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Morphological and Morphometric Analysis of Hypoglossal Canal and Its Importance in Cranial Base Surgery: A Skull Study

Year 2023, Volume: 15 Issue: 1, 136 - 143, 15.03.2023

Abstract

Objective: This study aims to analyze the morphological and morphometric features of the hypoglossal canal (HC) and its topographical relationship with the occipital condyle (OC) and to present guiding information to the relevant field experts.
Material And Method: This research was carried out with 33 adult Turkish skulls of unknown gender. Typing definitions of the skulls without damage to the posterior cranial fossa were made with the parameters related to a standard caliper and a protractor.
Results: The distance of the extracranial opening of the HC to the posterior end of the OC was 14.37±1.76 mm on the right side and 16.37±1.76 mm on the left (p<0.05), while the intracranial opening was determined to be greater than that of the OC and its distance to the posterior end was calculated as 8.95±1.00 mm on the right side and 10.41±1.24 mm on the left side (p<0.05). The angle between the extracranial opening of the HC/pharyngeal tubercle was 45.97±2.06 degrees on the right side and 48.05±2.97 degrees on the left side (p<0.05). It was determined that Type I was observed most frequently on the right side with a rate of 42.42% and on the left side with a rate of 18.18%. Bilaterally, only Type I and Type II b were detected.
Discussion: We believe that our research will guide surgeons, anatomists, and anthropologists in terms of making transcondylar, supracondylar, and lateral suboccipital approaches and examining the canal differences in Turkish society.

References

  • 1 Snell RS. Clinical Anatomy for Medical Students. 3rd ed. Boston: Little, Brown and Company. 1986;794–5.
  • 2 Soames RW. Skeletal system. In: Bannister LH, Berry MM, Collins P, editors. Gray’s Anatomy 38th ed. NY: ELBS with Churchill Livingstone. 1995;567–73.
  • 3 Uysal S, Gokharman D, Kacar M, Tuncbilek I, Kosa U. Estimation of sex by 3D CT measurements of the foramen magnum. J Forensic Sci. 2005;50(6): 1310–4.
  • 4 Boulton MR, Cusimano MD. Foramen magnum meningiomas: concepts, classifications, and nuances. Neurosurg Focus. 2003; 14(6): e10, indexed in Pubmed: 15669785.
  • 5 Radhakrishna SK, Shivarama CH, Ramakrishna A, Bhagya B. Morphometric analysis of foramen magnum for sex determination in South Indian population. NUJHS. 2012;2:20–2.
  • 6 Wen HT, Rhoton AL Jr, Katsuta T, de Oliveira E. Microsurgical anatomy of the transcondylar, supracondylar, and paracondylar extensions of the far-lateral approach. J Neurosurg.1997;87(4): 555-85.
  • 7 de Oliveira E, Rhoton AL, Jr., Peace D. Microsurgical anatomy of the region of the foramen magnum. Surg Neurol.1985;24(3):293-352.
  • 8 Matsushima T, Natori Y, Katsuta T, Ikezaki K, Fukui M, Rhoton AL. Microsurgical anatomy for lateral approaches to the foramen magnum with special reference to transcondylar fossa (supracondylar transjugular tubercle) approach. Skull Base Surg.1998;8(3):119-25.
  • 9 Perneczky A. The Posterolateral Approach to the Foramen Magnum. In: Samii, M. (eds) Surgery in and around the Brain Stem and the Third Ventricle. Springer, Berlin, Heidelberg 1986.
  • 10 Rhoton AL, Jr. The foramen magnum. Neurosurgery. 2000;47(3 Suppl): S155-93.
  • 11 Rhoton AL, Jr. The far-lateral approach and its transcondylar, supracondylar, and paracondylar extensions. Neurosurgery 2000;47(3 Suppl):S195-209.
  • 12 Matsushima K, Kawashima M, Matsushima T, Hiraishi T, Noguchi T, Kuraoka A. Posterior condylar canals and posterior condylar emissary veins-a microsurgical and CT anatomical study. Neurosurgical review. 2014;37(1):115-26.
  • 13 Ginsberg LE. The posterior condylar canal. AJNR Am J Neuroradiol. 1994;15(5):969-72.
  • 14 Gilsbach JM, Sure U, Mann W. The supracondylar approach to the jugular tubercle and hypoglossal canal. Surg Neurol. 1998;50(6):563-70.
  • 15 Wanebo JE, Chicoine MR. Quantitative analysis of the transcondylar approach to the foramen magnum. Neurosurgery. 2001;49(4):934-43.
  • 16 Kumar S, Verma R, Rai AM, Mehra RD. Morphological and Morphometric Analysis of Hypoglossal Canal in North Indian Dry Skulls and It's Significance in Cranial Base Surgeries. J Clin Diagn Res. 2017;11(3):3-7.
  • 17 Muthukumar N, Swaminathan R, Venkatesh G, Bhanumathy SP. A morphometric analysis of the foramen magnum region as it relates to the transcondylar approach. Acta Neurochir (Wien). 2005;147(8):889-95.
  • 18 Naderi S, Korman E, Çıtak G, Güvençer M, Arman C, Şenoğlu M, Tetik S, Arda MN. Morphometric analysis of human occipital condyle. Clinical Neurology and Neurosurgery 2005:107;191-199.
  • 19 Voyvodic F, Whyte A, Slavotinek J. The hypoglossal canal: normal MR enhancement pattern. AJNR Am J Neuroradiol. 1995;16(8):1707-1710.
  • 20 Tatagiba M, Koerbel A, Roser F. The midline suboccipital subtonsillar approach to the hypoglossal canal: surgical anatomy and clinical application. Acta Neurochir (Wien) 2006;148(9): 965-9.
  • 21 Wanebo JE, Chicoine MR. Quantitative analysis of the transcondylar approach to the foramen magnum. Neurosurgery. 2001;49(4): 934-43.
  • 22 Katsuta T, Matsushima T, Wen HT, Rhoton AL Jr. Trajectory of the hypoglossal nerve in the hypoglossal canal: significance for the transcondylar approach. Neurol Med Chir (Tokyo). 2000;40(4):206-10.
  • 23 Kizilkanat ED, Boyan N, Soames R, Oguz O. Morphometry of the hypoglossal canal, occipital condyle and foramen magnum. Neurosurgery. 2006;16(3):121-25.
  • 24 Singh V, Sethi R, Kharb P, Singh R. Bridging pattern of hypoglossal canal Reclassified. J Anat Soc India. 2014;63:S31-S34.
  • 25 Babu RP, Sekhar LN, Wright DC. Extreme lateral transcondylar approach: technical improvements and lessons learned. J Neurosurg. 1994;81(1):49-59.
  • 26 Paraskevas GK, Tsitsopoulos PP, Papaziogas B, Kitsoulis P, Spanidou S, Tsitsopoulos P. Osseous variations of the hypoglossal canal area. Med Sci Monit. 2009;15(3):BR75-BR84.
  • 27 Parvindokht B, Reza DM, Saeid B. Morphometric analysis of hypoglossal canal of the occipital bone in Iranian dry skulls. J Craniovertebr Junction Spine 2015; 6(3): 111-4.
  • 28 Saddler TW. Langman’s Medical Embryology, Development of Head & Neck. Philadelphia, USA: Wolter and Kluwer; 11th ed. 2009; 265-91.

