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The aim of this study is to evaluate cribriform-lamella (CL) angle and length of lateral lamella (LL) on CT scan and to correlate CL angle with LL length and Keros classification. Retrospective study analyzing 500 CT scans of PNS was performed at a tertiary care hospital. The CT scan anatomy of anterior cranial base was evaluated for Keros, CL angle and LL length. The relationship between these measurements was studied. Keros type I (75.2%) was the commonest finding in our study. Males have increased depth of olfactory fossa but there were no differences between the sides. Type A angle of CL (66.1%) was the commonest with females having an increased CL angle as compared to males. The LL length was 3.6 mm (± 0.8). There were no significant difference between sex/side of LL. Keros was found to be strongly correlated with the LL length whereas it has mild negative correlation with CL angle. There was no correlation between CL angle and LL length. Keros classification is the commonest criteria used to assess the risk of injury to anterior cranial base. However, we have found that the CL angle has an important role to play in the angulation/slope/level of anterior cranial base during endoscopic sinus surgery. CL angle needs to be considered as an important factor during endoscopic sinus surgery.

Introduction : CSF leaks are the most common surgical complication in the posterior fossawhich can be minimized with watertight dural closure which can be done either with native available dura and if not available with other materials. Materials and Methods : Aim of the study was to compare the occurrence of CSF leak in posterior fossa surgeries where different dural closure materials are used. This was a 5 year retrospective cohort study, conducted in the department of Neurosurgery, Government medical college, Thrissur, Kerala, India. Results and Discussion : A total of 49 cases were included in the study. The mean age of the study was 44.86 16.99(4 years- 70 years).Out of the 49 cases 18(36.7%) were male patients and 31(63.3%) were female patients. Total posterior fossa procedures are distributed as CP angle tumor excision 27(55.1%), Foramen magnum decompression for chiari malformation 12(24.5%), Other tumors of posterior fossa 7(14.3%) and vascular lesions of posterior fossa 3(6.1%). Out of the total 49 cases 20 (40.85%) are closed with pericranium, 14 cases (28.6%) are closed with primary dura, 9 cases (18.4%) with fascia lata and 6(12.2%)are closed with artificial dural patch. Out of the total 49 procedures 10(20.4%) has CSF leak and no CSF leak detected in 39(79.6%). It is found that cases closed with pericranium has got a significant capacity to decrease the CSF leak 13 (65%) out of 20 cases (a24.43, df=1 p=0.035).Odds ratio found to be 0.21 that gives 79% protection against CSF leak(95% CI=0.047-0.0968). Conclusion : Study concludes that, in cases of posterior fossa surgeries, closure with pericranium has a significant protection against CSF leak. Keywords: Cerebrospinal fluid leak, Posterior fossa surgeries, Dural closure methods.

BACKGROUND: Posterior dislocation of the condyle from the glenoid fossa fracturing the anterior wall of the canal and ultimately restricting lower jaw movements is a rare condition. It may occur due to lax intra-articular ligaments or periarticular tissue or as a result of injury to the chin region. Very few cases of this condition are reported in the literature. PURPOSE: The purpose of this article is to present a rare case report and review of literature related to posterior dislocation of bilateral mandible condyles to the external auditory canal, its diagnosis, and treatment with midline mandibulotomy. METHOD: We used conservation methods to reduce it initially but not succeeded. Then we used midline mandibulectomy to reduce the individual condyle to its original position without opening the condyle region. RESULTS: We achieved a successful reduction of the dislocation and achieved with good occlusion and postoperative mouth opening. No complications like recurrence and TMJ ankylosis occurred. CONCLUSION: Bilateral posterior dislocation is a rare condition; proper clinical, radiographic diagnosis, and early treatment with manual or surgical intervention are required to avoid complications.

BACKGROUND Geometric morphometric analysis with Procrustes superimposition is an advanced computational tool that can be used to quantify dynamic changes in complex three-dimensional structures. The present study couples high resolution CT imaging with a Geometric Morphometric approach in order to further understand the complex dysmorphology that occurs in unilateral coronal synostosis (UCS). METHODS Forty-one UCS patients and 41 age- and sex-matched controls received high-resolution CT imaging. Thirty-one anatomical landmarks were identified on each imaging set. A geometric morphometric workflow was used to perform a Procrustes superimposition to register landmarks into a common space. Procrustes-aligned landmarks were used to derive angle calculations, lengths, and other anatomical measurements. Three-dimensional coordinates were also used to perform a principal components analysis (PCA). RESULTS Unilateral coronal synostosis patients exhibited significant angular deviation at the levels of the inferior skull base, mid-posterior fossa, and vertex. Both left- and right-sided UCS patients showed increased lengthening in the transverse (left-right) dimension, exhibiting increased length between the left and right EAC (P = 0.047). Conversely, UCS patients revealed shortening in the midline AP dimension as evidenced by the decreased Nasal root-Lambda (P

BackgroundA rare genetic disorder called Kallmann syndrome results from a defect in the neuronal migration of olfactory axons and gonadotropin-releasing hormone neurons. MR imaging helps in confirming the diagnosis of Kallmann syndrome with characteristic morphological findings in the brain, in clinically suspicious cases of hypogonadotropic hypogonadism with anosmia/hyposmia.Case presentationA 15-year-old male teenager presented with complaints of a small penis and anosmia. Hormonal assay of gonadotropins and testosterone revealed low serum concentrations. MRI brain revealed the absence of the olfactory bulbs in the olfactory grooves and hypoplastic olfactory sulcus. With the gonadotropic hormonal assay showing low levels and characteristic MR imaging features of absent olfactory tracts and olfactory sulcus, the diagnosis of Kallmann syndrome was confirmed.ConclusionsMorphological abnormalities of olfactory tracts and olfactory sulcus can be accurately depicted with MR imaging through anterior fossa in the coronal plane. Therefore, MR imaging of the brain plays a significant role in diagnosing uncommon Kallmann syndrome and other associated brain abnormalities.

Background and objectives Defects of the anterior region of the pinna pose a reconstruction challenge owing to the complex topography and difficult access. We report our experience using the revolving door island flap (RDIF) to reconstruct pinna defects and present the surgical results. Material and methods Retrospective descriptive study of patients undergoing ear reconstruction using RDIF at different sites of the anterior region after resection of malignant tumors. Results Seventeen patients underwent surgery between 2011 and 2019 for squamous cell carcinoma (n = 7) and basal cell carcinoma (n = 10). Conventional histology showed disease-free surgical margins in all the resected tissue specimens. The mean follow-up period was 40 months. One local recurrence of squamous cell carcinoma was observed, which responded well to radiation therapy; all patients were free of disease at the end of follow-up. Only 3 patients presented minor complications (depression of the flap surface in 1 case and retraction of the ear toward the mastoid process in 2 cases). Subjective rating scales were used to evaluate cosmetic and functional outcomes as assessed by both the dermatologist and the patient. The normal contour of the pinna was conserved in all patients and no patients required additional corrective surgery. Conclusions Reconstruction of the pinna using RDIF allowed for satisfactory repair following complete resection of the tumors, while conserving structure and functionality. RDIF has been reported to be a very good option for reconstruction of the pinna. It is a simple technique that makes it possible to repair large defects with minimal risk of necrosis. In our series, the cosmetic results were excellent and recurrence rates were very low. RDIF provided optimal results in repairing lesions in the concha and in other regions, such as the antihelix, triangular fossa, and scapha.

