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Objective: To report a digital workflow for use and long-term outcome of cranioplasty with a 3D-printed patient-specific Polyetheretherketone (PEEK) implant in a 12-y-old German Shepherd dog after surgical removal of an extensive occipital bone multilobular osteochondrosarcoma (MLO). Study design: Retrospective case report. Animal: A 12-year-old neutered Female German Shepherd dog was presented with facial deformity, blindness, tetraparesis, and ataxia. Magnetic resonance imaging (MRI) and computed tomography (CT) identified a large skull-based mass extending extra-and intracranially with severe compression of the cerebellum and occipital lobes of the cerebrum. Methods: One-stage decompressive craniectomy using virtual surgical planned 3D-printed craniotomy cutting guides and the Misonix BoneScalpel® and reconstruction with a patient-specific 3D-printed PEEK cranial implant. Results: 3D-printed craniectomy cutting guides allowed an adequate fit of the cranial implant to the original skull. Misonix BoneScalpel® allowed performing a safe and extensive craniectomy. Postoperative CT (8  weeks after surgery) confirmed the PEEK cranial implant to be in place and without implant rejection. Clinically, the neurological examination identified only a right-hind limb delay in proprioception 8  weeks postoperatively, which remained unchanged at 18  months after surgery. Adjunctive treatment included metronomic chemotherapy. Eighteen months after surgery the dog passed away for reasons unrelated to the MLO, no implant-related complications were reported. Conclusion: 3D-printed craniectomy cutting guides, patient-specific PEEK cranial implant, and metronomic chemotherapy can lead to a successful longterm outcome in dogs with extensive skull MLO. Clinical significance: PEEK is an alternative biomaterial that can be used successfully for skull reconstruction. [ABSTRACT FROM AUTHOR]

Contrecoup brain injury refers to the classical opposite of the primary impact. Tamil Nadu has the highest rate of road traffic accident in India. Madurai has peak mortality due to accidents in India. Previous studies done on contrecoup head injury had shown patterns of injuries and mechanism of injury. Outcome and management of only occipitofrontal contrecoup head injury has been taken in this study. Mortality in this specific group is very high. Seventy-six patients of this specific head injury were admitted at Government Rajaji Hospital, Madurai. Patients were assessed for Glasgow coma scale (GCS), age, sex, progression of volume, mortality, traumatic brain injury-induced coagulopathy, and pillion rider outcome. Fourteen patients were surgically treated by decompressive craniectomy. Conservative management was done by antiepileptic and antiedema measures. Mostly affected were males (n = 54) followed by females (n = 22). GCS on admission mean value 9. In our study, mortality was 32% with sudden death of three patients due to hypothalamic compression. Hospital stay of the patient was significantly increased with progression of lesion with mean 9 days and p -value less than 0.01. Pillion riders (n = 18) were also affected in our study. Traumatic brain injury-induced coagulopathy (n = 12) was also detected, which was treated by injection tranexamic acid and injection vitamin K, thereby not leading to any death due to coagulopathy with significant p -value less than 0.01. We recommend helmet for both main and pillion rider with strict speeding regulations. [ABSTRACT FROM AUTHOR]

Introduction- A noticeable internal occipital crest is visible on the inside surface of the squamous portion of the occipital bone. It descends and bifurcates around the foramen magnum, enclosing a tiny depression known as the vermian fossa. The single or double occipital sinus is located in the falx cerebelli, which is connected to the crest. The fossa houses the inferior vermis of the cerebellum. A bony ridge that divides the vermian fossa into upper and lower parts might give the structure a somewhat triangular shape. There are not many research that describe the morphometric and morphologic characteristics of vermian fossa. Hence, the present study was done to evaluat the morphological and morphometric parameters of vermian fossa and internal occipital crest in the Indian adult human dry skull. Material and method- This study was a cross-sectional study conducted in department of Anatomy of Government Medical College, Handwara and Government Medical College Srinagar for a period of 9 months i.e. 1st September 2023 to 1st June 2014. A total of 140 bones were analysed. Any injured or pathologically altered skulls and occipital bones were excluded from the study. The vermian fossa were examined for their presence and morphology. Internal occipital crest were also seen for its shape and length. The data were recorded and tabulated in SPSS software version 20 and analysed. Result- In the present study the incidence of vermian fossa was found to be 80% of total skull. Vermian fossa was mainly triangular in shape (71.42% cases), followed by quadrangular (8.03% samples) and atypical (20.53% bones). The mean height and width of vermian fossa was measured to be 9.4±4.12 mm and 8.4±3.82 mm respectively. A sharp internal crest was more observed followed by rounded, widened. Ill-defined internal occipital crest was least observed in the present study. The internal occipital crest was 2.82±0.74 cm in length, measured from the internal occipital protuberance to its bifurcation. From the internal occipital protuberance to the posterior margin of the foramen magnum, the internal occipital crest was 4.25±0.46 cm in length on average. Conclusion- It is important for clinicians and radiologists to accurately understand the morphology, morphometry, and changes of the internal occipital crest and vermian fossa when performing diagnostic and therapeutic procedures. It is necessary to investigate variations in typical anatomical features. For this reason, morphologists and anatomists find this important. [ABSTRACT FROM AUTHOR]

Purpose: The topic of osseous variations of the craniocervical junction is a complex morphological and embryological chapter of human anatomy, with a possible impact on neurogical and vascular functionality in this morphological variable region. Material & methods: An until now undescribed anatomical variation of the exoccipital part of the occipital bone has been observed after maceration at the outer skull base of a West-European 68-year-old male body donor. Results: On both sites of the foramen magnum accessory osseous processes were observed that arise from the jugular process and point towards the lateral margin of the foramen magnum. On the left site this process forms a full arc that bridges the condylar fossa completely. Conclusion: The observed osseous bridge over the condylar fossa has not been reported on before and can be explained by the partial persistence of a primordial vertebra between atlas and occipital bone: the Proatlas. The resulting accessory structure may affect due to its topographic conditions the V3-Segment of the vertebral artery and its accompanying nerves, and thus, play a role in diagnosis and therapy of vascular and/or neurological symptoms of head and neck. [ABSTRACT FROM AUTHOR]

Background: Forensic age estimation is a procedure which utilises many methods to estimate the age of both living and deceased individuals, including those who have died in natural disasters or man-made catastrophes. The pattern and closure of spheno-occipital synchondrosis (SOS) fusion, along with subchondral ossification of the mandibular condyle, can be used to estimate age. Aim and objectives: This study aims to estimate age using computed tomographic (CT) images of spheno-occipital synchondrosis fusion (SOS) and mandibular condylar cortication (MCC), and to correlate these findings with chronological age. Materials and methods: The present study included 435 CT images of individuals aged 10-25 years. SOS fusion was assessed using a four-stage system, and MCC was assessed bilaterally using a three-stage system on the sagittal plane. Data on fusion stages and cortication types were entered along with chronological age, and then statistically analysed. Results: SOS fusion stage 2 occurred at similar age in males (19.82 ± 2.67 years) and females (19.23 ± 2.93 years). Earlier fusion of other stages was observed in females by a mean age of 2 years. MCC was completed 1 year earlier in females, with statistically significant differences (p ≤ 0.001). When comparing cortication types and different fusion stages, only type II cortication showed statistically significant differences compared to different fusion stages (p ≤ 0.001). Conclusion: Mandibular condylar cortication (MCC) and spheno-occipital synchondrosis (SOS) fusion were positively correlated with chronological age, suggesting that these parameters can be used as an adjunct method for age estimation. [ABSTRACT FROM AUTHOR]

