Minim Invasive Neurosurg 2008; 51(1): 21-25
DOI: 10.1055/s-2007-1022541
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

The Morphometric and Cephalometric Study of Anterior Cranial Landmarks for Surgery

M. Kazkayasi 1 , F. Batay 2 , G. Bademci 3 , O. Bengi 4 , I. Tekdemir 5 , 6
  • 1Department of Otorhinolaryngology, Head and Neck Surgery, University of Kirikkale Faculty of Medicine, Kirikkale, Turkey
  • 2Division of Neurosurgery, Bayindir Hospital, Ankara, Turkey
  • 3Department of Neurosurgery, University of Kirikkale Faculty of Medicine, Kirikkale, Turkey
  • 4Department of Orthodontics, Gulhane Military Medical Academy and School of Medicine, Ankara, Turkey
  • 5Department of Anatomy, University of Ankara, School of Medicine, Ankara, Turkey
  • 6This study was conducted at the Department of Anatomy, University of Ankara
Further Information

Publication History

Publication Date:
28 February 2008 (online)

Abstract

Objective: The aim of this work was to determine reliable bony landmarks for the anterior skull base and to standardize some specific dimensions among the frontal sinus and neighboring structures for safe anterior cranial surgery.

Methods: The study consisted of a topographical anatomic examination and cephalometric analysis of the skull. Thirty adult skulls (60 sides) were studied regarding the localization and dimensions of the supraorbital foramen (SOF), frontal sinus (FS), frontozygomatic fissure, infraorbital foramen, anterior nasal spine, and nasion. Differences between the measurement of skulls and cephalograms were analyzed by Student's t test. The Pearson correlation test was used for statistical analysis of the cephalogram.

Results: Examination of the 60 sides of the bony heads revealed that the shape of the SOF was a foramen in 25 sides (41%), a notch in 29 sides (49%), and a groove in 6 sides (10%). A total of 20 (33%) SOFs were inside the FS and the mean distance was 6.3+1.34 mm from the lateral border of the sinus, 27 (45%) of SOFs were outside of the FS and the mean distance was 8.8+2.01 mm, and 13 (22%) of SOFs were at the border of the FS. According to our measurements the medial border of the craniotomy should be placed approximately 43 mm lateral to the nasion to avoid entering into the frontal sinus.

Conclusion: To plan and to decide the convenient and safe anterior midline skull base approach and to avoid postoperative complications, bony landmarks and anatomic measurements around the SOF and FS will be helpful for the surgeon to constitute a simplification of topographic anatomy.

References

  • 1 Andersen NB, Bovim G, Sjaastad O. The frontotemporal peripheral nerves. Topographic variations of the supraorbital, supratrochlear and auriculotemporal nerves and their possible clinical significance.  Surg Radiol Anat. 2001;  23 97-104
  • 2 Webster RC, Gaunt JM, Hamdan US, Fuleihan NS, Giandello PR, Smith RC. Supraorbital and supratrochlear notches and foramina: anatomical variations and surgical relevance.  Laryngoscope. 1986;  96 311-315
  • 3 Weber R, Draf W, Kratzsch B, Hosemann W, Schaefer SD. Modern concepts of frontal sinus surgery.  Laryngoscope. 2001;  111 137-146
  • 4 Furth WR Van, Agur AM, Woolridge N, Cusimano MD. The orbitozygomatic approach.  Neurosurgery. 2006;  58 103-107
  • 5 Cutright B, Quillopa N, Schubert W. An anthropometric analysis of the key foramina for maxillofacial surgery.  J Oral Maxillofac Surg. 2003;  61 354-357
  • 6 Polselli R, Saban Y. Surgical anatomy of the face lifting.  Rev Laryngol Otol Rhinol. 2006;  127 41-46
  • 7 Meetze K, Palmer JN, Schlosser RJ. Frontal sinus complications after frontal craniotomy.  Laryngoscope. 2004;  114 945-948
  • 8 Tubbs RS, Elton S, Salter G, Blount JP, Grabb PA, Oakes WJ. Superficial surgical landmarks for the frontal sinus.  J Neurosurg. 2002;  96 320-322
  • 9 Chung MS, Kim HJ, Kang HS, Chung IH. Locational relationship of the supraorbital notch or foramen and infraorbital and mental foramina in Koreans.  Acta Anat (Basel). 1995;  154 162-166
  • 10 Saylam C, Ozer MA, Ozek C, Gurler T. Anatomical variations of the frontal and supraorbital transcranial passages.  J Craniofac Surg. 2003;  14 10-12
  • 11 Miller TA, Rudkin G, Honig M, Elahi M, Adams J. Lateral subcutaneous brow lift and interbrow muscle resection: clinical experience and anatomic studies.  Plast Reconstr Surg. 2000;  105 1120-1127
  • 12 Hakuba A, Shu-shan L, Nishimura S. The orbitozygomatic infratemporal approach. A new surgical technique.  Surg Neurol. 1986;  26 271-276
  • 13 Nie X. Cranial base in craniofacial development: developmental features, influence on facial growth, anomaly and molecular basis.  Acta Odontol Scand. 2005;  63 127-135
  • 14 Karakas P, Bozkir MG, Oguz O. Morphometric measurements from various reference points in the orbit of the male caucasians.  Surg Radiol Anat. 2002;  24 358-362
  • 15 Kazkayası M, Ergin A, Ersoy M, Bergi O, Tekdemir I, Elhan A. Certain anatomical relations and the precise morphometry of the infraorbital foramen-canal and groove; an anatomical and cephalometric study.  Laryngoscope. 2001;  111 609-614

Correspondence

M. KazkayasiMD 

8. Cad. 84. Sok. No: 4/11

Emek

06510 Ankara

Turkey

Phone: +90/312/223 04 54

Fax: +90/318/224 46 97

Email: mkazkayasi@yahoo.com

    >