Canalis Nervi Hypoglossi’nin Morfolojik/Morfometrik Analizi ve Kraniyal Taban Ameliyatlarında Önemi: Kuru Kafatası Çalışması

Year 2023, Volume: 15 Issue: 1, 136 - 143, 15.03.2023

Abstract

Amaç: Bu çalışmanın amacı CNH'nin morfolojik ve morfometrik özelliklerini ve condylus occipitalis (CO) ile topografik ilişkisini analiz ederek ilgili alan uzmanlarına yön gösterici bilgileri sunmaktır.
Materyal metot: Bu araştırma cinsiyeti bilinmeyen 33 yetişkin Türk kafatası ile yapılmıştır. Posterior kraniyal fossada hasarı olmayan kafataslarının standart kumpas ve bir açı ölçer ile ilgili parametreler ile tiplendirme tanımlamaları yapıldı.
Bulgular: CNH’nin ekstrakraniyal açıklığının CO’nin arka ucuna olan mesafesi sağ tarafta 14,37±1,76 mm, sol tarafta ise 16,37±1,76 mm (p<0,05) olarak belirlenirken intrakraniyal açıklığın CO’nin arka ucuna olan mesafesi ise sağ tarafta 8,95±1,00 mm, sol tarafta 10,41±1,24 mm (p<0,05) olarak hesaplanmıştır. Tuberculum pharyngeum-CNH’nin ektrakraniyal açıklığı arasındaki açının sağ tarafta 45,97±2,06 derece, sol tarafta ise 48,05±2,97 derece olduğu belirlenmiştir (p<0,05). En fazla Tip I’in sağ tarafta %42,42, sol tarafta ise %18,18 oranında gözlendiği belirlendi. Bilateral olarak sadece Tip I ile Tip II b tespit edilmiştir.
Tartışma: CNH'nin osteotik varyasyonları, içinden geçen hassas nörovasküler yapılar açısından klinik olarak önemlidir. Literatürde yer alan farklı ırklardaki dış açıklığın CNH’nin midsagittal düzleme olan sağ ve sol eğim açısı daha fazla iken araştırmamızda Türk toplumuna ait kafataslarındaki bu açıların daha az olduğu ve CNH ile CO arasındaki mesafelerin diğer popülasyonlara oranla daha kısa olduğu tespit edilmiştir. Dolayısı ile araştırmamızın transkondiler, suprakondiler ve lateral suboksipital yaklaşım yapmak ve Türk toplumuna ait kanal farklılıklarını incelemek açısından cerrahlar, anatomistler ve antropologlara yol gösterici olacağı kanaatindeyiz.