Purpose: This aim of this study was to investigate the analgesic efficacy and safety of lesser occipital nerve combined with great auricular nerve block (LOGAB) for craniotomy via a suboccipital retrosigmoid approach. Methods: Patients underwent vestibular schwannoma resection via a suboccipital retrosigmoid approach were randomly assigned to receive ultrasound-guided unilateral LOGAB with 5 ml of 0.5% ropivacaine (LOGAB group) or normal saline (NSB group). Numeric rating scale (NRS) scores at rest and motion were recorded within 48 h after surgery. Mean arterial pressure (MAP), heart rate (HR), opioid consumption and other variables were measured secondly. Results: Among 59 patients who were randomized, 30 patients received ropivacaine, and 29 patients received saline. NRS scores at rest (1.8 ± 0.5 vs. 3.2 ± 0.8, P = 0.002) and at motion (2.2 ± 0.7 vs. 3.2 ± 0.6, P = 0.013) of LOGAB group were lower than those of NSB group within 48 h after surgery. NRS scores of motion were comparable except for 6th and 12th hour (P < 0.05) in the LOGAB group. In LOGAB group, MAP decreased significantly during incision of skin and dura (P < 0.05) and intraoperative opoid consumption was remarkably reduced (P < 0.01). Postoperative remedial analgesia was earlier in the NSB group (P < 0.001). No patients reported any adverse events. Conclusion: Among patients undergoing craniotomy for vestibular schwannoma via a suboccipital retrosigmoid approach, LOGAB may be a promising treatment for perioperative analgesia and has the potential to maintain intraoperative hemodynamic stability. Clinical trial registration number: Chictr.org.cn ChiCTR2000038798. [ABSTRACT FROM AUTHOR]

Simple Summary: Simple Summary: This article focuses on conjoined twins in mammals, the theories that account for their development, their various clinical presentations, and the possible molecular implications of their development. We also present two different cases of monocephalic thoracopagus conjoined twin piglets. In both cases, the piglets also had other congenital malformations. The cases are described using necropsy and computed tomography scanning. Conjoined twins are rare congenital malformations that have been reported in mammals. Two different cases are presented in this study. Case No. 1 features monocephalic, thoracopagus-conjoined twin piglets with anencephaly and palatoschisis of the Pietrain breed, and case No. 2 features monocephalic, thoracopagus conjoined twin piglets with palatoschisis and bifid root tongue of a mixed breed. These cases were examined using post-mortem and computed tomography (CT) examinations. In both cases, the conjoined symmetrical twins had a single head, one neck, and fused thoracic cavities, while the abdominal cavities were separated. Similarly, in both cases, they had four forelimbs and four hindlimbs and duplicated foramen magnum. During CT examination, in case No. 1, severe abnormalities were observed in the skull and vertebral column. In the left twin, occult dysraphism was seen from the C2 vertebra until the end of the vertebral column, and in the right twin, from the C3 vertebra until the end of the state vertebral level. In case No. 2, the oral cavity contained a tongue with a bifid root connected with one hyoid bone, and the soft palate presented a small cleft. During CT examination, the parietal bone and the occipital bones were partially duplicated. This case also presented occult dysraphism, but only in the cervical vertebrae, C1–C6 for the left twin and C1–C5 for the right twin. In both cases, abnormalities of the internal organs were revealed during necropsy. Conjoined twins with multiple congenital anomalies presented here enhance our understanding of the various clinical forms of conjoined cases in veterinary medicine. [ABSTRACT FROM AUTHOR]

There have been archaeological and ethnographic reports of artificially modified crania from all continents. Archaeological excavations at the late fifth millennium BCE cemetery of Tol‐e Chega Sofla, located southwest of the Iranian plateau, also revealed these crania. This paper uses the morphometric approach to study Tol‐e Chega Sofla's modified crania. The outlines of normal and modified crania of Chega Sofla and Khuzestan residents' specimens were considered. How accurate is the morphometric approach in identifying and recognizing Chega Sofla's modified skulls from normal ones? Can it recognize small variations in the skull's morphology, such as the flattening of the squamous part of the occipital bone? The results of this method can be compared with descriptive studies. Finally, it is shown that the morphometric approach based on Elliptic Fourier Analysis can identify the deformed skull of Chega Sofla and its intensity, as well as the flattening of the squamous part of the occipital bone. [ABSTRACT FROM AUTHOR]

Post-mortem computed tomography (PMCT) enables the creation of subject-specific 3D head models suitable for quantitative analysis such as finite element analysis (FEA). FEA of proposed traumatic events is an objective and repeatable numerical method for assessing whether an event could cause a skull fracture such as seen at autopsy. FEA of blunt force skull fracture in adults with subject-specific 3D models in forensic pathology remains uninvestigated. This study aimed to assess the feasibility of FEA for skull fracture analysis in routine forensic pathology. Five cases with blunt force skull fracture and sufficient information on the kinematics of the traumatic event to enable numerical reconstruction were chosen. Subject-specific finite element (FE) head models were constructed by mesh morphing based on PMCT 3D models and A Detailed and Personalizable Head Model with Axons for Injury Prediction (ADAPT) FE model. Morphing was successful in maintaining subject-specific 3D geometry and quality of the FE mesh in all cases. In three cases, the simulated fracture patterns were comparable in location and pattern to the fractures seen at autopsy/PMCT. In one case, the simulated fracture was in the parietal bone whereas the fracture seen at autopsy/PMCT was in the occipital bone. In another case, the simulated fracture was a spider-web fracture in the frontal bone, whereas a much smaller fracture was seen at autopsy/PMCT; however, the fracture in the early time steps of the simulation was comparable to autopsy/PMCT. FEA might be feasible in forensic pathology in cases with a single blunt force impact and well-described event circumstances. [ABSTRACT FROM AUTHOR]

Positional plagiocephaly is a deformational cranial flattening frequently treated in pediatric neurosurgical practice. Positional maneuvers and orthotic helmet therapy are preferred therapeutic options for moderate-to-severe forms. Treatment response seems to be age-dependent. Nevertheless, predictive data are vague, and cost-efficiency might be a limiting factor for treatment. The purpose of this study was to investigate the early predictive value of sonographic parameters on the efficacy of orthotic helmet therapy through the assessment of changes in skull shape and correlation of the parameters with caliper cephalometry values and with age. A consecutive cohort of 49 patients < 10 months of age, undergoing orthotic helmet therapy for positional plagiocephaly, was recruited prospectively. The authors routinely assessed the patency of the lambdoid sutures by ultrasound and the following additional skull parameters were measured: suture width, adjacent full bone thickness, adjacent cortical bone thickness and occipital angle. Caliper cephalometric values, as well as demographic and clinical data were collected. Retrospective data analysis showed an inverse relation between both cortical and full skull bone thickness and early treatment efficacy, defined by a reduction in the occipital angle. The improvement of sonographic parameters correlated with the development of cranial caliper cephalometry values. In conclusion, the sonographic assessment of skull bone thickness is a safe and cost-effective tool to predict the early efficacy of orthotic helmet therapy in positional plagiocephaly and might, therefore, help the clinician to foresee the potential evolution of the deformity. [ABSTRACT FROM AUTHOR]