This study comparatively investigated gross features and osteometric variables in scapula of three rodents: tree squirrel (Funisciurus anerythrus ), house (Rattus Rattus ) and Wistar rats. A total of thirty three animals (11 per rodent species) were used for the study. The rodents were anaesthetized using ketamine and xylazine combination (80 mg/kg: 10 mg/kg body weight), sacrificed and processed for scapular bone extraction by burying method. Grossly, the scapular bones are flattened in all the rodents and have various shapes; semicircular in squirrel and roughly triangular in both Rattus rattus and Wistar rats. The scapula of the squirrel bears a hook-like acromion process and a distinct subscapular spine. Osteometric variables; scapular width and length of scapular neck are significantly reduced (p

Purpose The aim of this study was to test the hypothesis that the dose of estrogen replacement therapy may have an influence on the clinical, radiographic, and histopathologic changes within the temporomandibular joint (TMJ). Materials and Methods A prospective experimental study was conducted in 12 mature ovariectomized dogs. Dogs were randomly allocated into 1 of 4 groups (OVX-E0, dogs that did not receive any estrogen replacement therapy; OVX-E0.5, dogs that received 0.15 mg/kg of estradiol; OVX-E1, dogs that received 0.3 mg/kg of estradiol; and OVX-E2, dogs that received 0.6 mg/kg of estradiol); dogs were evaluated clinically for 12 weeks; and contact radiographic and histopathologic examinations of the TMJ were performed just after euthanasia. Results Radiographic examination of the TMJ in the OVX-E0 group showed narrowing of the joint space with marginal osteophyte formation along the mandibular condyle. The OVX-E0.5 group showed mild widening of the joint space with no remarkable changes within the mandibular fossa or condyle. The OVX-E1 group was free of radiographic changes within the TMJ. High doses of estrogen in the OVX-E2 group showed marked flattening of the mandibular condyle and fossa with sclerosis of the subchondral bone. Histopathologic sections in the OVX-E0 group showed thin compact bone with scanty, less organized lacunae. The OVX-E0.5 group showed compact bone of medium thickness with large osteons and disorganized lacunae. The OVX-E1 group showed thick compact bone with reduced intertubercular spaces and organized lacunae. The OVX-E2 group showed thin bone with reduced trabecular and increased intertrabecular thickness. The collagen content did not change significantly among the 4 groups, whereas its quality changed significantly (P Conclusions Estrogen dosage is potentially a key regulator of bone metabolism within the TMJ. Estrogen replacement therapy exhibited an inverted U–shaped beneficial effect. Estrogen depletion as well as high doses of estrogen resulted in clinical, radiographic, and histopathologic changes within the TMJ. Estrogen replacement therapy should be prescribed at the optimum dose when indicated as hormonal replacement therapy.

Introduction: Computed tomography (CT) has nowadays become the investigation of choice for diagnosis and evaluation of anatomical variations of the nose and paranasal sinuses. Methods: A cross sectional study was conducted in the Department of Radiology of Lumbini Medical College Hospital from June 2019 to May 2020. Total of 130 patients were enrolled for the study. All patients were subjected to Siemens Somatom scope 16 slice CT scan. Each scan was studied for the presence of agger nasi cell, concha bullosa, deviated nasal septum, haller cell, onodi cell, uncinate process variation and type of olfactory fossa. Results: The mean age of patients was 36. 86 ±12.06 years. There were 76 males (58.5%) and 54 females (41.5%) with male: female ratio of 1.4:1 with highest range in age group of 31 to 45 years (46.9%). Anatomical variation between male and female was statistically not significant (p>0.05). The most common anatomical variation noted was nasal septal deviation (73.1%), then agger nasi cell (59.3%), concha bullosa (24.6%), paradoxical medial turbinate (7.7%), onodi cell (6.9%), uncinate process variation (5.4%) and least was haller cell (4.6%). Most of the scans had more than one anatomical variation, which was statistically significant (p

Morphology of glenoid fossa might help the clinician in the diagnosis, establishing more biological treatment modalities and treatment response between patients with different skeletal malocclusions. This study aimed to assess the glenoid fossa morphology in different sagittal facial types using CBCT. The CBCT images of 64 patients with normal vertical growth patterns were classified into class I, class II, and class III based on the skeletal sagittal analysis. Depth, width, and angle of glenoid fossa were measured and assessed on CBCT images. One-way analysis of variance (ANOVA) and Tukey post-hoc test were used to compare mean values among the groups. There was a significant statistical difference in means of glenoid fossa' width between groups with skeletal class III and skeletal class I (P value: 0.038). However, no significant statistical differences were found in angle(P value = 0.18) and depth (P value = 0.40) of glenoid fossa among 3 groups. This study showed the glenoid fossa in class I patients was wider than class III patients. There were no statistically significant differences in the angle and depth of glenoid fossa in patients with a different sagittal skeletal pattern.

The proximal femoral nail is the most common device used to treat unstable intertrochanteric fractures (ITFs) (AO/OTA 31-A2 and A3) in the geriatric population. However, there is lack of radiological parameter to evaluate the entry point; hence, this study reports a new radiological parameter to evaluate the entry point of the nail. Besides, other risk factors were also examined. The series included 20 cases treated with proximal femoral nail. Those patients were emulated dependent upon clinically What's more radiologically with pelvic anteroposterior Furthermore hip parallel perspectives during 4weeks ,8weeks, 3 months,6 months postoperatively. Demographic data, radiological parameters, and side-difference of the separation from those piriformis fossa of the more terrific trochanteric tubercle in the anteroposterior perspective (dPG) were compared the middle of the union Furthermore disappointment gatherings. Student’s t test, χ 2 test, and different logistic relapse were utilized within those measurable analyses. Normal agdistis may be 63. The etiology of the fractures might have been 4 RTA patients (20%) Also 16 tumbling patients. The AO/OTA arrangement framework might have been utilized. There were 9 sort 31-A2 fractures (45%), this ponder exhibited that TAD>24mm , DPG>7mm expanded those danger about disappointment after nailing Previously, flimsy intertrochanteric fractures ,and it might have been An critical predictor from claiming disappointment. This recommended another radiological parameter, DPG will reflect the geometry of the more excellent trochanter following nailing , we discovered that expanded DPG will be connected with expanded danger from claiming disappointment. This ponder gives extra confirmation demonstrating that sex and tad have huge impacts on the results about flimsy ITFs following nailing. Moreover, the recently news person radiological parameter, dPG, could be used to anticipate those disappointment for ITFs approached utilizing proximal femoral nails.

