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Purpose: The aim of this study was to determine the external ear values in Turkish young adults with 2-dimensional photogrammetry., Methods: One hundred males and 100 females aged between 18 and 25 years were included in the study. Individuals were photographed from both sides. Ear length (superaurel-subaurel, spa-sba ), ear width (preaurel-postaurel, pra-pa ), and the angle between the vertical axis of the auricle and the line between spa and sba (ear incline angle, eia ) were measured in these photographs. Also, auricular index ( pra-pa / spa-sba ×100) was calculated., Results: The average values of the spa-sba, pra-pa , eia , and auricular index were found as 65.46±4.68 mm, 37.89±3.61 mm, 19.40±4.83 degrees, and 57.93±4.53 in males and 60.90±5.35 mm, 35.62±3.69 mm, 17.95±4.86 degrees, and 58.65±5.29 in females, respectively. While the values of spa-sba ( P =0.001 for the right side and P =0.001 for the left side), pra-pa ( P =0.001 for the right side and P =0.001 for the left side), and eia ( P =0.024 for the right side and P =0.041 for the left side) were statistically higher for males than females, there was no statistically significant difference between the sex and the auricular index ( P =0.404 for the right side and P =0.955 for the left side). Besides, there was no statistically significant difference between the sides for these 4 parameters ( P =0.760, 0.409, 0.225, and 0.521, respectively)., Conclusion: The authors believe that the results obtained for Turkish young adults can be used as reference values, which can be used in the diagnosis, follow, or surgical treatment of many diseases, forensic procedures, and planning esthetic surgery procedures., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 by Mutaz B. Habal, MD.)

Fossa navicularis (FN) is defined as bony depression that is not always present and is located anterior to the foramen magnum and pharyngeal tubercle on the inferior aspect of the basilar part of the occipital bone. It has been reported that FN can create an infection spread path from the pharynx to the intracranial structures. Therefore, the diagnosis of this variation is important. Although cone beam computed tomography (CBCT) diagnostic accuracy has mostly been verified in detection and quantification particularly on human skulls, there is no study comparing morphometric measurements between direct measurement on the skull and CBCT measurement. The main object of this study is to evaluate the presence of FN on dry bones and CBCT images of the same dry skull and to examine the morphometric and morphological features of this formation. Thirty-two random craniums that were made available for this study that did not have any fractures or deformities of the cranial base were examined. The sagittal diameter, transverse diameter, and depth of the FN was measured both directly on dry skulls and radiologically on CBCT images of dry skull. In addition, the shape of FN (SFN) was determined. FN was detected in 10 (31.25%) of 32 craniums examined with both modalities. It was determined that sagittal diameter of the FN, transverse diameter of the FN, depth of the FN, and the shape of FN did not show a statistically significant difference between the 2 measurements. Unlike the literature, FN was investigated on dry bones both directly and in CBCT images in this study. In contrast to previously thought the FN may be smaller according to this findings, and this small variation can be detected with CBCT images. According to this findings, it can be said that morphometric evaluations on CBCT are accurate and reliable, and CBCT is a safe method for clinical diagnosis and treatment., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 by Mutaz B. Habal, MD.)

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., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 by Mutaz B. Habal, MD.)

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., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 by Mutaz B. Habal, MD.)

Abstract: The lips play an important role in evaluating and recognizing the craniofacial complex and our perception of facial beauty and attractiveness. The aim of this study was to evaluate the anthropometric measurements of the lips of Turkish young adults and to look for sexual dimorphism. Anterior view photographs were taken of 100 females and 100 males who volunteered to participate in the study. Seven landmarks were determined, stomion (st), sublabiale (sl), subnasale (sn), labiale superius (ls), labiale inferius (li), crista philtre (cp), and chelion (ch). Then, using these landmarks, lower lip height (st-sl), upper lip height (sn-st), philtrum length (sn-ls), upper vermilion height (ls-st), lower vermilion height (li-st), cutaneous lower lip height (li-sl), philtrum width (cp-cp), and mouth width (ch-ch) were measured. It was observed that there was a statistical difference between genders in the parameters of st-sl, sn-st, sn-ls, li-sl, and ch-ch (P = 0.001, for these parameters). Besides, using these distances, 6 anthropometric ratios (ls-st/li-st, sn-ls/ls-st, li-sl/li-st, sn-st/st-sl, cp-cp/ch-ch, and ls-li/ch-ch) were calculated. Among the ratios investigated, sn-ls/ls-st, li-sl/li-st, and cp-cp/ch-ch were statistically significantly larger in males compared females (P = 0.012, P = 0.002, and P = 0.001, respectively). We believe that the results obtained in this study regarding lip anthropometry will help determine the standard values that can be used for the Turkish population aged 18 to 25., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 by Mutaz B. Habal, MD.)

