Condylus Occipitalis’in Morfometrik-Topografik Özelliklerinin ve Klinik Öneminin Değerlendirilmesi

Year 2022, Volume: 6 Issue: 2, 212 - 219, 31.08.2022

Serdar Babacan Rohat Bayat Mustafa Deniz

https://doi.org/10.29058/mjwbs.1160776

Abstract

Amaç: Kraniyovertebral bileşkede uygulanacak cerrahi operasyonlarda morbidite ve mortaliteyi
azaltmak için kafa tabanında yer alan anatomik yapıların ve bu yapılar arasındaki topografik ilişkinin
bilinmesi önemlidir. Lateral suboksipital kraniotomi ve condylus occipitalis rezeksiyonu tercih edilen
yöntemler arasındadır. Condylus occipitalis rezeksiyonu sırasında etrafında yer alan nörovasküler
yapılar hasar görebilir. Çalışmanın amacı, kişinin kafa iskeleti morfometrisinden yola çıkarak, condylus
occipitalis’in tam olarak yerini belirleyecek ve etrafındaki anatomik yapılara olan uzaklıkları tahmin
edecek regresyon formüllerini geliştirmektir.
Gereç ve Yöntemler: Çalışma Harran Üniversitesi Tıp Fakültesi Anatomi Laboratuvarında bulunan 22
condylus occipitalis (11 kafatası) üzerinde gerçekleştirildi. Belirlenen 27 parametre kafataslarının alt, ön,
yan ve arka fotoğrafları üzerinde Image J programı ile ölçüldü. Çoklu doğrusal regresyon analizi yapıldı. Bulgular: Condylus occipitalis’in morfometrik ve topografik özelliklerini belirlemek için; Condylus occipitalis uzunluğu= -2,142 + (0,330 x
P15) – (0,468 x P19) – (0,748 x P20) + (0,807 x P21) Düzeltilmiş R2= 0,911; Tahminin Standart Hatası= 0,938 şeklinde formüller geliştirilmiştir.
Sonuç: Tanımlayıcı istatistik bulgularında gözlenen en küçük en büyük değer arasındaki fark ve bu değerler arasındaki dağılım ile literatürde
yer alan çalışmalardaki farklı bulgular dikkate alındığında ortalama değerler üzerinden yapılacak girişimlerde hatalı uygulamalar olabilir.
Geliştirmiş olduğumuz formüllerin kişiye özgü yaklaşımlarda fayda sağlayacağı kanaatindeyiz.

Keywords

Condylus occipitalis, Kafa tabanı, Lateral suboksipital kraniotomi

Evaluating The Morphometric-Topographic Features of the Occipital Condyle and the Clinical Significance

Abstract

Aim: To reduce morbidity and mortality in surgical operations to be applied to the craniovertebral junction,
it is important to know the anatomical structures in the skull base and the topographical relationship
between these structures. Lateral suboccipital craniotomy and occipital condyle resection are among
the preferred methods. Surrounding neurovascular structures may be damaged during occipital condyle
resection. The aim of study was to develop regression formulas that will determine the precise location
of the occipital condyle and estimate the distances to the surrounding anatomical structures, based on
the skull morphometry of the person.
Material and Methods: The study was carried out on 22 condylus occipitalis (11 skulls) at Harran
University, Medical Faculty Anatomy Laboratory. The determined 27 parameters were measured via the
Image J program on the skulls’ inferior, anterior, lateral and posterior aspect photographs. Multiple linear
regression analysis was performed.
Results: To determine the morphometric and topographic features of the occipital condyle, the
equations have been developed such as; The occipital condyle length= -2.142 + (0.330 x P15) – (0.468
x P19) – (0.748 x P20) + (0.807 x P21); Adjusted R2= 0.911, Standard Error of the Estimation= 0.938.
Conclusion: Considering the difference between the minimum and the maximum values observed in
descriptive statistics, the distribution between these values, the different findings in the studies in the
literature, there may be erroneous applications in the attempts to be made over the mean values. We
believe that the formulas we have developed will be beneficial in personal-specific approaches.