Chondroblastoma is a rare bone tumor, accounting for less than 2% of all bone tumors. Tumors arising in the temporal bone are extremely rare. A 66-year-old female was referred to the ENT department with hearing disturbance on the right side. Computed tomography showed a mass with a bony defect on the right squamous part of the temporal bone and glenoid fossa. T2-weighted magnetic imaging revealed a low signal mass in the right squamous part of the temporal bone. The pathological diagnosis from a biopsy specimen was chondroblastoma. Complete resection of the tumor and reconstructive surgery were performed by the surgical team, which included ENT, brain, oral maxillofacial, and plastic surgeons. Histopathological findings of the surgical specimen revealed that mononuclear cells and multinucleated giant cells proliferated with extensive hemosiderin deposition with a background of fibrous tissue and a cartilage-like myxoid matrix. Immunohistochemically, the nucleus and cytoplasm of mononuclear cells were positive for the anti-S-100 protein antibody. Therefore, the pathological diagnosis of chondroblastoma was confirmed. The patient has been followed up for 5 years and 7 months postoperatively without any severe clinical disturbance or sign of recurrence.

Objectives: To determine the prevalence of the pneumatization of the articular tubercle (PAT) and glenoid fossa (PGF) concerning the sex, laterality and locularity in a sample of Egyptian population using CBCT images. Subjects and methods: 210 CBCT scans (74 males and 136 females) were assessed retrospectively by an oral and maxillofacial radiologist. The presence of pneumatization was identified bilaterally on a serial of reformatted sagittal cuts at the articu‌lar tubercle and the roof of the glenoid fossa. Age and sex for all patients were recorded as well as the type and laterality for the pneumatiza‌tion cases. Results: 19.1 % of the scans exhibited PAT and 35.24% exhibited PGF. Of the scans found with PAT, 50% were unilateral (20% on the right and 30% on the left) and 50% were bilateral. Moreover, 15 of the PAT cases were unilocular and 28 were multilocular with 3 cases showing different locularity between sides. For PGF, 41.9% of the PGF cases were unilateral (13.5% on the right and 28.4% on the left) and 58.1% were bilateral. Only 16 of the PGF cases were unilocular, while 61 were multilocular with 3 cases also showing different locularity between sides. There was no significant difference between both sexes regarding the PAT or PGF prevalence, laterality or locularity. Conclusion: In the studied sample, the prevalence of PAT and PGF was 19.1 and 35.24% respectively. The prevalence was not linked to sex or laterality or locularity.

WOS:000543953700001 PubMed: 32596805 In this retrospective study, we aimed to present important anatomical structures and distances for posterior fossa surgery by temporal multidetector computed tomography (MDCT). The temporal MDCT images of 317 adult patients (158 males and 159 females) were retrieved from the hospital's picture archiving and communication system (PACS). In the coronal temporal MDCT views, the cochlea-carotid canal and jugular bulb-mastoid bone outer surface were measured. In the axial MDCT views, the carotid canal-jugular bulb and carotid canal-posterior fossa distances were measured; the carotid canal and jugular bulb anterior-posterior (AP) and transverse dimensions were also measured. The bilateral cochlea-carotid canal, jugular bulb-mastoid bone outer surface, and right carotid canal-jugular bulb distances were significantly greater in the males than those in the females (p < 0.05). The carotid canal-posterior fossa distance was not different in both genders (p > 0.05). The carotid canal-jugular bulb and the carotid canal-posterior fossa distances were greater on the left side than those on the right side in both genders (p < 0.05). In males, the outer surface distance was greater on the left jugular bulb-mastoid bone than that on the right side of that bone (p < 0.05). The difference between the carotid canal AP dimensions was not significant between males and females (p > 0.05). However, the carotid canal transverse dimension, jugular bulb AP, and transverse dimensions were significantly greater in the males than those in the females, bilaterally (p < 0.05). In each gender separately, the carotid canal AP and transverse dimensions were greater on the left side and the jugular bulb AP and transverse dimensions were greater on the right side than those on the left side (p < 0.05). Positive correlations were found between the cochlea-carotid canal, the jugular bulb-mastoid bone outer surface, and the carotid canal-jugular bulb distances as well as between the jugular bulb-mastoid bone outer surface and the carotid canal-posterior fossa distances (p < 0.05). In older patients, the carotid canal-posterior fossa distances were shorter on the left side (p < 0.05). Vascular and neural localizations should be well understood in the operative area before applying the surgical approach in the posterior fossa. Computed tomography (CT) has a greater role in the evaluation of bone structures and vascular canals in this area.

The aim is to assess the relationship of Anterior Ethmoid Artery with the Upper Attachment of the Uncinate Process and their relation with the Lateral Lamella of the Cribriform Plate in multiplanar reconstructions (i.e. coronal, axial and sagittal) of Computed Tomography. We measured the depth of the olfactory fossa, the length of the LLCP and determined the most superior attachment of the uncinate process, which designates boundaries of the frontal recess anteriorly, laterally and medially [20,22]. Methods: All CT examinations were performed using the 320-detector Aquilion ONE CT Scanner (Canon Medical Systems, Otawara, Japan). Axial, coronal,sagittal reconstructions were performed by using dedicated workstation software (Vitrea Enterprice Siute, Version 6.7; Vital Images, Minnetonka USA). The Statistica 13 software was used for the analysis, results were considered statistically significant at the level of p

Background: Surgical treatment of symptomatic femoroacetabular impingement (FAI) and dysplasia requires careful characterization of acetabular morphology. The lateral center-edge angle (LCEA) is often used to assess lateral acetabular anatomy. Previous work has questioned the LCEA as a surrogate for acetabular contact/articular cartilage surface area because of the variable morphology of the lunate fossa. Hypothesis: We hypothesized that weightbearing articular cartilage of the acetabulum would poorly correlate with LCEA secondary to significant variation in the size of the lunate fossa. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: Patients with 3D CT imaging undergoing either hip arthroscopy or periacetabular osteotomy for FAI or symptomatic hip instability were retrospectively identified. The LCEA and femoral head diameter were measured on an anteroposterior pelvis radiograph. Patients were grouped according to their lateral acetabular coverage as undercoverage (LCEA, 40°). Patients were randomly identified until each group contained 20 patients. The articular surface area was measured from preoperative 3D CT data. Linear regression analysis was performed to examine the relationship between articular surface area and LCEA. Continuous and categorical data were analyzed utilizing analysis of variance and chi-square analysis. Statistical significance was set at P < .05. Results: No difference in age ( P = .52), body mass index (BMI) ( P = .75), or femoral head diameter ( P = .66) was noted between groups. A significant difference in articular surface area was observed between patients with undercoverage and those with overcoverage (20.4 cm2 vs 24.5 cm2; P = .01). No significant difference was identified between the undercoverage and normal groups (20.4 cm2 vs 23.3 cm2; P = .09) or the normal and overcoverage groups (23.3 cm2 vs 24.5 cm2; P = .63). A moderate positive correlation was observed between LCEA and articular surface area across all patients ( r = 0.38; P = .002) but not when patients with undercoverage were excluded ( r = 0.02; P = .88). Significant variation in surface area was observed within each group such that no patient in any group was outside of 2 SDs of the means of the other groups. When patients were categorized into quartiles established by the articular surface area for the entire population, 40% of patients with overcoverage were observed in the first or second quartile (lower area). Conclusion: Lateral acetabular undercoverage based on the LCEA (25°), however, is not predictive of increased, normal, or decreased acetabular surface area.