The jugular foramen (JF) is located between the temporal and occipital bones. The JF is a primary pathway for venous outflow from the skull and passage of nerves. Variations are common in this region and may have clinical and surgical implications. To analyze the sexual dimorphism and JF morphology in skulls from Northeastern Brazil. 128 human skulls from the Anatomy Laboratory of the Federal University of Paraíba, 64 male and 64 female, were selected and the JFs analyzed for bone septation and the presence of a dome. Data analysis considered P<0.05 as significant. On at least one side, complete septation was observed in 26 skulls (20.3%), incomplete septation in 93 skulls (72.6%) and 61 skulls (47.6%) did not present septation. In 114 skulls (89%), 47.6% female and 41.4% male, have a unilateral presence of the dome and 71 (55.4%) have it bilaterally. Posterolateral compartment diameters and JF area had higher values on the right side in the total sample and separated by sex (P<0.05). Most morphometric variables of the anteromedial compartment were higher in male than in female (P<0.05), fact that was not observed in the posterolateral compartment (P>0.05). This study showed a higher prevalence of complete septation in males compared to females. Morphometric analysis presented a peculiar morphology of the JF in this study. These results suggests that the surgical approach to diseases that affect the JF may be peculiar to the studied population, confirming the importance of morphological analysis of the skull base. [ABSTRACT FROM AUTHOR]

Modified human skulls are among the unique finds recovered from archaeological contexts. They exhibit various forms of deformation, which can be attributed to factors such as diseases, cultural practices, post-burial lithostatic pressure, and life history events. Particularly significant are intentionally deformed skulls, with examples, albeit in small numbers, found throughout Southwest Asia, not to mention the Iranian Plateau. However, these skulls have not received adequate attention in Iran due to problems such as focusing on other research priorities during excavations and the imbalance in the analysis of the various types of excavation findings. Examples of such skulls have been unearthed from the Neolithic sites in the Central Zagros. Recently, excavations at Tol-e Chega Sofla in the Zohreh Plain (Behbahan, Khuzestan) have yielded thirteen skull specimens with deformed proportions in a relatively well-preserved state. Hence, there is an excellent opportunity to study such skulls within the context of the Iranian Plateau. The study of the deformed skulls of Chega Sofla reveals similarities in the methods of skull deformation with the other areas of Southwest Asia. At Tol-e Chega Sofla, the practice of skull deformation using bandages is evident, along with various other traditions of cranial modification. The BG1 mass grave samples show similarities with the Ali Kosh and Seyh Hüyük skulls, while the BG6.1 specimen does not resemble any of the BG1 mass grave skulls and is similar to the modified skull of Burial no.5 in Chagha Sefid. It is worth mentioning that unintentional skull deformation, resulting in the flattening of some parts of the occipital bone, has also been observed in Chega Sofla. [ABSTRACT FROM AUTHOR]

Recent years have witnessed a rapidly growing interest in CVJ bony abnormalities, and a qualitative and quantitative analysis of relevant literatures is necessary. This study aims to identify and summarize the published articles related to craniovertebral junction bony abnormalities, to analyze and visualize the current research trends and major contributors. We collected data from Web of Science, excluding certain article types. Two researchers screened articles for relevance. Data were organized with EndnoteX9, and analyzed using VOSviewer and CiteSpace for co-authorship, co-occurrence, keyword burst, and co-citation analyses to identify research trends and collaborations. A total of 2,776 articles were included, revealing an increasing trend in annual publications of CVJ bony abnormalities. The USA was the leading country. King Edward Memorial Hospital was the most prolific institution, and Seth GS Medical College had the most citations. The Spine is the most popular journal with the highest number of publications and citations. Professor Goel Atul from India emerged as the most influential pioneer in this field. Keyword analysis highlighted surgical techniques, diagnosis, and anatomy as the primary research hotspots and Fixation, Placement, and Basilar invagination gradually become the new research trend. However, there is a relative weakness in basic research and epidemiology. This study provides valuable insights into the current research trends and critical contributors in CVJ bony abnormalities, guiding evidence-based decisions and fostering international collaborations to advance knowledge in this field. [ABSTRACT FROM AUTHOR]

This study aimed to examine the mechanism of occipital condyle fractures (OCFs), their clinical symptoms, computer tomography (CT) scan findings, treatment options, and classification. A retrospective analysis was conducted on 43 patients with OCFs who were admitted to our neurosurgery center between 2017 and 2023. The investigation covered their clinical symptoms, CT scan results, and treatment outcomes. It was found that 25.6% of the patients suffered from severe craniocerebral injuries with Glasgow Coma Scale (GCS) scores of 3–8 points, 9.3% had moderate injuries with GCS scores of 9–12 points, and 65.1% exhibited mild injuries with GCS scores of 13–15 points. Of these patients, 90.7% showed improvement upon discharge, 4.7% succumbed to their injuries, and another 4.7% developed paraplegia. Symptoms indicative of OCF in individuals with CCJ injuries included neck pain, swelling, cranial nerve palsy, and posterior pharyngeal wall swelling. Frequently observed complications in OCF patients included cerebral contusion, occipital bone fractures, and skull base fractures. Employing thin-layer CT scans of the CCJ area, along with sagittal and coronal CT reconstructions, is essential for identifying OCFs. The fractures were classified into 3 types based on the Anderson-Montesano classification, which, when modified, provides enhanced treatment guidance. OCFs are predominantly present in cases of high-energy trauma, with high-resolution thin-layer CT scans serving as the preferred diagnostic method. The application of the modified Anderson-Montesano classification, distinguishing between stable and unstable fractures, facilitates the determination of suitable treatment strategies. Stable OCFs can be managed using a rigid neck brace, while unstable OCFs may require Halo-vest frame fixation or surgical intervention. [ABSTRACT FROM AUTHOR]

Background: Obtaining accurate knowledge of the anatomical structure of the skull helps in ontogenetic studies and determining sexual polymorphisms. Objectives: This study uses anatomical dissection and radiography to develop a size standard for the skull of the Saanen goat; information that will be applied to clinical evaluation and decision‐making. Methods: A total of 14 adult Saanen goat skulls (7 male and 7 female goats) were taken from the slaughterhouse and transferred to the clinic of the Faculty of Veterinary Medical Teaching Hospital, Urmia University, Urmia, Iran. Radiographs of each skull were prepared in the dorsal–ventral, left and right lateral recumbency. These heads were then brought over to the anatomy department, where the chosen morphometric traits were assessed and their means recorded. Results: According to the findings of this study, the dorsal view of the skull revealed an incisive raphe and a widespread foramen of the nose. In the ventral view, the incisive bones were observed in the most cranial region of the skull. The base of the occipital bone was relatively large, and the jugular process was well‐developed. In the lateral view, the incisive bone was extended to the cranial and had a narrow process on the dorsal surface. Regarding infra‐orbital foramen, it was visible in the maxillary bone. Moreover, the lacrimal bone was perceived as a distinct bone. Conclusion: The precise standards acquired in this study can be utilized to interpret the findings and make clinical decisions about the normal and abnormal size of the bones that make up the skulls of the Saanen goats. [ABSTRACT FROM AUTHOR]

This article presents a comparative study on the anatomical assessment of the foramen magnum (FM) among the South Indian population using CT scans. The study found that the most common shape of the FM in both dry skulls and CT scan images was hexagonal. There were no significant differences in measurements between the two methods. The study provides valuable information for surgeons and medical professionals. The document is a list of references to various studies and articles related to the anatomical assessment of the foramen magnum and spinal cord, which can be useful for researchers studying these features in different populations. [Extracted from the article]

