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Morphometric Analysis of Fossa Navicularis Magna in Patients with Cleft Palate: A Cone Beam Computed Tomographic Study

Document Type : Original Article

Authors

1 Department of Oral Medicine and Radiology, AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), Nitte (Deemed to be University), Mangalore, India

2 Consultant Maxillofacial Radiologist, Viscan Diagnostics, Madurai, India

Abstract

Background: The present study investigated the prevalence and morphometric characteristics of fossa navicularis magna (FNM) in cleft palate/lip patients using cone beam computed tomography (CBCT) scans.
Methods: This retrospective study evaluated 400 CBCT scans of cleft palate/lip subjects aged between 10 and 39. The image sections were scrutinized for the presence and the shape of FNM. Axial and sagittal sections were examined to determine the length, depth, width, and volume of FNM. Two independent examiners evaluated FNM, considering age groups and gender.
Results: This study included 400 CBCT scans from 208 males (52%) and 192 females (48%). The mean age was 17.78 ± 4.1 years. FNM was more common among the female cleft palate/lip population (53.1%) and among subjects aged 10–19 years (group A), with no significant association (P > 0.05). We observed a statistical difference between the length (P = 0.033), width (P = 0.025) and volume (P = 0.037) of FNM among subjects aged 10–19 years. Considering the difference between genders, the length of FNM (P = 0.011) was significant among the female cleft palate/lip population. Considering the shape of FNM, the oval form (69.8%) was more frequent than the round form (30.2%).
Conclusion: In the present study, FNM was observed in 24% of the cleft palate/lip population, which is comparatively higher than the previously reported incidence of FNM among the general (non-cleft) population. To the best of our knowledge, this was the first study to evaluate and systematically assess the morphometric characteristics and volume of FNM among cleft palate/lip patients.

Highlights

Renita Lorina Castelino (Google Scholar) (PubMed)