Caso clínico: Masculino de 49 años, con dolor tipo cólico e intermitente, en fosa renal derecha que irradia hacia flanco derecho, acompañado de náusea y vómito en múltiples ocasiones. Se diagnosticó uréter retrocavo mediante urotomografía. El paciente fue ingresado al servicio de urología. Se realizó uretero-ureteroanastomosis desmembrada derecha con abordaje abierto por lumbotomía. Se encontró dilatación de la pelvis renal y tercio superior de uréter derecho, así como trayecto ureteral que discurre posterior a la vena cava inferior. La evolución postquirúrgica del paciente fue satisfactoria. Relevancia: Es una anomalía congénita rara en la que el uréter pasa por detrás de la vena cava inferior. Solo existen alrededor de 200 casos reportados en el mundo. Implicaciones clínicas: Se presenta hasta en un 70% de los casos con dolor en el flanco derecho que puede ser sordo y persistente o un cólico renoureteral franco. El método de diagnóstico principal es la urotomografía y su tratamiento casi siempre es quirúrgico. Conclusión: Los pacientes con uréter retrocavo pueden o no requerir tratamiento quirúrgico, según su manifestación de síntomas, y de requerirlo se puede realizar cirugía abierta o de mínima invasión ya que aún no existe un estándar de oro quirúrgico descrito.

Purpose This study sought to assess the relationships between a morphological characteristic of the superior semicircular canal (SSC) and both the roof thickness of the glenoid fossa (GF) and bone changes of the temporomandibular joint (TMJ) on three-dimensional images. Methods Cone-beam computed tomography (CBCT) images of 200 individuals (105 females and 95 males; 400 temporal bone regions) were examined by two different observers. The correlations between the bone thickness overlying the SSC and the thickness of the roof of the GF with TMJ's bone pathologies were analyzed. Results The superior semicircular canal dehiscence (SSCD) was significantly associated with dehiscence of the roof of the GF. The relationship between the dehiscence of the SSC and the roof thickness of the GF was found to be strongly correlated (p < 0.05). There were no statistically significant differences between the bone changes of TMJ and the presence or absence of the SSCD. Conclusions A correlation between the bone thickness overlying the SSC and the roof thickness of the GF was found. However, there was no relationship between the bone thickness overlying the SSC and bone changes of TMJ.

The aim of this study was to evaluate temporomandibular joint (TMJ) condyle and glenoid fossa morphology with measurements on Computed Tomography (CT) and volumetric analysis using InVesalius software program. 250 condyles in 125 patients (mean age: 40.64) was evaluated on CT. Length, width, and height of the condyle, condylar volume, the thickness of glenoid fossa (TGF), condyle surface area, anterior space (AS), superior space (SS), and posterior space (PS) were measured in this study. Two left and right sides of the jaw have been measured. Linear measurements were performed with the image analysis program (Image J, 1.4 v version, National Institutes of Health, Bethesda, MD). Volume and surface area measurements were performed with InVesalius software (CTI, Campinas, SaoPaulo, Brazil). To compare the dimensions of the condyle between males and females, there was only a significant difference in left AS and SS and no significant difference was found between males and females in other measured factors. There was a significant difference between the age groups and left SS. A significant difference was also found between the age groups and condylar height, condyle surface area, and condylar volume on both right and left sides. Evaluation of condylar morphology is important to assess the TMJ anomalies and bony changes. This study showed no significant differences between gender and all measured factors except in the left AS and SS. However, age factor had a major effect on the morphology.

Introduction: Skull base (SB) injuries happens mostly either in the thinnest or the least resistant part of skull base. The lateral lamella of cribriform plate is one of the common sites of injury during endoscopic anterior skull base surgeries. The anterior ethmoid artery (AEA) visualization is considered as a significant anatomical landmark in such surgeries. Studies correlating their positional relation with morphology of olfactory fossa remains limited. This study aims to look into the relation of AEA to that of SB in different types of olfactory fossa morphology. Materials and Methods: A retrospective radiological study was done on 100 coronal CT images from patients who were subjected to paranasal CT imaging. In bone window of coronal CT scans, the position of AEA in relation to SB was noted and the vertical distance between them was measured. Based on the distance of AEA from SB, 3 groups were subdivided as follows: Group A - mm and Group C - > 5 mm. The depth of the olfactory fossa was measured and categorized according to Keros classification. Results: Out of 200 sides, AEA was found below SB in 167 out of 200 (83.5%) with majority belonging to Group A (101 out of 167). Keros type II was commonly observed among all the groups. The position of AEA below SB was seen at a greater frequency as the height of SB increased with the Keros classification and was statistically significant (P = .006) Conclusion: The knowledge of presence of anterior ethmoid artery outside the skull base with long lateral lamella preoperatively would help the surgeon to avoid intraoperative complications during endoscopic skull base or sinus surgeries. Keywords: Anterior ethmoid artery, Skull base, Lateral lamella, Olfactory fossa, Keros.

Posterior shoulder instability is often hard to diagnose with clinical examination. Patients generally present with vague pain, weakness, and/or joint clicking but less frequently complaining of frank sensation of instability. Imaging examinations, especially MR imaging and magnetic resonance arthrography, have a pivotal role in the identification and management of this condition. This review describes the pathologic micro/macrotraumatic magnetic resonance features of posterior shoulder instability as well as the underlying joint abnormalities predisposing to this condition, including developmental anomalies of the glenoid fossa, humeral head, posterior labrum, and capsular and ligamentous structures.

Background Primary lacrimal sac melanoma is an extremely rare condition with fewer than 50 cases reported so far. Clinically, its symptoms resemble those of dacryocystitis, leading to frequent misdiagnosis. During diagnosis, imaging examination is often performed to differentiate tumors from inflammation. In this report, we present a case of primary lacrimal sac melanoma and summarize the CT and MRI characteristics of lacrimal sac melanoma. Case presentation We report a 50-year-old female patient who had undergone a dacryocystectomy for the left lacrimal sac mass. Postoperative pathological examination confirmed the presence of primary malignant melanoma. Three months later, a lump in the lacrimal sac area was found. The patient underwent CT and MR examinations. CT scan demonstrated a partially well-defined soft mass in the fossa of left lacrimal sac extending into the nasolacrimal duct and anterior ethmoid sinus. MRI revealed an intermediate signal intensity on T1 and iso-or hyper-signal on T2 weighted images. Histopathological examination on biopsy confirmed recurrence of primary lacrimal sac melanoma. Discussion and conclusions None has described the CT and MR findings of primary lacrimal sac melanoma so far. Typically, MR images show hyperintensity signal on T1-weighted images and hypointense signal on T2-weighted images owing to the paramagnetic properties of melanin. In contrast to previous reports and the present case, most cases do not present these typical signals. Thus, reporting such radiological findings is important to create awareness on variant images of primary lacrimal sac melanoma. This will reduce misdiagnosis and mistreatment.