Objective We retrospectively reviewed the CT and MRI features of patients with benign osteoblastoma in the calvarium and skull base (CSBOB). Methods Nine cases of pathologically confirmed benign CSBOB were analysed retrospectively. The patients had undergone CT and/or MRI. Tumour location, size, and imaging features were reviewed and recorded. Results The patients included four males and five females with a mean age of 27.0 years (age 14-40 years). The tumours were located in the frontal bone in 3 patients, the occipital bone in 3 patients, and in the parietal bone, sphenoid bone, and skull base in 1 patient each. On CT, the tumours measured 5.1 ± 3.3 (1.8-8.4) cm. Seven tumours were shown to have caused expansile bony destruction with an eggshell appearance and varying degrees of calcification or matrix mineralization. Multiple septa were observed in 5 tumours. Intracranial growth was observed in 5 tumours. On MRI, 7 tumours showed heterogeneous hypo- to isointensity on T1WI. Heterogeneous high signal patterns with low signal rims and septa were observed in 6 tumours on T2WI, and 4 showed a fluid-fluid level. On contrast-enhanced imaging, 6 tumours showed peripheral and septal enhancement, and 2 showed the dural tail sign. Conclusions Benign CSBOB is a rare tumour characterized by expansile bony destruction, septa, a sclerotic rim and calcification or matrix mineralization on CT and MRI. Advances in knowledge The findings from this study contribute to a better understanding of benign CSBOB and provide valuable imaging features that can aid in its diagnosis and differentiation from other tumours in the calvarium and skull base. [ABSTRACT FROM AUTHOR]

This article, published in the Anatolian Journal of General Medical Research, discusses a case report of prostate cancer metastasis to the occipital bone. Prostate cancer typically metastasizes to the pelvic lymph nodes and axial skeleton, making metastasis to the occipital bone rare. The article highlights the use of 68Ga-PSMA PET/CT scanning, which has been shown to be more sensitive than conventional imaging techniques in detecting prostate cancer. The authors emphasize the importance of this imaging method in cases where metastasis cannot be demonstrated by conventional methods, as it can influence treatment decisions. [Extracted from the article]

Background: Spheno-occipital synchondrosis is a growth center that is involved in craniofacial development. Since osteogenesis of this synchondrosis occurs relatively later than other synchondroses, it has been taken into account for age estimation in forensics. This study aimed to evaluate spheno-occipital synchondrosis using Cone-Beam Computed Tomography (CBCT) in an Iranian population. Methods: In this cross-sectional study, 148 CBCT images (76 women and 72 men) of patients aged 7-25 years, with a mean age of 19.92±6.3 years, were assessed by two radiologists to analyze the sphenooccipital synchondrosis fusion degree using a four-stage system. In addition, the third molar development degree (Demirjian index) was assessed in panoramic and cross-sectional views of CBCT images. The correlation between spheno-occipital synchondrosis fusion degree and age was obtained. Multiple regression analysis was used for age estimation using spheno-occipital synchondrosis fusion degree and third molar development degree (Demirjian index). Intra-observer and inter-observer coefficients of agreements were also measured. IBM SPSS Statistics 20.0 was used. Results: There was a positive correlation between spheno-occipital synchondrosis fusion degree and age (r=0.75, p<0.001). The multiple regression model provides a more robust model than when each age marker is utilized individually. The kappa coefficient was 0.53 for inter-observer agreement and 0.77-0.92 for intra-observer agreement. Conclusion: Assessing the four-stage spheno-occipital synchondrosis fusion degree was not a robust method; however, combined with the third molar development (Demirjian index), it could be considered as an appropriate marker for age estimation in 7-25-year-old Iranian population. [ABSTRACT FROM AUTHOR]

Occipitalization of atlas is an osseous anomaly of the craniovertebral junction, which occurs at the base of the skull in the region of the foramen magnum. It is the fusion of first cervical vertebra with the occipital bone of the skull. A 16-year-old patient reported with chief complaint of irregularly placed teeth. Routine lateral cephalogram assessment revealed the presence of fusion between first cervical vertebrae (C-1) and base of skull. The radiographic investigation revealed the presence of fusion along with the clinical findings of short neck, short face, cleft palate, missing teeth, and pain during neck extension and flexion. Such cases of craniocervical anomaly can cause orthopedic and neurological problems like abnormal posture of head, restricted neck movements, cervical pain, pain in extremities, wasting of muscles, and convulsions. The comprehensive radiographic assessment of all structures visible in cephalogram of orthodontic patient can help in identification of such anomalies and sensitize the patients about symptomatic or asymptomatic condition. [ABSTRACT FROM AUTHOR]

An 11‐year‐old, female‐neutered beagle was presented with a growing soft tissue mass arising within the deep tissues of the left cranial cervical region. At presentation, facial asymmetry was evident along with palpable lymphadenomegaly. Magnetic resonance imaging demonstrated a locally invasive cervical mass with intracranial invasion through focal osteolysis of the occipital bone. After antihistamine administration, cytology confirmed mast cell tumour (MCT) with metastasis to local lymph nodes and liver. The owner chose to pursue lomustine and prednisolone, which were dispensed, but, before home administration, prolonged seizures/status epilepticus occurred prompting euthanasia. Postmortem examination confirmed a high‐grade MCT associated with, and infiltrating through, muscle, calvarium, dura mata, leptomeninges and the underlying brain. We present the clinical, imaging, and pathological findings of an unprecedented case of extracranial MCT tumour causing osteolysis of an imperforate flat bone (occipital bone) and intracranial invasion. [ABSTRACT FROM AUTHOR]

Penetrating brain injuries are rare events in modern times. In this article we present the case of an adolescent with a knife, lodged in the occipital region needing surgical care. The patient was conscious, cooperative, and vitally stable with a Glasgow coma scale (GCS) of 15/15 with no lateralizing signs. Computed tomography (CT) scan of the brain demonstrated the knife blade in the suboccipital bone with suspicious injury to the right transverse sinus. General anesthesia was provided and airway secured in a lateral position using a video laryngoscope. Surgery was performed in the prone position using the Mayfield head holder. All measures to prevent secondary brain injury were taken. The patient remained vitally stable during surgery and could be extubated after surgery. Planning and preparation are vital for the smooth conduct of the case. [ABSTRACT FROM AUTHOR]

The Dicynodontia (Therapsida: Anomodontia) is one of the most successful Permo-Triassic terrestrial tetrapod clades and the oldest specimens are recorded from the middle Permian Eodicynodon Assemblage Zone of South Africa. Their fossil record is abundant and species-rich across Pangea. By contrast, the fossil record of the basal-most anomodonts, which includes non-dicynodont anomodonts and early forms of dicynodonts, is patchy and their morphology and phylogeny are deduced from relatively few specimens. Discovered in 1982 and described in 1990, the holotype of Eodicynodon oelofseni (NMQR 2913) is one of the better-preserved early anomodont specimens. However, it has been suggested that E. oelofseni does not belong to the genus Eodicynodon. Here, using CT-scanning and 3D modeling, the skull of Eodicynodon oelofseni, Patranomodon nyaphulii and Eodicynodon oosthuizeni are redescribed. In the framework of this study, the application of 3D scanning technology to describe anatomical structures which were previously inaccessible in these fossils has enabled detailed redescription of the cranial morphology of the basal anomodonts Patranomodon, Eodicynodon oelofseni and £ oosthuizeni and led to a greater understanding of their cranial morphology and phylogenetic relationships. Based on an anatomical comparison and phylogenetic analyses (Bayesian and cladistics) the phylogenetic relationships of basal anomodonts are reassessed and it is suggested that NMQR 2913 does not belong to the genus Eodicynodon but likely represents a separate genus basal to other dicynodonts. A new genus is erected for NMQR 2913. This presents one of the first applications of Bayesian Inference of phylogeny on Therapsida. [ABSTRACT FROM AUTHOR]

