Figure - available from: Surgical and Radiologic Anatomy
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Coronal view of the accessory “external” infraorbital foramen (A) situated lateral to the main infraorbital foramen (B) in the right side of the face in a late prenatal individual
Source publication
Purpose:
The importance of the infraorbital canal in the growth of the maxilla and associated mid-facial region has significance for innervation of this region as well as the associated dentition, yet little is known about the development of the canal. An analysis of its dimensions and morphology during the late prenatal and early postnatal period...
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Background
Sinus lift procedures have become a routine and reliable way to gain bone volume in the posterior maxilla for implant placement. The presence of an antral septum in the maxillary sinus increases the risk of complications and subsequent implant failure. This study was designed to estimate the prevalence of maxillary sinus septa and its co...
Citations
... The route of the IOC is fixed in the late prenatal period when it branches out to innervate the maxillofacial region during the development of the teeth of the upper jaw [38]. Since the maxillary sinus reaches a mature size only at around the age of 16 years [39], and the secondary pneumatization stage actually continues long after the nerve canal is in place, we suggest that as the sinus increases in size, it encompasses the infraorbital nerve canal whose route has already been set. ...
This CT-based study aimed to characterize and explain the existence of two anatomical structures positioned near the maxillary sinuses, which are of clinical relevance in rhinology and maxillofacial surgery. A total of 182 head scans (92 males and 90 females) were inspected for infraorbital ethmoid cells (IECs) and for the type (route) of infraorbital canal (IOC). The maxillary sinuses were segmented, and their volumes were measured. Statistical analysis was conducted to reveal the associations between the two anatomical variations, namely, sex and the maxillary sinus volume. Infraorbital ethmoid cells were noted in 43.9% of the individuals studied; they were more frequent in males (53.3%) than in females (34.4%). The descending infraorbital nerve (type 3 IOC) was found in 13.2% of individuals and was independent of sex. Infraorbital ethmoid cells were associated with the IOC types. The maxillary sinus volume was found to be sex-dependent. A large sinus volume is significantly associated with IOC Type 3 (the descending canal) and the presence of IEC. Dentists, radiologists, and surgeons should be aware that individuals with extensive pneumatization of the maxillary sinuses are more likely to display a descending IOC and IEC. These findings should be studied, along with CT scans, before treatment and surgery.
... The LV micro-CT scanning system has been used in research for oral surgery (Beetge et al., 2018;Stan et al., 2019;Theye et al., 2018), biomedical (Grace et al., 2022;Kusins et al., 2019;Wearne et al., 2022) and medical research (Hutchinson et al., 2016;Kramer et al., 2019;Main et al., 2021;Smit et al., 2020;Tan et al., 2022;Welsh et al., 2020), paleontology (Clement et al., 2021), and forensic investigations (Alsop et al., 2022, Braun et al., 2022, Nikolova et al., 2019, Rutty et al., 2012. The non-invasive nature of this type of micro-CT scanner, as well as its technical capabilities, suggests that it could be of great value for the investigation of rare, delicate, and valuable archaeological human remains. ...
Archaeological investigation of the dentoalveolar complex in-situ within a human skull requires detailed measurements using non-invasive techniques. Standard macroscopic and radiographic methods have limitations but Large Volume Micro-Computed Tomography (LV Micro-CT) scanning has the potential to acquire data at high resolution in microns. In this study, archaeological specimens are analysed using three-dimensional data visualisation software from LV Micro-CT scans with the aims of 1) determining whether LV Micro-CT can act as a single technique to provide detailed analysis of the dentoalveolar complex; 2) how findings from the LV Micro-CT technique compare with standard methods. These aims are explored by measuring a range of human skull specimens from a rare archaeological sample requiring non-invasive methods, for multiple dental and alveolar bone health categories. The LV Micro-CT technique was the only method to provide a full range of detailed measurements across all categories studied. A combination of macroscopic and radiographic techniques covered a number of categories, but the use of multiple methods was more time-consuming, did not provide the same level of accuracy, and did not include all measurements. There were high levels of reproducibility for intra-operator scoring and good inter-operator agreement from 4 operators with 1 operator whose results were outliers. As a further investigation of the potential of the LV Micro-CT technique, an additional individual, a fragile, fragmented skull of an infant was studied. This investigation confirms the value of LV Micro-CT scanning as a non-invasive, accurate, single technique for the extensive analysis of the dentoalveolar complex within archaeological skulls, which also allows the relationship of different tissues to be studied in-situ.
... In attempting to understand these patterns seen in adults, ontogenetic patterns need to be considered. Several researchers suggest that the surrounding structures may influence the morphology and course of the ION pathway during growth and development (Casperson et al., 2009;Farah & Faruqi, 2008;Moss & Greenberg, 1967;Smit et al., 2021). The IOF itself appears early in ontogeny and remains relatively stable, retaining its position relative to the cranial base, while the surrounding structures may grow and reposition around it (Moss & Greenberg, 1967). ...
... However, based on the results of the current study, we would hypothesize that longer and/or more intense growth periods of anterior-posterior lengthening of the maxilla, particularly including the sinus within, would result in IOCs that protrude more into the sinus. Indeed, the important effect of anterior-posterior growth has been previously indicated: Smit et al. (2021) notes that the IOC continues to elongate further into the postnatal growth period, while IOC width attains adult size earlier. However, while several ontogenetic studies exist in terms of the IOF and ION (see above), studies specifically evaluating the protrusion of IOC across age-categories in a wide range of populations, in relation to the surrounding MS dimensions have not been evaluated-particularly in a wide range of morphological diverse populations. ...