The purpose of this study was to evaluate the tooth structure theoretically required to be removed in the coronal and cervical regions to accomplish 3 different endodontic access preparations in a novel digital model. The deviation of the center of access cavity from the central fossa will also be measured and compared among the 3 endodontic cavity designs, which in turn may serve as suggested points of entry for different access openings.Twenty-one maxillary molars and 15 mandibular molars were selected and 3-dimensionally imaged with cone-beam computed tomographic imaging. Three-dimensional (3D) volume reconstructions were made and converted into stereolithography files. Digital access cavity preparation was performed on each 3D reconstruction model with the 3 most commonly used endodontic access preparations: minimally invasive (MI), modified straight-line (MS), and traditional straight-line (TS) techniques. After the access cavity outlines were determined, digital sectioning of each reconstructed 3D tooth model was performed orthogonal to the long axis of the tooth at 3 levels: (1) passing through the central fossa, (2) 1.5 mm apical to the central fossa, and (3) 2 mm apical to the cementoenamel junction. The linear distance from the centroid of the access opening to the central fossa was measured to calculate the point of entry, and the amount of tooth structure removal at the pericervical area was measured to calculate the theoretically minimum amount of linear dentin removal required. Two-way repeated measures analysis of variance was performed for the interactions between different access designs and the amount of cervical dentin removal. Other data were statistically analyzed with 1-way repeated measures analysis of variance. The Tukey post hoc test was used for multiple comparisons. Significance was set at .05.The amount of deviation of the center of the access cavity from the central fossa in all test groups was less than 1 mm. The dimensions of access openings differed significantly among the 3 access forms (TS MSMI, P.0001). The amount of required cervical dentin removal was the greatest in the TS method followed by the MS and MI methods (P.0001).The central fossa could serve as good starting points in all access preparations in both maxillary and mandibular molars. Dentin removal in the coronal and cervical regions was the greatest in the TS design followed by the MS and MI designs. When comparing different canals in the same access form, less cervical dentin was sacrificed in the palatal canals of maxillary molars and the distal canals of mandibular molars.

The anterior extent of the sphenoidal sinus in the posterior ethmoid was less investigated. Our purpose was to study whether, or not, the occurrence of a sphenoethmoidal sinus (SES) relates to a sagitally-shortened ethmoid. A retrospective cone-beam computed tomography (CBCT) was performed on 36 patient files. In six patients were found SES extended anteriorly above the posterior third of the middle turbinate (MT). Two of these patients had bilateral SES with ethmoidal chambers included in the lateral and superior nasal walls and draining in the sphenoethmoidal recesses. The correlation between the nasion-to-concha sphenoidalis distance and the presence of SES was statistically significant (less than 40 mm in SES cases and more than 40 mm in non-SES cases). We also found: (i) superior turbinates (STs) with ethmoidal and sphenoidal insertions on one side and ethmoidal and maxillary insertions on the opposite side (the maxillary insertion of ST modifies surgical landmarks and was not previously reported), (ii) MT perforation and (iii) pterygoid recess of the maxillary sinus located beneath the pterygopalatine ganglion fossa. The SES thus shortens sagitally the lateral nasal wall but does not modify its morphology. The MT perforation, ST maxillary insertion and the pterygoid recess are rare anatomic variants not reported previously in our knowledge.

Intriguing anatomists and surgeons for centuries, the exact function and biomechanical significance of the ligamentum teres (LT) remains incompletely understood. The LT, also described as the ligamentum femoris capitis, is an intra-articular extrasynovial ligament extending from the cotyloid fossa of the acetabulum to the fovea on the femoral head. Some studies have described it as a vestigial structure in the adult hip. More recent biomechanical studies, however, along with histological and anatomical studies, have suggested the LT to have an important function in proprioception, nociception, and as a secondary stabilizer of the hip joint. The advent and increased utilization of hip arthroscopy to treat hip pathology over the past two decades has ignited a renewed interest in the role of the LT, as well as techniques and indications for management of pathology. In the constellation of intra-articular pain generators of the hip, LT injuries have historically been difficult to diagnose through physical examination or advanced imaging. Numerous classification systems have been proposed based on arthroscopic appearance, and for most cases, conservative management is adequate. In patients undergoing hip arthroscopy, LT débridement usually suffices, although in cases of persistent pain and severe instability, reconstruction of the ligament may be indicated. Multiple methods for reconstruction have been described, with the greatest variation in the method of acetabular fixation of the graft. Future research should focus on clarifying the role of the LT, appropriate surgical indications for reconstruction, and optimization of graft fixation within the acetabulum.

The peculiar sphenoidal “pits” of the common warthog (Phacochoerus africanus) long have been recognized as a feature that distinguishes that species from the closely related desert warthog (P. aethiopicus). Authors seem to regard these structures as blind pockets that do not extend beyond the basicranium. However, these structures actually are openings that lead into a complex system of sinuses (the sphenoidal sinuses) located in the sphenoid and squamosal, and occasionally extending into the occipital and parietal bones. The openings appear to serve as a drain into the nasopharynx. The sphenoidal “pits” of P. africanus as currently defined by most authors are, therefore, not homologous with the sphenoidal pits of P. aethiopicus. We suggest that the term “sphenoidal apertures” be applied to these openings. The true homologue of the sphenoidal pits of P. aethiopicus is the bone that surrounds the sphenoidal apertures in P. africanus. This would include the thin bony sheet that forms the floor of the opening and that bears a shallow fossa. We recommend the term “sphenoidal shelf” be employed to describe this part of the true sphenoidal pit of P. africanus. In addition to the sphenoidal sinuses, the maxillary and frontal sinuses of P. africanus also are described. We report the possibility of mammalian cranial sinuses arising from nasopharyngeal diverticula rather than from diverticula originating from the nasal cavity proper. Previously, such nasopharyngeal pneumatization only has been known to occur in Reptilia. Possible sinus functions are discussed including shock absorption, lightening of the skull, improvement of olfaction, and enhancement of the immune system. In addition to P. africanus, sphenoidal apertures also occur in Babyrousa, and in an extinct perissodactyl, a brontothere (= titanothere).

Objective To investigate the effects of fixed anterior biteplane treatment on temporomandibular joint in deep bite patients. Methods The sample comprised 17 Class II patients with deep bite and decreased lower anterior facial height. The average patient age was 9.9±0.9 years. Transcranial temporomandibular joint radiographs were obtained from the subjects before (T0) and after fixed anterior biteplane treatment (T1). Anterior joint space, posterior joint space, superior joint space, anteroposterior thickness of the condylar head, vertical height of the articular fossa, and the articular fossa slope were measured on temporomandibular joint radiographs to evaluate the position of the mandibular condyles in the glenoid fossa. Results The average treatment duration was 8.5±2.1 months. Slope of the articular fossa, vertical height of the articular fossa, anteroposterior thickness of the condyle, posterior joint space, superior joint space, and anterior joint space showed no statistically significant difference between T0 and T1 (p>0.05). Conclusion Fixed anterior biteplane appliance treatment did not change the condyle fossa relationship in Class II deep bite patients at the time of appliance removal.