Background: Transcranial alternative current stimulation (tACS) refers to a promising non-invasive technique to improve brain functions. However, owing to various stimulation parameters in the literature, optimization of the stimulation is warranted. In this study, the authors aimed to compare the effect of tACS electrode montages on occipital responses. Methods: In three montage sessions (i.e., Oz-Cz, Oz-cheek, and sham), 10 healthy young adults participated, receiving 20-min 2-mA alpha-tACS. Pattern- reversal visual evoked potentials (VEPs) were measured before tACS (T0), immediately after (T20), and 20 min (T40) after tACS. Normalized changes in time-domain features (i.e., N75, P100 amplitudes, and P100 latency) and frequency-domain features [i.e., power spectral density in alpha (PSDα) and beta (PSDβ) bands] were evaluated. Results: In contrast to our hypothesis, the occipital response decreased immediately (T20) after receiving the 20-min tACS in all montages in terms of P100 amplitude (p = 0.01). This reduction returned to baseline level (T0) in Oz-cheek and sham conditions but sustained in the Oz-Cz condition (T40, p = 0.03) after 20 min of tACS. The effects on N75 amplitude and P100 latency were statistically insignificant. For spectral analysis, both PSDα and PSDβ were significantly increased after tACS at T20, in which the effect sustained until T40. However, there was no differential effect by montages. There was no significant difference in the occurrence of sensations across the montages. The effectiveness of the blinding is supported by the participants' rate of guessing correctly. Conclusion: This study revealed an immediate inhibitory effect of tACS, regardless of the montages. This inhibitory effect sustained in the Oz-Cz montage but faded out in other montages after 20 min. [ABSTRACT FROM AUTHOR]

This article, published in the Journal of Neurological Surgery, discusses a rare case of spheno-occipital enchondroma in a pediatric patient with Ollier's disease. Enchondromas are cartilaginous tumors that typically occur in long bones but can also be found in the flat bones of the skull. Multiple lesions are associated with rare skeletal dysplastic disorders, and there is a risk of transformation to chondrosarcoma. The patient in this case underwent surveillance imaging and eventually had the lesion surgically removed. The article emphasizes the importance of long-term surveillance and multidisciplinary management for patients with enchondromatosis. [Extracted from the article]

Autosomal dominantly inherited neurofibromatosis type I (NF1) is a systemic disorder caused by a mutation of a gene on chromosome 17q11.2 and characterized by multiple café-au-lait spots, lentiginous macules, Lisch nodules of the iris, and tumors of the nervous system. Bony manifestations such as scoliosis, dysplasia of the greater sphenoidal wing, tibial pseudoarthrosis, short stature, and macrocephaly have been reported in approximately 50% of patients. However, calvarial bone defects are rare. After screening 324 articles, 23 cases (12 adult and 11 pediatric patients) of occipital bone defects in NF1 patients were selected. All patients had a single/multiple bone defect over the lambdoid suture. Adjacent benign plexiform neurofibromas were observed in 14 patients (60.8%, 7 adults and 7 children); one adult patient was diagnosed with neurofibrosarcoma. Meningoencephalocele over the occipital defect was noted in 8 cases (34.78%, all adults). Cranioplasty was performed in only 17.39% of patients. Histologic examination was performed in 7 of the 15 patients with associated neurofibromas/neurofibrosarcomas. Biopsy of the bone margins surrounding the defect was performed in only one case. Pathologic examination of the herniated parieto-occipital or cerebellar tissue was not performed in any of the patients studied. We report the case of a 9-year-old girl with NF1 and a significant occipital bone defect and performed a systematic review of the relevant literature to highlight the challenges in treating this condition and to investigate the underlying mechanisms contributing to bone defects or dysplasia in NF1. [ABSTRACT FROM AUTHOR]

Purpose: To characterise dynamic postural stability of gait in patients with vestibular hypofunction (PwVH) using a sensor-based assessment while performing dynamic tasks and to correlate the results of this evaluation with clinical scales. Methods: This cross-sectional study involved 22 adults between 18 and 70 years old from a healthcare hospital centre. Eleven patients suffering from chronic vestibular hypofunction (PwVH) and eleven healthy controls (HC) were evaluated through a combined inertial sensor-based and clinical scale assessment. Participants were equipped with five synchronised inertial measurement units (IMUs) (128 Hz, Opal, APDM, Portland, OR, USA): three IMUs were located on the occipital cranium bone, near the lambdoid suture of the head, at the centre of the sternum, and at L4/L5 level, just above the pelvis, and were used to quantify gait quality parameters, while the other two were located slightly above lateral malleoli and used to perform stride and step segmentation. Three different motor tasks were performed in a randomized order: the 10-m Walk Test (10mWT), the Figure of Eight Walk Test (Fo8WT) and the Fukuda Stepping Test (FST). A set of gait quality parameters related to stability, symmetry and smoothness of gait were extracted from IMU data and correlated with the clinical scale scores. PwVH and HC results were compared to test for significant between-group differences. Results: Significant differences were found for the three motor tasks (10mWT, Fo8WT and FST) when comparing PwVH and HC groups. For the 10mWT and the Fo8WT, significant differences between the PwVH and HC groups were found for the stability indexes. Considering the FST, significant differences between the PwVH and HC groups were also found in the stability and symmetry of gait. A significant correlation was found between the Dizziness Handicap Inventory and gait indices during the Fo8WT. Conclusions: In this study, we characterized the dynamic postural stability alterations during linear, curved, and blindfolded walking/stepping in PwVH combining an instrumental IMU-based with traditional clinical scales approach. Combining instrumental and clinical evaluation for dynamic stability of gait alterations in PwVH is useful in thoroughly evaluating the effects of unilateral vestibular hypofunction. [ABSTRACT FROM AUTHOR]

Introduction: The occipital condyles are located lateral to anterior half of foramen magnum. Being the important component of craniovertebral region, occipital condyles are exposed to variety of clinical conditions. These clinical conditions may need surgical interventions for their treatment. In transcondylar approach to craniovertebral junction lesions partial occipital condylectmies are done commonly. It has been reported after such condylectomies that there have occurred post-operative atlanto occipital joint instability and hypoglossal nerve palsies. These post-operative complications have been attributed to population specific variations in the occipital condyles. Hence it is important to have meticulous knowledge of the occipital condyles. Aims: The aim of this study was to measure the morphometric parameters of the occipital condyles like length, width, height, anterior intercondylar distance (AID) and posterior intercondylar distance (PID) of the Indian population and to compare them with the other populations. Materials and Methods: The study was conducted in Government Medical College Srinagar, J&K, India, on 198 occipital condyles (76 occipital bones and 23 articulated skulls). Measurements were done with the help of Vernier's calliper. Mean and standard deviation of the morphometric parameters were analysed and comparison was done. Results: The length of occipital condyles on the right side was 22.86 + 3.05mm and on the left side it was 22.76 + 2.80 mm with the mean of 22.81 + 2.92mm. The width on the right side was 12.23 + 1.51mm while on the left side it was found to be 11.43mm + 1.36mm with the mean of 11.83 + 1.43mm. the height of the occipital condyles on the right side was found to be 9.37 + 1.29mm and on the left side it was 9.16 + 1.15mm with the mean of 9.27 + 1.22 mm. the mean anterior intercondylar distance (AID) was found to be 19.57 + 2.81mm while the mean value of posterior intercondylar distance (PID) was found to be 39.62 + 4.23mm. Conclusion: the mean values of all the parameters in the study showed side variations values were found more on the right side than that of left side. there was also difference in these values between the Indian and the other populations for successful surgeries on the occipital condyles, the surgeon must take care of these variations. The study thereby forms the morphometric reference to the surgeons to carry out successful surgeries. [ABSTRACT FROM AUTHOR]