Keywords

Main Subjects

References
  1. Cankal F, Ugur HC, Tekdemir I, Elhan A, Karahan T, Sevim A. Fossa navicularis: anatomic variation at the skull base. Clin Anat. 2004;17(2):118-22. doi: 10.1002/ca.10191.
  2. Segal N, Atamne E, Shelef I, Zamir S, Landau D. Intracranial infection caused by spreading through the fossa naviclaris magna - a case report and review of the literature. Int J Pediatr Otorhinolaryngol. 2013;77(12):1919-21. doi: 10.1016/j. ijporl.2013.09.013.
  3. Rai R, Iwanaga J, Shokouhi G, Loukas M, Mortazavi MM, Oskouian RJ, et al. A comprehensive review of the clivus: anatomy, embryology, variants, pathology, and surgical approaches. Childs Nerv Syst. 2018;34(8):1451-8. doi: 10.1007/s00381-018-3875-x.
  4. Neiswanger K, Mukhopadhyay N, Rajagopalan S, Leslie EJ, Sanchez CA, Hecht JT, et al. Individuals with nonsyndromic orofacial clefts have increased asymmetry of fingerprint patterns. PLoS One. 2020;15(3):e0230534. doi: 10.1371/ journal.pone.0230534.
  5. Salari N, Darvishi N, Heydari M, Bokaee S, Darvishi F, Mohammadi M. Global prevalence of cleft palate, cleft lip and cleft palate and lip: a comprehensive systematic review and meta-analysis. J Stomatol Oral Maxillofac Surg. 2022;123(2):110-20. doi: 10.1016/j.jormas.2021.05.008.
  6. Adanir SS, Bahşi İ, Orhan M, Kervancioğlu P, Beger O, Yalçin ED. Radiologic evaluation of the fossa navicularis: incidence, morphometric features, and clinical implications. Surg Radiol Anat. 2021;43(11):1887-93. doi: 10.1007/s00276-021- 02742-5.
  7. Barghan S, Tahmasbi Arashlow M, Nair MK. Incidental findings on cone beam computed tomography studies outside of the maxillofacial skeleton. Int J Dent. 2016;2016:9196503. doi: 10.1155/2016/9196503.
  8. Hegde S, Ajila V, Kamath JS, Babu S, Pillai DS, Nair SM. Importance of cone-beam computed tomography in dentistry: an update. SRM J Res Dent Sci. 2018;9(4):186-90. doi: 10.4103/srmjrds.srmjrds_26_18.
  9. Yang J, Scarfe WC, Angelopoulos C. Incidental findings on CBCT. In: Scarfe WC, Angelopoulos C, eds. Maxillofacial Cone Beam Computed Tomography: Principles, Techniques and Clinical Applications. Cham: Springer International Publishing; 2018. p. 553-89. doi: 10.1007/978-3-319-62061-9_16.
  10. Dief S, Veitz-Keenan A, Amintavakoli N, McGowan R. A systematic review on incidental findings in cone beam computed tomography (CBCT) scans. Dentomaxillofac Radiol. 2019;48(7):20180396. doi: 10.1259/dmfr.20180396.
  11. Ersan N. Prevalence of fossa navicularis among cleft palate patients detected by cone beam computed tomography. Yeditepe J Dent. 2017;13:21-3. doi: 10.5505/ yeditepe.2017.87597.
  12. Bayrak S, Göller Bulut D, Orhan K. Prevalence of anatomical variants in the clivus: fossa navicularis magna, canalis basilaris medianus, and craniopharyngeal canal. Surg Radiol Anat. 2019;41(4):477-83. doi: 10.1007/s00276-019-02200-3.
  13. Alalade AF, Briganti G, McKenzie JL, Gandhi M, Amato D, Panizza BJ, et al. Fossa navicularis in a pediatric patient: anatomical skull base variant with clinical implications. J Neurosurg Pediatr. 2018;22(5):523-7. doi: 10.3171/2018.5.Peds18157.
  14. Testut L. Traité d’Anatomie Humaine. Paris: Librairie Octave Doin; 1921. p. 142-3. doi: 10.1002/qj.49704820410.
  15. Rosemann G, Schaupp H. [The pathogenesis of the nasopharyngeal bursa (Tornwaldt’s disease) (author’s transl)]. HNO. 1975;23(7):207-9. [German].
  16. Miller RH, Sneed WF. Tornwaldt’s bursa. Clin Otolaryngol Allied Sci. 1985;10(1):21-5. doi: 10.1111/j.1365-2273.1985. tb01160.x.
  17. Miyahara H, Matsunaga T. Tornwaldt’s disease. Acta Otolaryngol Suppl. 1994;517:36-9. doi: 10.3109/00016489409124336.
  18. Beltramello A, Puppini G, El-Dalati G, Girelli M, Cerini R, Sbarbati A, et al. Fossa navicularis magna. AJNR Am J Neuroradiol. 1998;19(9):1796-8.
  19. Kaplan FA, Yesilova E, Bayrakdar IS, Ugurlu M. Evaluation of the relationship between age and gender of fossa navicularis magna with cone-beam computed tomography in orthodontic subpopulation. Journal of The Anatomical Society of India. 2019;68(3):201-4. doi: 10.4103/jasi.jasi_79_19.
  20. Magat G. Evaluation of morphometric features of fossa navicularis using cone-beam computed tomography in a Turkish subpopulation. Imaging Sci Dent. 2019;49(3):209-12. doi: 10.5624/isd.2019.49.3.209.
  21. Ray B, Kalthur SG, Kumar B, Bhat MR, D’souza AS, Gulati HS, et al. Morphological variations in the basioccipital region of the South Indian skull. Nepal J Med Sci. 2014;3(2):124-8. doi: 10.3126/njms.v3i2.13457.
  22. Ersan N. Prevalence and morphometric features of fossa navicularis on cone beam computed tomography in Turkish population. Folia Morphol (Warsz). 2017;76(4):715-9. doi: 10.5603/FM.a2017.0030.
  23. Syed AZ, Mupparapu M. Fossa navicularis magna detection on cone-beam computed tomography. Imaging Sci Dent. 2016;46(1):47-51. doi: 10.5624/isd.2016.46.1.47.
  24. Benadjaoud Y, Klopp-Dutote N, Choquet M, Brunel E, Guiheneuf R, Page C. A case of acute clival osteomyelitis in a 7-year-old boy secondary to infection of a Thornwaldt cyst. Int J Pediatr Otorhinolaryngol. 2017;95:87-90. doi: 10.1016/j. ijporl.2017.02.008.
  25. Chaurasia A, Patil R, Katheriya G. Radiomorphometeric evaluation of clivus in Indian paediatric population visiting a tertiary dental hospital-a cone beam computed tomography study. J Clin Diagn Res. 2018;12(2):ZC05-8. doi: 10.7860/ jcdr/2018/32373.11158.
  26. Collins HB. Frequency and distribution of fossa pharyngea in human crania. Am J Phys Anthropol. 1927;11:101-6. doi: 10.1002/ajpa.1330110106.
  27. Sekhon PS, Ethunandan M, Markus AF, Krishnan G, Rao CB. Congenital anomalies associated with cleft lip and palate-an analysis of 1623 consecutive patients. Cleft Palate Craniofac J. 2011;48(4):371-8. doi: 10.1597/09-264.
  28. Hofmann E, Prescher A. The clivus: anatomy, normal variants and imaging pathology. Clin Neuroradiol. 2012;22(2):123-39. doi: 10.1007/s00062-011-0083-4.
  29. Prabhu SP, Zinkus T, Cheng AG, Rahbar R. Clival osteomyelitis resulting from spread of infection through the fossa navicularis magna in a child. Pediatr Radiol. 2009;39(9):995-8. doi: 10.1007/s00247-009-1283-9.
  30. Chong VF, Fan YF. Radiology of the nasopharynx: pictorial essay. Australas Radiol. 2000;44(1):5-13. doi: 10.1046/j.1440- 1673.2000.00765.x.
  31. Currarino G. Canalis basilaris medianus and related defects of the basiocciput. AJNR Am J Neuroradiol. 1988;9(1):208-11.

 

Journal of Kerman University of Medical Sciences
Volume 32
Pages 1-7
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