The epiphyseal tubercle plays an important role in epiphyseal stabilization. While the majority of studies have focused on tubercle morphology, there is a paucity of information on the morphological features of the metaphyseal fossa, where the tubercle sits on the metaphysis. The goal of this study was to determine the developmental changes in the capital femoral metaphyseal fossa. Computed tomography of the pelvis from 80 children and adolescents 8-15 years old were used to create three-dimensional models of the proximal femur. Depth, width, length, and surface area of the metaphyseal fossa were measured and the impact of age and sex on fossa morphology was assessed using the linear regression and two-way analysis of variance, respectively. The metaphyseal fossa was located in the posterosuperior quadrant of the metaphysis without any variations in the location with increasing age (P .1). However, with increasing age, there was a reduction in all metaphyseal fossa measurements including the depth, length, width, and surface area (P .01). No significant differences were noted for the metaphyseal fossa measurements between males and females (P .1). The metaphyseal fossa reduces in size from 8 to 15 years of age in a similar fashion in males and females. As the metaphyseal fossa adjacent to the tubercle matches the area where a focal radiolucency has been observed in early slipped capital femoral epiphysis (SCFE), further studies should clarify the mechanisms by which the interlocking interaction of the epiphyseal tubercle and its fossa contributes to or is affected by SCFE.

Objectives: The purpose of this study is to explore the curative effect of open surgical excision and endoscopic radiofrequency ablation (RA) in the treatment of piriform fossa fistula (PSF). Methods: Retrospective study of 80 cases of PSF in the Department of Otolaryngology-Head and Neck Surgery, Shanghai Children’s Hospital, from June 2009 to June 2017. Results: In this series, there were 43 males and 37 females, and the mean age was 5.2 years (17 days to 12 years). Surgical excision was performed for 62 patients. Radiofrequency ablation was performed for 18 patients. Six cases of postoperative temporary hoarseness occurred, and the hoarseness rates were not significantly different between the excision and RA groups (6.4% vs 11.1%, respectively, P = .88). Two cases of temporary neck abscess occurred in the RA group. After the mean follow-up period of 3.1 years (1-8 years), no recurrence was found between the excision and RA groups. Conclusions: The curative effect of excision and RA for PSF is not significantly different; each of the 2 methods has its advantages and disadvantages. However, RA for PSF has the merit of being minimally invasive, easy to operate, and safe; this procedure seems to be more suitable in the clinic.

Introduction: Anatomy of Human Orbit is complex, which plays main character in the assessment of craniofacial complex. The bony orbit which lodges the Eye ball is significant not only for anatomists but also for oral and maxillofacial surgeons, forensic experts, ophthalmic surgeon, and Neurosurgeon. The main objectives of the existent study to specify the common location orbital parameters of the Maharashtrian population. Materials and Methods: 31 dry human skulls were taken for observational study from department of anatomy IIMSR Warudi, Badnapur. All skulls were adult type. The exact age and sexes of the skulls were not known. Those were used for tutorial teaching for medical students. Measurements: The measurements for dimension of orbital cavities were taken with the help of manual Vernier Caliper. Orbital Length: This indicates distance between superior and inferior margin of orbital fossa. Orbital Breadth: Distance between medial and lateral walls of orbital fossa (from frontal process of zygomatic arch to frontal process of maxilla. Orbital Index: Calculated as Orbital length/Orbital Breadth X 100. Measurements were recorded and expressed as Mean± Standard Deviation and range (Min. value – Max. value of each measurement). Results: The results indicate that right orbital length displayed (33.70 ± 1.20 mm) and right orbital Breadth exhibited(38.90 ± 2.20 mm). From these consequences, orbital index was estimated as orbital length/Orbital breadth x 100. A mean orbital index of right side 86.63mm and left side 85.99mm was deduced (Table 1). The assessment of figures from pair of orbits by paired t test shows statistically significant difference in orbital length (p=0.021) and orbital index (p=0.011). Whereas, Orbital breadth has not shown statistically significant difference (p=0.25). Conclusion: This study specifies valuable reference orbital morphometric facts of Maharashtrian population, which are very significant throughout the Maxillofacial Plast

Diurnal primates commonly modify their behaviour in response to predator vocalizations, but little is known about how nocturnal primates perceive predator calls. Mouse lemurs do not innately perceive predator calls as dangerous but may learn to do so in the wild. I hypothesized that wild brown mouse lemurs (Microcebus rufus) in Ranomafana National Park, Madagascar, differentiate between predator and non-predator vocalizations and exposed 29 adult subjects to calls of 3 sympatric predators (goshawk, fossa and owl), 3 sympatric non-predators and 4 controls. Brown mouse lemurs did not differentiate among stimuli, and there was no evidence that any recording was associated with danger, as neither activity nor spatial preferences changed in response to a stimulus, nor did subjects exhibit obvious behaviours indicative of danger such as flight or position on the branches. The failure to perceive predator calls as dangerous is common among small nocturnal solitary prey species and could be explained by a lack of learning opportunities. In social species acquired behaviours can spread quickly by social learning. Solitary species like mouse lemurs have to individually learn to associate predator calls with danger which is dependent on encounter rates. Unlike diurnal prey mouse lemurs lack the opportunity to observe diurnal raptors and associate their calls with the bird, and owls are proficient predators, which are difficult to observe in a rain forest where they hunt cryptically from perches. While sometimes nocturnal, the fossa is solitary and largely silent, and is also particularly rare at my study site. Cryptic, rare or non-vocal predators provide prey with few opportunities to associate their calls with danger. Mouse lemurs are subject to high predation rates by a wide range of predators and need to balance the costs and benefits of antipredation behaviours. Their cryptic lifestyle and preference for dense vegetation lowers the likelihood of being detected by predators, and they utilize visual and olfactory predator cues to make decisions about risk. Furthermore, their high reproductive output compensates for the high predation rates.