Background: Temporal bone squamous cell carcinoma (TBSCC) is a very rare condition. The prognosis is dismal for advanced tumors. Due to its rarity, information in the literature is scarce. Here, we report a unique case of TBSCC with cerebellar invasion and hydrocephalus. Case Description: A 46-year-old reported right-sided hearing loss and a painful right retroauricular mass for 4 months. Magnetic resonance imaging revealed a 8.7 × 7.6 × 6.4 cm mass invading the right temporal and occipital bones. After a biopsy and 3 surgical procedures over 6 months, the diagnosis of TBSCC was obtained. Due to invasion of the cerebellar tissue and obstructive hydrocephalus, a ventriculoperitoneal shunt was performed. The patient was referred for adjuvant radiotherapy. However, palliative care was initiated due to tumor progression. Conclusion: We report a case of advanced TBSCC with poor prognosis despite surgical treatment and radiotherapy. More data are necessary to provide new and better treatment to these patients. [ABSTRACT FROM AUTHOR]

Introduction: The knowledge of Jugular foramen is important to neurosurgeons while performingsurgeries related to Jugular foramen because, in case of tumor invasion, all structures are not clearly seenand hence correct knowledge is required when approachingsuch tumors or other related diseases. The diameters of Jugular foramen are different in different sex, races, and age. Objective: This osteological study was to provide complete knowledge of Jugular foramen in Indian population with some other characteristics like dome and separation in Jugular foramen. Material and Methods: 68 skulls were obtained from anatomy department, NHLMMC and BJMC. Anteroposterior and transverse diameter of jugular foramen was measured using vernier calipers. The presence of dome shaped bony roof and septa was observed using magnifying glass. We did not include bones with broken or damaged Jugular foramen. Results: We found dome in 4 skulls on right side and in 1 skull on left side. Separation was found complete in 11 skulls, partial in 81 skulls and absent in 44 skulls. In 55.8%, size of the foramen was greater on right side than left. Average anteroposterior diameter was0.82cm and average transverse diameter was 1.10 cm. [ABSTRACT FROM AUTHOR]

The foramen magnum is an important topographic opening in the occipital bone of skull, which connects cranial cavity and spinal canal. Foramen magnum is closely related to some vital neurological structures that relay information to and from the brain and spinal cord. These neurological structures are significant for many surgical approaches of cranio-cervical junction. Surgical procedures in the region of foramen magnum, are essential due to the high mortality rate. For this reason, anatomical variations of the structures which are related to foramen magnum as well as the morphological and morphometric variations of foramen magnum should be well known before any surgical procedure. The aim of this study was to determine gender based on morphometry analysis of foramen magnum using geometric method. The present study was performed on 799 patients of known sex and age (424 male and 375 female), who were came in the OPD of Radiodiagnosis department of Era's Lucknow Medical Collage & Hospital, Era University for computerized tomography scanning of Head & Neck region. Radiological images also provide a patient's clinical history. Thus, the process of exclusion in respect to patients with pathological conditions of the skull is achieved. The anteroposterior and transverse dimensions of the foramen magnum was analysed in relation to age and sex. Variations in the shape and size of the foramen magnum was simultaneously observed between the gender. The objectives of this study were to improve data on the variations of different morphological and morphometric parameters of the foramen magnum in the north Indian population and also establish the association with age and gender determination. [ABSTRACT FROM AUTHOR]

Introduction: Jugular foramen in the posterior cranial fossa is located between the temporal and occipital bones at the posterior end of petro-occipital fissure, above and lateral to the foramen magnum. Several important structures surround the jugular foramen and knowledge of their spatial relationship is the key in understanding the potential clinical effects of nearby lesions. Materials and Methods: The material for the present study comprised of 60 adult human dry skulls of unknown sex. Morphometric parameters of jugular foramen and jugular fossa were noted. Presence or absence of intrajugular process, jugular tubercle, mastoid canaliculus, cochlear canaliculus and tympanic canaliculus were noted. Results: All parameters of jugular foramen from posterior cranial fossa were greater on right side except anteromedial width of JF which was slightly higher on left side. All parameters of jugular foramen from base of skull were greater on right side and difference was found to be statistically highly significant. Mastoid canaliculus, cochlear canaliculus and tympanic canaliculus were seen bilaterally in 68.33% skulls, 95% skulls and 95% skulls respectively. Discussion: Various pathological lesions, tumors involving jugular foramen and nearby structure require microsurgical approaches to enter into this region. Hence, a detailed knowledge of the jugular foramen is needed to all the neurosurgeons while doing surgery in this region. [ABSTRACT FROM AUTHOR]

In many world regions, conflict resulting from power struggles can lead to interpersonal violence. In the recent colonial past, tribes in Papua and Papua New Guinea engaged in war and raiding that resulted in interpersonal violence, abduction, slavery, and casualties. This case study focuses on the analysis of a colonial period individual from Biak Island, Papua, Indonesia, using a biocultural approach. Only the cranium was available for analysis. Standard osteological methods were used to determine that the individual was likely a young to mid‐aged (26‐ to 42‐year‐old) adult female. Skeletal lesion type and patterning were observed macroscopically with digital photography and a newly developed ultraviolet light photography technique. Multiple sharp force trauma injuries were identified on the frontal, temporal, and occipital bones of the cranium. Interpreting the pattern of trauma within the context of the colonial period in Papua, it is suggested that this female individual may have been murdered, possibly as a slave taken during tribal warfare. This report is a significant resource for future bioarchaeological studies in Papua as it provides one of the only accounts of skeletal trauma during the colonial period in the region. [ABSTRACT FROM AUTHOR]

To provide further information on the identification of the occipital artery (OA) and suggest an improved approach to its anterograde dissection technique for harvesting. Six cadaveric specimens were prepared for surgical simulation, and the anterograde approach was used to harvest the OA; a hockey stick incision was made from the C2 spinous process through the nuchal ligament to the mastoid tip. By retracting the scalp flap from the posterior arch of C2 to the transverse process, the suboccipital triangle was reflected by a single myocutaneous flap from the inferior nuchal line. In addition, 70 head computed tomography angiography scans were assessed bilaterally (n = 140) to study the running pattern of the OA. The mean total length of the mobilized OA was 11.8 ± 0.7 cm, with a diameter of 1.5 ± 0.1–2.1 ± 0.2 mm at the suboccipital segment and 1.3 ± 0.1 mm at the upper edge of the surgical incision. The average distance of OA at the inferior nuchal line to the midline was 2.9 ± 0.3 cm, the average distance of OA at the superior nuchal line to midline was 4.1 ± 0.2 cm, the average distance of OA at incision edge to midline was 5.2 ± 0.3 cm. Orientational anterograde technique for OA harvesting is a fast and easy approach. This approach avoids critical neurovascular structures. The most important step is to identify the OA near the lateral edge of the superior oblique muscle. Subsequently, in conjunction with preoperative computed tomography angiography, an imaginary line that crosses the inferior and superior nuchal lines may be established to assist in the separation of the OA. [ABSTRACT FROM AUTHOR]