Competing Interests: The authors report no conflicts of interest.

Abstract: Although many studies in the literature examine distances and angles about the nose, there are no clear standard values for different races and ethnic groups. The aim of this study is to determine the anthropometric measurement standards related to the external nose in Turkish young adults between the ages of 18 and 25. The subjects participating in this study were 100 female and 100 male volunteers. Six landmarks (nasion, subnasale, pronasale, alar, subalar and maxillofrontale) on the nose were chosen, and these landmarks were identified on the photographs. Then, using these landmarks, a total of seven distances (nose height, dorsum of nose length, distance between the subnasale and pronasale, nose width, right nostril floor width, left nostril floor width and root of nose width) and four angles (nasofrontal, nasofacial, nasomental and nasolabial angles) measurements were made. There were statistically significant differences between gender in nine parameters. One parameter (nasofrontal angle) is higher in females, and seven parameters (nose height, dorsum of nose length, nose width, right nostril floor width, left nostril floor width, root of nose width and nasofacial angle) are higher in males. It is accepted that distances and angles about the nose differ according to race and ethnicity. The authors believe that the results obtained in this study will help determine the standard values that can be used for the Turkish population between the ages of 18 and 25., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 by Mutaz B. Habal, MD.)

Abstract: In the surgical procedures such as osteotomy to be applied to ramus of the mandible, care should be taken not to damage the inferior alveolar nerve (IAN). The safe zone, which is the area above and behind the mandibular foramen (MF), is the ramus of mandible area, where these surgeries can be performed without damaging the inferior alveolar neurovascular bundle. It was aimed to determine the safe zone in the ramus of mandible in the cone-beam computed tomography (CBCT) images of individuals. The CBCT images of 300 Turkish individuals between the ages of 18 to 65 were bilaterally and retrospectively evaluated. Three parameters on the sagittal and two parameters on the axial plane were measured. Additionally, two ratios were calculated which determined the superior and posterior part of the safe zone through the measured parameters. In this study, the safe zone was determined as the area where 55% of the upper part and 49% of the posterior part of the mandibular ramus. Determining the safe zone in surgical procedures to be applied to the ramus of mandible will help protect the neurovascular structures passing through the MF, reduce complications and increase the success rate of the surgical procedure. However, it is seen that there are few studies on this subject in the literature and there are some differences between these studies. The authors think that preoperative CBCT screening will be safer for each patient in the mandibular ramus osteotomies and more studies should be done on different populations to determine standard values., Competing Interests: The authors report no conflict of interest., (Copyright © 2020 by Mutaz B. Habal, MD.)

Abstract: In the literature, most of the craniofacial anthropometric landmarks found on both bones and soft tissue have been clearly defined and widely used. However, it seems that few landmarks such as nasion are generally often set incorrectly. Therefore, in this study, it was aimed to examine the nasion and sellion in the dry bones and to review the definitions of each landmarks. A total of 41 adult skulls, whose nasofrontal region was not deformed and whose age, gender and ethnic origin were not known, were examined. It was found that nasion and sellion are at the same point in 24 of the 41 (58.54%) bones examined, and that in 17 of them (41.46%), sellion is below the nasion. In the bones where the sellion is below the nasion, the average distance between each two landmarks was determined as 4.53 ± 0.95 mm. Consequently, we think that it is not possible to determine nasion in the indirect craniofacial soft tissue analyzes, and it would be better to use sellion as a reference landmark instead of nasion., Competing Interests: The authors report no conflict of interest., (Copyright © 2021 by Mutaz B. Habal, MD.)

Introduction: Crista galli is extremely important in the endoscopic transcribriform approaches and some extradural approaches. Because of its clinical significance, the morphometric properties of crista galli should be well known. In this study, it was aimed to examine the morphometry and the pneumatization incidence of the crista galli in cone beam computed tomography (CBCT) images., Material and Methods: In this retrospective study, the length and width of the crista galli were measured in CBCT images of 300 healthy individuals. Besides, the presence of crista galli pneumatization was examined., Results: The length and width of the crista galli were determined to be as 14.03 ± 2.93 mm and 3.73 ± 1.48 mm, respectively. Pneumatized crista galli was detected in 53 out of 300 individuals (17.67%). There was no statistical difference between the presence of pneumatization and both length and width values of the crista galli (P = 0.876 and P = 0.478, respectively). In addition, no relationship was determined between age and the presence of pneumatization (P = 0.167)., Conclusion: In this study, it is seen that the length (range: 6.00-23.40 mm) and width (range: 1.40-8.00 mm) of crista galli are in a very wide range. Besides, it is seen in the literature that the incidence of crista galli pneumatization is in a very wide range (2.4% to 66.6%). Based on the available data, it will not be possible to determine a specific range of values for crista galli morphometry. Therefore, the authors think that CT imaging is extremely important in preoperative evaluation., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 by Mutaz B. Habal, MD.)