OBJECTIVES/HYPOTHESIS Upper respiratory tract infections are a common cause of temporary and permanent olfactory dysfunction in the general population. Postviral or postinfectious olfactory loss (PIOL) develops only in rare cases. The aim of this study was to investigate the anatomical features of olfactory cleft (OC) in patients with PIOL to shed light on possible predisposing factors for PIOL. STUDY DESIGN Retrospective study. METHODS We retrospectively evaluated paranasal sinus computed tomography (CT) scan results of patients diagnosed with PIOL. A control group consisted of normosmic individuals who underwent paranasal sinus CT scans before septoplasty surgery. We compared the olfactory fossa depth, OC width, and volume on the CT scans of the PIOL and control groups. RESULTS In total, 71 individuals fulfilled the study criteria (PIOL group, n = 32; control group, n = 39). There was no statistically significant difference in the olfactory fossa depth in the two groups. The OC width and volume in the PIOL group was found to be significantly increased than that in the control group (P

Anterior mandibular dislocation (AMD) is defined as the displacement of the condylar head out of the glenoid fossa beyond the articular eminence, and that does not reduce spontaneously to its normal position. The Hippocratic method is the usual approach for condylar repositioning at most health centers although it is perceived by the patient as an unpleasant, brusque technique and outcomes are not always favorable. OBJECTIVE: The aim of this work is to describe a new simplified nontraumatic manual technique and its application in a series of cases. METHOD: A procedure based on gently and constantly guiding the patient’s mouth opening and closing movements is described in detail. RESULTS: Forty-two patients were treated with a treatment success rate of 100%, and no pain associated with the procedure. Procedure time was 1.5–7 min in 40 of the 42 treated cases. CONCLUSION: The procedure presented here is an improvement on the original technique: it is simple, fast, effective, can be performed in any setting, and avoids use of brusque force, which is the factor that causes the patient most discomfort and fear.

The surgical removal of the infratemporal parapharyngeal lesions (IPL) is challenging due to its anatomical complexity. Previous surgical approaches have often been too invasive and necessitated sacrifice of normal function and anatomical structures, particularly in the retromandibular nerve region. Therefore, we sought to identify an approach corridor to this area that requires less sacrifice and report an innovative approach through a retromandibular fossa route to the IPL. Five cadaveric specimens were dissected bilaterally with a trans-tympanic plate and styloid process approach. These specimens were investigated microanatomically and morphometrically to examine the extent of the approach in the parapharyngeal space. The clinical application of this approach was compared to previous approaches to the IPL used in our clinical series of 20 cases. Using this novel approach, the inferior alveolar nerve was identified in all specimens, while the chorda tympani and lingual nerve were identified in 6 (60%) and 4 (40%) dissections, respectively. In all specimens, the petrous portion of the internal carotid artery and the exit of the lower cranial nerve were identified. The average length of the exposed lower cranial nerves was 16.6 ± 3.8 mm (range: 11–25 mm). The described approach is feasible for accessing the IPL at the retromandibular nerve and is less invasive than conventionally used approaches.

Boering’s arthrosis is a rare disorder of the temporomandibular joints that usually occurs in the second decade and seldom after age 20. It was first described by G. Boering in 1966. It is more common in females and can be unilateral or bilateral. The disease results in resorption of the condyle with elongation of the articular surface resulting in the characteristics toadstool appearance observed on panoramic images. Condylar changes are often accompanied by anterior displacement of the disc and remodeling of the glenoid fossa. Facial asymmetry is almost always present. We present a case of a 9-year-old female with Boering’s arthrosis. She presented with facial asymmetry and bite abnormality but did not report symptoms typically associated with temporomandibular disorders.

This technique is suitable to lesions situated in the region of the anterior fossa, suprasellar cisterns, parasellar region and Sylvian fissure. Should assess the supra-orbital approach through eyebrow entry point to surgical extraction from claiming tumors to foremost cranial fossa What's more supra-sellar area. A 50 mm entry point in the eyebrow What's more a supraorbital minicraniotomy will be performed. 20 patients harboring separate lesions were worked around for beneficial postoperative Furthermore cosmea outcomes. We infer that thisapproach is safe Furthermore advantageous in chose cases. 20 patients harboringdifferent lesions were worked looking into with useful postoperative Furthermore cosmea effects. We infer that thisapproach will be protected What's more advantageous in chose cases.

Introduction: Dental implant is the most preferable option for the replacement of missing teeth because of its advantage of maintaining the structural and functional integrity of bone, like that of a natural tooth. Aim and Objectives of the Study: Aim of this study is to evaluate the depth of submandibular gland fossa and its relationship with the mandibular canal, based on gender and side of the mandible. Materials and Methods: 100 CBCT scans of both males and females were acquired. The deepest region of submandibular gland fossa and the superior, parallel, and the inferior relationship of the mandibular canal to submandibular gland fossae were obtained. Results: The mean ± SD of the depth of the submandibular gland fossa on the right side in males and females were 1.69 ± 0.73 mm and 1.62 ± 0.58mm, respectively, and those on the left were 1.69 ± 0.61 mm and 1.56 ± 0.42 mm, respectively. The deepest region in both the genders was above the infra-alveolar canal. Conclusion: Males showed greater depths when compared to females, Right side of the mandible showed greater depth when compared to the left side in both genders. Therefore, careful evaluation of alveolar bone thickness during implant placements is of great importance in males.

Teratomas have been reported to occur in multiple organ regions, and are less common in non-gonadal regions, such as the neck and chest, than in gonadal and midline regions of the body, such as ovaries and testis. Cases have been reported of a large teratoma of the anterior mediastinum extending to the neck, causing symptoms such as dyspnea, which can be quickly detected by Ultrasound, and patients can be quickly treated. In adults, primary teratoma at the suprasternal foss that not accumulate thyroid gland upward and not invade the mediastinum are rare, usually have no obvious clinical symptoms and are found in most patients by chance. In this literature, we report a rare case of mature cystic teratoma in the suprasternal fossa of a 33-year-old male. Preoperative ultrasonography showed a superior sternal fossa tumor with less calcification and more adipose tissue. The final pathologic diagnosis was mature cystic teratoma through open surgery of the suprasternal neck incision. The patient was followed up for 9 months and there was no recurrence. We believe that the suprasternal notch approach is a safe and effective method for the treatment of mature teratoma without protruding into the superior mediastinum.

Magnetic resonance imaging (MRI) was used to observe growth of the mandibular condyle, mandibular fossa, and articular disc as a single unit. Changes in each component's relative position and size were observed using 7-tesla MRI. Mandibular condyle chondrocytes' growth was evaluated with immunohistochemistry, using the expression of zinc transporter ZIP13. Three-dimensional T1-weighted (T1w) MRI was used to obtain images of the TMJ of Sprague Dawley rats at 4-78 days old (P4-78) with a voxel resolution of 65 μm. Two-dimensional T1w MR images were acquired after a subcutaneous injection of the contrast reagent gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA). The T1w MR images showed that the mandibular condyle was located posterior to the mandibular fossa until P20; however, it then moved to a location underneath the mandibular fossa. In the Gd-DTPA enhanced images, the articular disc was identified as a region with lower signal intensity from P20. The number of ZIP13-positive chondrocytes at P6 was larger than the number at P24. In conclusion, the mandibular condyle with cartilage and disc grows on the posterior side of the mandibular fossa until P20, which was the weaning age. Then, the condyle fit into the mandibular fossa and completed the functional unit.