Background: Rectus capitis lateralis muscle (RCLM) is located at the border between the ventral and dorsal muscle groups, but the nerve topographical anatomy around the muscle is obscure. Materials and methods: We observed the RCLM in histological sections of 12 midterm and 10 near-term fetal heads (9–18 and 26–40 weeks of gestational age). Results: At midterm, the RCLM wrapped around the inferiorly protruding inferolateral corner of the cartilaginous occipital bone. The muscle was adjacent to, or even continued to, the intertransversarius muscle between the atlas and axis. At near-term, the jugular process of the occipital bone, that is, the RCLM upper insertion, was either cartilaginous or bony, depending on age. The process formed a collar supporting the internal jugular vein from the inferior side. Moreover, the muscle is tightly attached to or inserted into the venous wall itself. The cartilaginous jugular process was adjacent to Reichert's cartilage, and the uppermost muscle fibers passed through a narrow space between these cartilages. The RCLM appeared to accelerate the jugular process elongation, resulting in complete union of the occipital and temporal bones. The ventral ramus of the first cervical nerve passed between the RCLM and rectus capitis anterior muscle to reach the longus capitis muscle. No nerve passed between the RCLM and the obliquus capitis superior muscle (a muscle at the suboccipital triangle). Conclusion: The dorsoventral position of the RCLM seemed to correspond to the scalenus posterior muscle in a laminar arrangement of the cervical axial musculature. [ABSTRACT FROM AUTHOR]

Introduction: Sagittal craniosynostosis (SC) is associated with scaphocephaly, an elongated narrow head shape. Assessment of regional severity in the scaphocephalic head is limited by the use of serial computed tomographic (CT) imaging or complex computer programing. Three-dimensional measurements of cranial surface morphology provide a radiation-free alternative for assessing cranial shape. This study describes the creation of an occipital bulleting index (OBI), a novel tool using surface morphology to assess the regional severity in patients with SC. Methods: Surface imaging from CT scans or 3D photographs of 360 individuals with SC and 221 normocephalic individuals were compared to identify differences in morphology. Cartesian grids were created on each individual's surface mesh using equidistant axial and sagittal planes. Area under the curve (AUC) analyses were performed to identify trends in regional morphology and create measures capturing population differences. Results: The largest differences were located in the medial regions posteriorly. Using these population trends, a measure was created to maximize AUC. The OBI has an AUC of 0.72 with a sensitivity of 74% and a specificity of 61%. When the frontal bossing index is applied in tandem, the two have a sensitivity of 94.7% and a specificity of 93.1%. Correlation between the two scores in individuals with SC was found to be negligible with an intraclass correlation coefficient of 0.018. Severity was found to be independent of age under 24 months, sex, and imaging modality. Conclusions: This index creates a tool for differentiating control head shapes from those with SC and has the potential to allow for objective evaluation of the regional severity, outcomes of different surgical techniques, and tracking shape changes in individuals over time, without the need for radiation. [ABSTRACT FROM AUTHOR]

Red snapper fish is one of the most economically important marine fish groups in the world with high morphological similarities. Currently, the taxonomy of snappers relies on external morphological characteristics and genetics (DNA barcoding). Relying solely on morphology for taxonomy might lead to invalid results, whereas the genetic approach is known to be costly and time-consuming. Therefore, this study aims to examine the difference in the head bone (Osteocranium) osteology of two red snappers species namely Lutjanus malabaricus and L. timorensis, harvested from Aceh waters, Indonesia using an alternative approach based on osteological characteristics. A total of five fish samples of each species were collected from fishermen operating in the northern waters of Aceh and were landed at the Lampulo Fish Port, Banda Aceh City, Indonesia. Osteology samples were prepared through six steps, including exterior muscle elimination, immersion in 70% alcohol solution, drying, photographing bones, image editing, and identification of terminology. The results showed that the cranial of Lutjanus is supported by 25 bones, where 13 bones showed differences among the two species of red snappers, namely the nasal, preethmoidal, ethmoidal lateralis, prefrontal, foramen frontal, pterotic, lacrimal, crista occipital, interopercular, opercular, palatinum, preopercular, and premaxilla bones. Among these, a significant difference was found in the angle of the crista occipital bone, where L. timorensis was higher than L. malabaricus. Therefore, it was concluded that the crista occipital bone was a key characteristic to distinguish between the two species of red snappers examined. This study showed that the osteocranium approach can be employed to validate the taxonomic status of these species. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional study aimed to investigate the association between the occipital spur length and craniofacial morphology in individuals with occipital spur (OS). Methods: The study included cephalometric images from 451 individuals (196 females, 255 males, age range was 9–84 years). The spur length and craniofacial characteristics were evaluated using cephalograms. Based on spur length, subjects were divided into two groups: the OS group (N = 209) and the enlarged occipital spur (EOS) group (N = 242). Descriptive statistics, Independent T-test, Mann–Whitney U test, chi-square test, Kruskal–Wallis test, and age- and sex-based stratified analyses were performed. The level of significance was set at p < 0.05. Results: Males had significantly larger spur length than females. Spur length was shorter in individuals under 18 than the groups over 18. After adjusting for gender and age, ramus height, mandibular body length, effective length of maxilla, effective length of mandible, anterior cranial base length, posterior cranial base length, anterior facial height, posterior facial height, facial height index, and lower anterior facial height had statistically significant differences between OS group and EOS group. Conclusions: Males exhibit greater spur length than females. Patients under 18 had a shorter spur length than adults. Linear craniofacial measurements were found to be greater in subjects with EOS than the individuals with OS. The craniofacial growth and development of an individual might be associated with EOS. The causal relationship between EOS and craniofacial development requires further longitudinal studies. [ABSTRACT FROM AUTHOR]

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Purpose: Sheep are used as a large-animal model for otology research and can be used to study implantable hearing devices. However, a method for temporal bone extraction in sheep, which enables various experiments, has not been described, and literature on middle ear access is limited. We describe a method for temporal bone extraction and an extended facial recess surgical approach to the middle ear in sheep. Methods: Ten temporal bones from five Hampshire sheep head cadavers were extracted using an oscillating saw. After craniotomy and removal of the brain, a coronal cut was made at the posterior aspect of the orbit followed by a midsagittal cut of the occipital bone and disarticulation of the atlanto-occipital joint. Temporal bones were surgically prepared with an extended facial recess approach. Micro-CT scans of each temporal bone were obtained, and anatomic dimensions were measured. Results: Temporal bone extraction was successful in 10/10 temporal bones. Extended facial recess approach exposed the malleus, incus, stapes, and round window while preserving the facial nerve, with the following surgical considerations: minimally pneumatized mastoid; tegmen (superior limit of mastoid cavity) is low-lying and sits below temporal artery; chorda tympani sacrificed to optimize middle ear exposure; incus buttress does not obscure view of middle ear. Distance between the superior aspect of external auditory canal and tegmen was 2.7 (SD 0.9) mm. Conclusion: We identified anatomic landmarks for temporal bone extraction and describe an extended facial recess approach in sheep that exposes the ossicles and round window. This approach is feasible for studying implantable hearing devices. [ABSTRACT FROM AUTHOR]