Abstract: This study aims to examine the values of the orbital region in Turkish young adults by the two-dimensional photogrammetry. Anthropometric measurements of the eye and eyelid-related parameters were taken from 100 female and 100 male volunteer Turkish young adults, ranging in age from 18 to 25 years. Endocanthion (en), exocanthion (ex), and pupil (p) were identified on the photograph and the distances between these points were measured with the ImageJ program. The average values of the en-en, ex-en (R), ex-en (L), p-p, and ex-ex were found as 32.92 ± 2.84, 32.48 ± 2.06, 32.22 ± 2.01, 65.32 ± 3.77, and 97.75 ± 5.09 mm, respectively. There were statistically significant differences between the genders in all parameters. Although there are many studies examining these parameters, comprehensive studies are needed in different populations and in many cases. In this study, we believe that the results obtained for Turkish young adults can be used as reference values., Competing Interests: The authors report no conflicts of interest., (Copyright © 2020 by Mutaz B. Habal, MD.)

Abstract: The aim of this study was to evaluate the craniofacial anthropometric measurements of Turkish young adults between the ages of 18 and 25. Anterior view and side profile photographs were taken of 100 females and 100 males who volunteered to participate in the study and had no craniofacial anomalies, history of facial trauma, or history of orofacial surgery. Thirteen landmarks on the face and head were chosen, and these landmarks were identified on the photographs. Then, using these landmarks, a total of 19 distance measurements were made, 16 from the anterior view, and 3 from the side profile. There were statistically significant differences between the sexes in 13 parameters: 2 parameters (t-n and ft-ft) being higher in females and 11 parameters (v-n, v-t, t-gn, sn-gn, n-gn, st-gn, sl-gn, fz-fz, z-z, tr-tr and go-go) being higher in males. Also, 7 facial anthropometric ratios were calculated. There were statistically significant differences between the genders in all ratios. The literature reveals that craniofacial anthropometric measurements have been performed on many different populations and that there are numerous differences between the results of the studies conducted. We are of the opinion that the results obtained in this present study will contribute to the literature by helping to determine the standard values for the Turkish population between the ages of 18 and 25, which can be used in diagnosis, treatment and postoperative evaluation in areas such as forensic science, orthodontics, clinical genetics, maxillofacial surgery, and plastic surgery., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 by Mutaz B. Habal, MD.)

The aim of this study was to observe the course of the marginal mandibular branch of the facial nerve (MMBFN) in relation to the inferior border of the mandible and parotid gland and its relevance to surgical procedures such as rhytidectomy and parotid gland surgery. In this study, 50 specimens were dissected. The relationships between the MMBFN and the inferior border of the mandible were recorded and analyzed. We found that posterior to the facial artery, the MMBFN ran above the inferior border of the mandible in 37 (74%) of the specimens. In 11 (22%) specimens, below the inferior border of the mandible it was divided into two branches at the crossing point with the facial artery. In 2 (4%) specimens the MMBFN divided into two branches at the point of emergence from the parotid gland. There were no statistical differences between the left and right sides, and both sexes. The MMBFN is one of the most vulnerable branches to surgical injury because of its location. For this reason, the surgeons who are willing to operate on this area, especially for the rhytidectomies, should have a true knowledge about the anatomy of this branch.

Unlabelled: Descriptions of superficial anatomic landmarks for the identification of the zygomatic branches of the facial nerve, and their relevance for plastic surgery, are lacking in the literature. This paper provides such a description and discusses its relevance to facial surgery., Materials and Methods: Sixty-six specimens, including the parotid region, from 33 adult cadavers were dissected and studied. All specimens were fixed in formaldehyde, and the superficial tissues were removed and the zygomatic branches of the facial nerve, the parotid gland, the tragus and the lateral palpebral commissure were identified. The vertical and horizontal relationships were recorded and analyzed., Results and Conclusions: A total of 69.7% of the cadavers had two branches, 25.8% had three branches, and 4.5% had a single zygomatic branch. The mean horizontal distance of the zygomatic branch (the most upper one) as it emerged from the anterior border of the parotid gland and the tragus was 30.71 mm, whereas the mean vertical distance of the zygomatic branch from the midpoint between the tragus and the lateral palpebral commissure was 19.29 mm. The branching patterns with the buccal branches were reported. There were no statistical differences between the left and right sides or between the sexes. The zygomatic branches of the facial nerve were always under the oblique line between the tragus and the lateral palpebral commissure and have a close relationship with the buccal branches of the facial nerve under this anatomic landmark. Application of the results in facial surgery is discussed.