Keywords

Occipital condyle, Skull base, Lateral suboccipital craniectomy

References

• 1. Mahajan D, Agnihotri A, Sheth A, Brar R. An anatomical perspective of human occipital condyles and foramen magnum with neurosurgical correlates. Anatomy. 2013;6-7:29-33.
• 2. Verma R, Kumar S, Rai AM, Mansoor I, Mehra RD. The anatomical perspective of human occipital condyle in relation to the hypoglossal canal, condylar canal, and jugular foramen and its surgical significance. J Craniovert Jun Spine. 2016;7:243‐9.
• 3. Standring S. Head and neck: Overview and surface anatomy. In: Gleeson M, Tunstall R, editors. Gray’s Anatomy. The Anatomical Basis of Clinical Practice. 40th ed. Edinburg: Churchill and Livingston; 2008.415-6.
• 4. Avci E, Dagtekin A, Ozturk AH, Kara E, Ozturk NC, Uluc K, Akture E, Baskaya M.Anatomical variations of the foramen magnum, occipital condyle and jugular tubercle. Turk Neurosurg. 2011;21:181-90.
• 5. Al-Mefty O, Borba LAB, Aoki N, Angtuaco E, Pait G. The transcondylar approach to extradural nonneoplastic lesions of the craniovertebral junction.J Neurosurg 1996;84:1-6.
• 6. Seyfried DM, Rock JP. The transcondylar approach to the jugular foramen: A comparative anatomic study. Surg Neurol 1994;42:265-71.
• 7. Dowd GC, Zeiller S, Awasthi D. Far lateral transcondylar approach: Dimensional anatomy. Neurosurgery 1999;45(1):95-100.
• 8. Ilhan P, Kayhan B, Erturk M, Sengul G. Morphological analysis of occipital condyles and foramen magnum as a guide for lateral surgical approaches. MOJ Anatomy & Physiology. 2017;3(6):188-194.
• 9. Alpyörük Taşer F, Başoğlu H. Condylus Occıpitalis'lerin Morfometrik DeğErlendı̇rı̇lesı̇: "Cerrahı̇ Uygulamalar için Bir Rehber". Ege Tıp Dergisi. 2003;42(2):121-125.
• 10. Pereira GAM, Lopes PTC, Santos AMPV, Duarte RD, Piva L, Pozzobon A. Morphometric Analysis Related to the Transcondylar Approach in Dry Skulls and Computed Tomography. Int. J. Morphol. 2012;30(2):399-402.
• 11. Bosco A, Venugopal P, Shetty AP, Shanmuganathan R, Kanna RM. Morphometric Evaluation of Occipital Condyles: Defining Optimal Trajectories and Safe Screw Lengths for Occipital Condyle-Based Occipitocervical Fixation in Indian Population. Asian Spine J 2018;12(2):214-223.
• 12. De Oliveira E, Rhoton AL Jr, Peace D. Microsurgical anatomy of the region of the foramen magnum. Surg Neurol 1985;24:293-352.
• 13. Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis. Nature Methods 2012;9:671-675.
• 14. Shamkuwar S, Mokhasi V. Morphometry And Morphology Of Occıpıtal Condyle Related To The Transcondylar Approach In Dry Skulls. Int J Anat Res. 2018; 6(4.1):5830-34.
• 15. Aras Y, Kırış T. Foramen Magnum Meningiomları. Türk Nöroşirürji Dergisi. 2011;21(2):158-161.
• 16. Batay F, Yakupoğlu H, Ulus A, Deda. Foramen Magnum Tümörlerinde Cerrahi Strateji. Türk Nöroşirürji Dergisi. 2005;15(1):69-75.
• 17. La Marca F, Zubay G, Morrison T, Karahalios D. Cadaveric study for placement of occipital condyle screws: technique and effects on surrounding anatomic structures. J Neurosurg Spine. 2008;9:347-53.
• 18. Gonzalez LF, Klopfenstein JD, Crawford NR, Dickman CA, Sonntag VK. Use of dual transarticular screws to fixate simultaneous occipitoatlantal and atlantoaxial dislocations. J Neurosurg Spine. 2005;3:318-23.
• 19. Bayat P, Bagheri M, Ghanbari A, Raoofi A. Characterization of Occipital Condyle and Comparison of its Dimensions with Head and Foramen Magnum Circumferences in Dry Skulls of Iran. Int. J. Morphol. 2014;32(2):444-8.
• 20. Kalthur SG, Padmashali S, Gupta C, Dsouza AS. Anatomic study of the occipital condyle and its surgical implications in transcondylar approach. Journal of Craniovertebral Junction and Spine. 2014;5(15):71-7.
• 21. Saluja S, Das SS, Vesudeva N. Morphometric Analysis of the Occipital Condyle and Its Surgical Importance. Journal of Clinical and Diagnostic Research. 2016;10(11):AC01-AC04.
• 22. Degno S, Abhra M, Asmare Y, Muche A. Anatomical Variation in Morphometry and Morphology of the Foramen Magnum and Occipital Condyle in Dried Adult Skulls. The Journal of Craniofacial Surgery. 2019;30:256-9.
• 23. Anjum A, Pandurangam G, Garapati S, Bandarupalli N, Rabbani H, Divya P. Morphology and morphometric study of occipital condyles. Int J Anat Res 2021;9(1.3):7905-11.
• 24. Bernstein DN, Ikpeze TC, Foxx K, Omar A, Mesfin A. Anatomical Parameters for Occipital Condyle Screws: An Analysis of 500 Condyles Using CT Scans. Global Spine Journal.2021 Jan 21:2192568220983311.
• 25. Zhou J, Espinoza Orías AA, Kang X, He J, Zhang Z, Inoue N, An HS. CT-based morphometric analysis of the occipital condyle: focus on occipital condyle screw insertion. J Neurosurg Spine. 2016;25(5):572-579.
• 26. Gretel González-Colmenares, César Sanabria Medina, Martha Patricia Rojas-Sánchez, Katherine León, Anderson Malpud, Sex estimation from skull base radiographs in a contemporary Colombian population, Journal of Forensic and Legal Medicine, 2019;62:77-81.
• 27. Meyvacı SS, Hızal M, Ankaralı H. Examination of craniofacial parameters in Turkish males with golden ratio in piriform aperture size. J Surg Med. 2021;5(3):289-293.