Background/aim Down syndrome (DS) patients often show characteristic changes in the skull, e.g. short cranial base. The synchondroses of the skull base have a significant influence on the shape of the skull. The sphenooccipital synchondrosis (SOS) is the last of the basal synchondroses to ossify. This report is about residual ossification of SOS in an elderly patient with DS. Case report The 65-year-old DS patient was polytraumatized by a fall. In the course of treatment, a purulent otitis externa on the right side was diagnosed, which had developed as a result of the fracture of the fossa glenoidalis. Computed tomograms of the skull base showed the fracture of the mandibular condyle, glenoid fossa and vestiges of SOS. Conclusion The coincidental finding of vestiges of SOS in an elderly patient with DS raises the question of whether cross-sectional skull base images can show differences in the ossification of SOS between DS patients and a normal population.

Purpose To compare the 3D morphology of the metaphyseal fossa among mild, moderate and severe stable slipped capital femoral epiphysis (SCFE) and normal hips. Methods We identified pelvic CT of 51 patients (55% male; mean 12.7 years (sd 1.9; 8-15)) with stable SCFE. In all, 16 of 51 hips (31%) had mild, 14 (27%) moderate and 21 (41%) severe SCFE. A total of 80 patients (50% male; mean age 11.5 years (sd 2.3; 8 to 15)) with normal hips who underwent pelvic CT due to abdominal pain made up the control cohort. CT scans were segmented, and the femur was reformatted using 3D software. We measured the metaphyseal fossa depth, width, length and surface area after the epiphysis was subtracted from the metaphysis in the 3D model. Results The metaphyseal fossa width was significantly larger in severe (adjusted difference: 6.9%; 95% confidence interval (CI) 2.1 to 11.8; p = 0.001), moderate (6.5%; 95% CI 0.8 to 12.2; p = 0.02) and mild SCFE (6.2%; 95% CI 0.8 to 11.6; p = 0.01), in comparison with normal hips. Severe SCFE showed larger fossa length compared with mild SCFE (6.8%; 95% CI 0.6 to 13.0; p = 0.02) and normal hips (6.0%; 95% CI 1.4 to 10.6; p = 0.004). The fossa surface area was larger in severe (3.5%; 95% CI 1.3 to 5.7; p < 0.001) and moderate SCFE (2.7%; 95% CI 0.1 to 5.2; p = 0.03) when compared with normal hips. There were no differences in fossa depth between SCFE and normal hips. Conclusion The metaphyseal fossa is wider and more extensive but not deeper in hips with moderate and severe SCFE in comparison with normal hips. Although hips with severe SCFE had larger length and surface area than mild SCFE hips, further research is needed to clarify whether enlargement of the metaphyseal fossa is a consequence of slip progression. Level of Evidence III

Background: Temporomandibular joint is a mobile synovial joint where articulated bones are separated by a joint cavity. Its functional harmony is disrupted by a long standing period of edentulousness which could be analyzed using lateral Cephalograph. Aim and Objectives: To evaluate the condyle–fossa position and articular eminence angulation in dentate and edentate patients using a lateral cephalogram along a different axis. Materials and Methods: Cross-sectional study consisted of randomly selected 40 patients with 20 dentulous patients (Group I), and age- matched 20 completely edentulous patients (Group II), within an age group 45–65 years. Lateral cephalograms were performed for all selected patients using single Kodak 8000C digital OPG/Ceph machine, (Rochester, New York, United States). All the radiographs were digitally traced and evaluated twice for condyle- fossa position along X and Y axis and articular eminence angulation by an Oral & maxillofacial radiologist at an interval of two days. The collected data was tabulated and analyzed using SPSS Software version 20 using unpaired t-test and tests of normality. Results: Significant difference in condyle - fossa distances along the X and Y axis in two study groups was suggestive of more upwards and forwardly placed condyles and more anteriorly placed glenoid fossae in Group II patients. Also, articular eminence angulation was noted more in edentulous patients but the difference was statistically insignificant. Conclusion: A great variation in condylar–fossa position was observed in the edentulous patient when compared to the dentulous patient due to remodeling or degenerative changes that occur during the period of edentulousness.

Pneumatization in the osseous components of the temporomandibular joint (TMJ) may represent a complicating factor in TMJ surgery. This study determined the prevalence and characteristics of pneumatized articular eminence (PAE) and pneumatized glenoid fossa (PGF) using cone beam computed tomography (CBCT) scans of patients with and without dentofacial deformities. The CBCT of 587 asymptomatic patients (216 class I, 179 class II, 192 class III) were assessed to determine PAE and PGF. Age, sex, laterality, and type (uni/multilocular) of pneumatization were recorded. Differences were tested using the χ2 test and binary logistic regression models (P

Neuroenteric cysts, are rare benign endodermal lesions which mostly occur in the central nervous system. We report a case of a neuroenteric cyst in a 30-year-old man who presented with rhinoliquorrhea at the ENT department. After clinical examination, a semisolid mass was revealed in the left nostril. The Computer Tomography Scan revealed a frontal ethmoidal nasal meningoencephalocele with inferior extension into the left nostril. Gadolinium-enhanced T1-weighted MR images showed a well-defined frontal mass with ring-like enhancement and extension into the cribriform plate of the ethmoid bone and into the left nostril. The lesion measured 10/10/20 mm. The tumor was totally resected using a unilateral subfrontal approach. At five months’ follow-up, the patient showed significant amelioration of symptoms and remission of cerebrospinal fluid leakage. Native and Contrast-enhanced Cerebral Computer Tomography, as well as Magnetic Resonance Imaging showed total surgical resection of the cyst. Supratentorial neurenteric cysts involving the anterior fossa are rare. Intracranial neurenteric cysts should be differentiated by any well-demarcated cystic tumors. The gold standard treatment remains complete surgical resection with favorable outcome.

Background The relationship between the lateral deviation of chin and the upper and middle facial third asymmetry is still controversial. The purpose of this study is to evaluate the correlation of upper and middle facial third asymmetry with lateral deviation of chin using 3-dimensional computed tomography. The study was conducted on patients who underwent orthognathic surgery from January 2016 to August 2017. A total of 40 patients were included in this retrospective study. A spiral scanner was used to obtain the 3-dimensional computed tomography scans. The landmarks were assigned on the reconstructed 3-dimensional images, and their locations were verified on the axial, midsagittal, and coronal slices. The Pearson correlation analysis was performed to evaluate the correlation between chin deviation and difference between the measurements of distances in paired craniofacial structures. Statistical analysis was performed at a significance level of 5%. Results In mandible, the degree of chin deviation was correlated with the mandibular length and mandibular body length. Mandibular length and mandibular body length are shorter on the deviated-chin side compared to that on the non-deviated side (mandibular length, r = −0.897, p value < 0.001; mandibular body length, r = −0.318, p value = 0.045). In the upper and middle facial thirds, the degree of chin deviation was correlated with the vertical asymmetry of the glenoid fossa and zygonion. Glenoid fossa and zygonion are superior on the deviated-chin side than on the non-deviated side (glenoid fossa, r = 0.317, p value = 0.046; zygonion, r = 0.357, p value = 0.024). Conclusion Lateral deviation of chin is correlated with upper and middle facial third asymmetry as well as lower facial third asymmetry. As a result, treatment planning in patients with chin deviation should involve a careful evaluation of the asymmetry of the upper and middle facial thirds to ensure complete patient satisfaction.