Objective:This study assessed the relationship of the fusion stage of spheno-occipital synchondrosis (SOS) with midpalatal (MPS) and zygomaticomaxillary (ZMS) sutures on cone-beam computed tomography (CBCT) scans of 7 to 21-year-old patients.Methods:This cross-sectional study evaluated the CBCT scans of 176 patients between 7 and 21 years presenting to a maxillofacial radiology clinic. The fusion stage of SOS was determined using a five-stage classification system. The percentage of opening depth of MPS was measured on two middle coronal cuts in the anterior and posterior half of the palate. To assess ZMS, suture fusion was evaluated in four age groups in the axial cut visualizing its maximum length. Data were analyzed using the Kruskal-Wallis, Mann- Whitney U, and Bonferroni tests and regression models.Results:The percentage of MPS opening significantly decreased in both the anterior and posterior halves with age (p

Down syndrome, also known as trisomy 21, is associated with congenital cervical spine abnormalities, including atlantoaxial instability with or without os odontoideum, atlanto-occipital instability, and hypoplasia of the atlas. Herein, we report a case of Down syndrome complicated by congenital atlanto-occipital dislocation. The patient presented with severe cervical myelopathy at 13 years of age after a 10-year follow-up. Radiography and computed tomography revealed os odontoideum protruding into the foramen magnum and congenital anterior atlanto-occipital dislocation. Additionally, a bifurcated internal occipital crest with a thinned central portion of the occipital bone was noted. Magnetic resonance imaging revealed kyphotic alignment of the spinal cord with severe compression at the foramen magnum level. As the neurological impairment was partially improved by halo vest immobilization, we performed in situ O-C2 fusion with an iliac autograft and decompression of the foramen magnum and posterior arch of C1. An improvement was observed immediately after surgery. Two years after surgery, radiography and computed tomography showed solid O-C2 segment fusion. The accumulation of similar cases is essential for determining the prognosis or optimal treatment for this rare congenital condition. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study aimed to discuss 3 cases of congenital cholesteatoma located posterior to the sigmoid sinus, with no/minimal involvement of mastoid, and compare them with cases presented in the literature to better define this rare entity. METHODS: Retrospective chart analysis of 3 congenital cholesteatomas located posterior to the sigmoid sinus treated surgically in 2 skull-base centers and literature review. Though congenital cholesteatoma can arise outside the middle ear, only a few cases presenting in the retrosigmoid occipital bone have been described earlier. RESULTS: In all 3 patients, there was a delay in the presentation, as symptoms were nonspecific or lacking, leading in 1 case to severe complications. Computed tomography and magnetic resonance imaging, especially diffusion-weighted imaging scans, allowed accurate diagnosis and surgical planning. Surgery happened to be challenging due to the tight adherence of the cholesteatoma to the thinned dural surface. Complete excision was achieved in all the cases. CONCLUSION: Congenital cholesteatoma located posterior to the sigmoid sinus is a rare entity and is even more exceptional after a critical review of the literature. Complete excision is quintessential to prevent intradural extension or infection. The most important surgical issue is the management of the posterior fossa dura and the sigmoid sinus. We recommend meticulous dissection with slow peeling of the epithelial lining from the dura. Bipolar coagulation of the dura may help in avoiding recidivism. Moreover, cerebrospinal fluid (CSF) leak during dissection has to be avoided as long as possible, because the loss of tension of the already thinned dura makes its peeling particularly difficult. [ABSTRACT FROM AUTHOR]

Skull shape analysis provides useful information on wildlife ecology and potential local adaptations. Common bottlenose dolphins (Tursiops truncatus) often differentiate between coastal and offshore populations worldwide, and skull shape analyses can be particularly useful in this context. Here we quantify skull shape variation between coastal populations from the Gulf of Guayaquil (Ecuador) and the Mediterranean Sea, compared to offshore specimens from multiple oceans. We analysed skull shape differences using 3D models from museum specimens through geometric morphometrics (3DGM). Two complementary landmark approaches included single-point semi-landmarks in homologous features, as well as pseudo-landmarks placed automatically. Results show skull shape distinction between both coastal populations and offshore specimens. Offshore specimens showed little differentiation between distinct locations. Skull shape patterns mostly diverged in the shape and length of rostrum, as well as the shape of the ascending processes of the maxilla, pterygoids, and occipital bones. However, both coastal populations differed in the patterns and direction of change of those features and were also morphologically distinct. Our results are consistent with local data on site fidelity and social structure in the coastal populations. Skull shape changes suggest divergent feeding and sound production patterns are potential drivers, probably specific to the local environment of each community. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the relationship of the fusion stage of spheno-occipital synchondrosis (SOS) with midpalatal (MPS) and zygomaticomaxillary (ZMS) sutures on cone-beam computed tomography (CBCT) scans of 7 to 21-year-old patients. Methods: This cross-sectional study evaluated the CBCT scans of 176 patients between 7 and 21 years presenting to a maxillofacial radiology clinic. The fusion stage of SOS was determined using a five-stage classification system. The percentage of opening depth of MPS was measured on two middle coronal cuts in the anterior and posterior half of the palate. To assess ZMS, suture fusion was evaluated in four age groups in the axial cut visualizing its maximum length. Data were analyzed using the Kruskal-Wallis, MannWhitney U, and Bonferroni tests and regression models. Results: The percentage of MPS opening significantly decreased in both the anterior and posterior halves with age (p<0.002). With an increase in SOS grade, the percentage of MPS opening in both the anterior and posterior halves significantly decreased (p<0.001). By an increase in the ZMS stage, the SOS grade significantly increased (r=0.565, p<0.001). Conclusion: The MPS opening percentage in the anterior and posterior halves decreased with age, with a greater reduction in the posterior half. A significant inverse correlation exists between the SOS fusion stage and the percentage of MPS opening. In SOS grades I-III, the mean percentage of MPS opening was 100% in all age groups (with the highest frequency of ZMS stage I), indicating a higher chance of success for orthodontic treatments such as rapid maxillary expansion in these individuals. [ABSTRACT FROM AUTHOR]

Objective : This study aimed to evaluate the chronological age range associated with each stage of spheno-occipital synchondrosis (SOS) fusion in patients with cleft lip and palate compared to the noncleft group, using cone-beam computed tomography (CBCT) images. Design : In this study, the degree of SOS fusion was assessed using a 4-stage scoring system on CBCT images of 190 individuals (92 patients with cleft lip and palate, 98 noncleft individuals). A χ2 test was performed to assess the correlation between age and fusion stage. The independent sample t tests were used to evaluate the differences in the mean values of the samples of each group and each sex, as well as the mean value of each stage (P <.05). Results : The results showed that there was no significant difference in the timing of the SOS fusion stages between the patients with cleft palate and the noncleft group. Although the fusion process of SOS begins about one year earlier in females, the complete ossification occurs at the mean age of 18.5 for both sexes in the experimental group and the mean age of 19.0 in the noncleft group. Conclusions : The present study found no differences in the fusion stages of the spheno-occipital synchondrosis between patients with cleft lip and palate and healthy individuals. [ABSTRACT FROM AUTHOR]