References

  • 1 Snell RS. Clinical Anatomy for Medical Students. 3rd ed. Boston: Little, Brown and Company. 1986;794–5.
  • 2 Soames RW. Skeletal system. In: Bannister LH, Berry MM, Collins P, editors. Gray’s Anatomy 38th ed. NY: ELBS with Churchill Livingstone. 1995;567–73.
  • 3 Uysal S, Gokharman D, Kacar M, Tuncbilek I, Kosa U. Estimation of sex by 3D CT measurements of the foramen magnum. J Forensic Sci. 2005;50(6): 1310–4.
  • 4 Boulton MR, Cusimano MD. Foramen magnum meningiomas: concepts, classifications, and nuances. Neurosurg Focus. 2003; 14(6): e10, indexed in Pubmed: 15669785.
  • 5 Radhakrishna SK, Shivarama CH, Ramakrishna A, Bhagya B. Morphometric analysis of foramen magnum for sex determination in South Indian population. NUJHS. 2012;2:20–2.
  • 6 Wen HT, Rhoton AL Jr, Katsuta T, de Oliveira E. Microsurgical anatomy of the transcondylar, supracondylar, and paracondylar extensions of the far-lateral approach. J Neurosurg.1997;87(4): 555-85.
  • 7 de Oliveira E, Rhoton AL, Jr., Peace D. Microsurgical anatomy of the region of the foramen magnum. Surg Neurol.1985;24(3):293-352.
  • 8 Matsushima T, Natori Y, Katsuta T, Ikezaki K, Fukui M, Rhoton AL. Microsurgical anatomy for lateral approaches to the foramen magnum with special reference to transcondylar fossa (supracondylar transjugular tubercle) approach. Skull Base Surg.1998;8(3):119-25.
  • 9 Perneczky A. The Posterolateral Approach to the Foramen Magnum. In: Samii, M. (eds) Surgery in and around the Brain Stem and the Third Ventricle. Springer, Berlin, Heidelberg 1986.
  • 10 Rhoton AL, Jr. The foramen magnum. Neurosurgery. 2000;47(3 Suppl): S155-93.
  • 11 Rhoton AL, Jr. The far-lateral approach and its transcondylar, supracondylar, and paracondylar extensions. Neurosurgery 2000;47(3 Suppl):S195-209.
  • 12 Matsushima K, Kawashima M, Matsushima T, Hiraishi T, Noguchi T, Kuraoka A. Posterior condylar canals and posterior condylar emissary veins-a microsurgical and CT anatomical study. Neurosurgical review. 2014;37(1):115-26.
  • 13 Ginsberg LE. The posterior condylar canal. AJNR Am J Neuroradiol. 1994;15(5):969-72.
  • 14 Gilsbach JM, Sure U, Mann W. The supracondylar approach to the jugular tubercle and hypoglossal canal. Surg Neurol. 1998;50(6):563-70.
  • 15 Wanebo JE, Chicoine MR. Quantitative analysis of the transcondylar approach to the foramen magnum. Neurosurgery. 2001;49(4):934-43.
  • 16 Kumar S, Verma R, Rai AM, Mehra RD. Morphological and Morphometric Analysis of Hypoglossal Canal in North Indian Dry Skulls and It's Significance in Cranial Base Surgeries. J Clin Diagn Res. 2017;11(3):3-7.
  • 17 Muthukumar N, Swaminathan R, Venkatesh G, Bhanumathy SP. A morphometric analysis of the foramen magnum region as it relates to the transcondylar approach. Acta Neurochir (Wien). 2005;147(8):889-95.
  • 18 Naderi S, Korman E, Çıtak G, Güvençer M, Arman C, Şenoğlu M, Tetik S, Arda MN. Morphometric analysis of human occipital condyle. Clinical Neurology and Neurosurgery 2005:107;191-199.
  • 19 Voyvodic F, Whyte A, Slavotinek J. The hypoglossal canal: normal MR enhancement pattern. AJNR Am J Neuroradiol. 1995;16(8):1707-1710.
  • 20 Tatagiba M, Koerbel A, Roser F. The midline suboccipital subtonsillar approach to the hypoglossal canal: surgical anatomy and clinical application. Acta Neurochir (Wien) 2006;148(9): 965-9.
  • 21 Wanebo JE, Chicoine MR. Quantitative analysis of the transcondylar approach to the foramen magnum. Neurosurgery. 2001;49(4): 934-43.
  • 22 Katsuta T, Matsushima T, Wen HT, Rhoton AL Jr. Trajectory of the hypoglossal nerve in the hypoglossal canal: significance for the transcondylar approach. Neurol Med Chir (Tokyo). 2000;40(4):206-10.
  • 23 Kizilkanat ED, Boyan N, Soames R, Oguz O. Morphometry of the hypoglossal canal, occipital condyle and foramen magnum. Neurosurgery. 2006;16(3):121-25.
  • 24 Singh V, Sethi R, Kharb P, Singh R. Bridging pattern of hypoglossal canal Reclassified. J Anat Soc India. 2014;63:S31-S34.
  • 25 Babu RP, Sekhar LN, Wright DC. Extreme lateral transcondylar approach: technical improvements and lessons learned. J Neurosurg. 1994;81(1):49-59.
  • 26 Paraskevas GK, Tsitsopoulos PP, Papaziogas B, Kitsoulis P, Spanidou S, Tsitsopoulos P. Osseous variations of the hypoglossal canal area. Med Sci Monit. 2009;15(3):BR75-BR84.
  • 27 Parvindokht B, Reza DM, Saeid B. Morphometric analysis of hypoglossal canal of the occipital bone in Iranian dry skulls. J Craniovertebr Junction Spine 2015; 6(3): 111-4.
  • 28 Saddler TW. Langman’s Medical Embryology, Development of Head & Neck. Philadelphia, USA: Wolter and Kluwer; 11th ed. 2009; 265-91.
There are 28 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Berin Tuğtağ Demir 0000-0001-8301-9257

