not common, especially those involving unilateral coronal and lambdoid sutures. Based on the experience on 6 cases, we analyzed the skull morphology of combined unilateral coronal-lambdoid suture synostosis and evaluated the surgical outcome of suturectomy. METHODS: Patients who underwent an operation for craniosynostosis in Seoul National University Children's Hospital from 2010 to 2018 were reviewed. For qualitative analysis of the surgical outcome, five typical morphologic characteristics (ipsilateral superior orbital rim deviation, deviation of the nasal ridge, ipsilateral frontal flattening, contralateral parietal bulging, ipsilateral occipitomastoid bulging) in unilateral coronal-lambdoid suture synostosis were evaluated based on medical photos, plain skull radiographs, and CT scans. For quantitative analysis, three parameters (nasal root deviation, orbital asymmetry, posterior skull base deviation) were measured. RESULTS: Among 316 patients with craniosynostosis, 41 patients had nonsyndromic, multi-suture synostosis. There were 6 unilateral coronal-lambdoid suture synostosis patients who were all treated with suturectomy. Qualitative evaluation of the postoperative outcome revealed that the nasal root and orbital rim deviations and the contralateral occipitomastoid bulging showed satisfactory improvements. However, ipsilateral frontal flattening and contralateral parietal bulging were improved but still present in most cases. Quantitative, craniometric analysis supported the qualitative outcomes. The nasal ridge deviation angle was corrected from 7.04 to 1.79 degrees. The posterior skull base deviation angle improved from 6.29 to 3.55 degrees. CONCLUSION: Unilateral coronal-lambdoid suture synostosis suturectomy followed by helmet therapy resulted in favorable outcomes, although the correction of frontal flattening was less satisfactory than the other measures. Considering the minimal invasiveness of the treatment, suturectomy may be a viable option for these patients.