Dilara Patat 0000-0001-5237-4846

Publication Date March 15, 2023
Acceptance Date March 1, 2023
Published in Issue Year 2023 Volume: 15 Issue: 1

Cite

APA Tuğtağ Demir, B., & Patat, D. (2023). Morphological and Morphometric Analysis of Hypoglossal Canal and Its Importance in Cranial Base Surgery: A Skull Study. Konuralp Medical Journal, 15(1), 136-143. https://doi.org/10.18521/ktd.1229112
AMA Tuğtağ Demir B, Patat D. Morphological and Morphometric Analysis of Hypoglossal Canal and Its Importance in Cranial Base Surgery: A Skull Study. Konuralp Medical Journal. March 2023;15(1):136-143. doi:10.18521/ktd.1229112
Chicago Tuğtağ Demir, Berin, and Dilara Patat. “Morphological and Morphometric Analysis of Hypoglossal Canal and Its Importance in Cranial Base Surgery: A Skull Study”. Konuralp Medical Journal 15, no. 1 (March 2023): 136-43. https://doi.org/10.18521/ktd.1229112.
EndNote Tuğtağ Demir B, Patat D (March 1, 2023) Morphological and Morphometric Analysis of Hypoglossal Canal and Its Importance in Cranial Base Surgery: A Skull Study. Konuralp Medical Journal 15 1 136–143.
IEEE B. Tuğtağ Demir and D. Patat, “Morphological and Morphometric Analysis of Hypoglossal Canal and Its Importance in Cranial Base Surgery: A Skull Study”, Konuralp Medical Journal, vol. 15, no. 1, pp. 136–143, 2023, doi: 10.18521/ktd.1229112.
ISNAD Tuğtağ Demir, Berin - Patat, Dilara. “Morphological and Morphometric Analysis of Hypoglossal Canal and Its Importance in Cranial Base Surgery: A Skull Study”. Konuralp Medical Journal 15/1 (March 2023), 136-143. https://doi.org/10.18521/ktd.1229112.
JAMA Tuğtağ Demir B, Patat D. Morphological and Morphometric Analysis of Hypoglossal Canal and Its Importance in Cranial Base Surgery: A Skull Study. Konuralp Medical Journal. 2023;15:136–143.
MLA Tuğtağ Demir, Berin and Dilara Patat. “Morphological and Morphometric Analysis of Hypoglossal Canal and Its Importance in Cranial Base Surgery: A Skull Study”. Konuralp Medical Journal, vol. 15, no. 1, 2023, pp. 136-43, doi:10.18521/ktd.1229112.
Vancouver Tuğtağ Demir B, Patat D. Morphological and Morphometric Analysis of Hypoglossal Canal and Its Importance in Cranial Base Surgery: A Skull Study. Konuralp Medical Journal. 2023;15(1):136-43.