The purpose of the current study was to investigate relationships between maxillary sinus (MS) dimensions and the bony structures associated with the infraorbital nerve (ION). Computed tomographic scans of 87 adult crania (174 sides) from four morphologically diverse groups (West Africans, East Africans, North Asians, Europeans) were utilized. Seven primary variables were collected: infraorbital canal (IOC) type; infraorbital foramen (IOF) shape; distance from the foramen rotundum to IOF (FR‐IOF); distance from the posterior wall of the infraorbital groove to IOF (IOG‐IOF); and MS length, breadth, and height. Chi‐square analyses indicated a significant association between IOC‐type and IOF‐shape (Pearson chi‐square = 12.710; p‐value = .013), with the most common pattern being oval IOFs and Type‐I IOCs (45.68% of the sample; 74/162 sides). Analysis of covariance indicated a significant effect of ancestry (F = 8.333; p < .001) and MS length (F = 15.406; p < .001) on IOG‐IOF distance. Ordinal regression analyses indicated that MS length (Wald chi‐square = 7.103; p = .008) also maintained a significant effect on IOC‐type, while multinominal regression analyses indicated that none of the measured parameters had a significant effect on IOF‐shape. These results have clinical implications: recognizing IOC‐type and IOF‐shape relative to the MS is important to avoid ION damage during medical procedures. Overall, this study found most individuals possess Type‐I IOCs (housed in the maxillary sinus roof) and oval‐shaped IOFs. Most aspects of the ION pathway, including IOC‐type and IOF‐shape, were not influenced by ancestry or sex. However, antero‐posteriorly longer MSs tend to possess Type‐III IOCs protruding into the sinus, which could lead to surgical complications.
... Вивчення індивідуальних анатомічних особливостей над-, підочноямкових та підборідних отворів у плодів та новонароджених з наступною побудовою математичних моделей є актуальним завданням морфологічної науки, зважаючи на збільшення частоти природжених вад щелепно-лицевої ділянки [10][11][12]. Систематизовані дані про особливості просторовочасових перетворень морфометричних параметрів даних структур та з'ясування їх кореляції сприятимуть індивідуалізації норми, удосконаленню методів ранньої діагностики та розробці нових способів хірургічної корекції природжених вад лиця [1,2,7]. ...
Using modern anatomical methods, 57 preparations of human fetuses 4-10 months and 7 newborns were studied in order to create models of distances of supra-, suborbital and chin openings between themselves and to standard landmarks in fetuses and newborns taking into account their morphometric parameters. The model of the distance from the supraorbital foramen to bregma (Y1): Y1 = β0 + 0.092 x parietal-heel length of the fetus, where β0 :: 2,783, if the age period = 4 months; 3,106 = 5 months; -0.662 = 6 months; 4,728 = 7 months; 2,676 = 8 months; 0.402 = 9 months; -1,727 = 10 months; 9,094 = newborns; model of the distance between the supra- and suborbital foramina (Y2): Y2 = β0 + 0.011 x parietal-heel length of the fetus, where β0 :: 8,147, if the age period = 4 months; 9.086 = 5 months; 10,260 = 6 months; 12,020 = 7 months; 12,129 = 8 months; 15,164 = 9 months; 17,429 = 10 months; 18,808 = newborns; model of the distance between the orbital and chin openings (Y3): Y3 = β0 + 0.002 x parietal-heel length of the fetus, where β0 :: 8.987, if the age period = 4 months; 9,134 = 5 months; 9,892 = 6 months; 12,250 = 7 months; 11,636 = 8 months; 16,755 = 9 months; 17,877 = 10 months; 18,054 = newborns; model of the distance between the chin holes and the lower edge of the mandible (Y4): Y4 = β0 + 0.008 x parietalheel length of the fetus, where β0 :: 0.268, if the age period = 4 months; 0.178 = 5 months; 0.020 = 6 months; -0.152 = 7 months; 0.020 = 8 months; - 0.115 = 9 months; -0.079 = 10 months; -0.039 = newborns; model of the distance between the orbital foramina (Y5): Y5 = β0 + 0.030 x parietal-heel length of the fetus, where β0 :: 5,762, if the age period = 4 months; 5,895 = 5 months; 11,227 = 6 months; 13,793 = 7 months; 11,691 = 8 months; 11,173 = 9 months; 12,633 = 10 months; 14,494 = newborns; model of the distance between the orbital foramina (Y6): Y6 = β0 + 0.008 x parietal-heel length of the fetus, where β0 :: 9,272, if the age period = 4 months; 11,081 = 5 months; 13,467 = 6 months; 16,854 = 7 months; 15,912 = 8 months; 17,653 = 9 months; 22,635 = 10 months; 23,447 = newborns; model of the distance between the chin holes (Y7): Y7 = β0 - 0.014 x parietal-heel length of the fetus, where β0 :: 12,959, if the age period = 4 months; 15,282 = 5 months; 18,117 = 6 months; 23,178 = 7 months; 23,175 = 8 months; 30,496 = 9 months; 32,227 = 10 months; 33,272 = newborns.
Background
The canine fossa, a depression on the surface of the maxillary bone, is important clinically due to the nexus of the neurovascular elements which occur in this region and supply the superficial and deep structures of the face. While it is known that there is much variation in the neurovascular structures of this region, little is known about sex differences. The aim of this study was to investigate and map the neurovascular branching within the region of the canine fossa of a South African population, with particular reference to any sex differences.
Methods
Sixty hemifaces (n = 30 female; n = 30 male) of individuals between the ages of 40 and 100 years were dissected. The origin, number of branches, connections between branches, origin of connecting branches and the distribution of the neurovascular structures associated with the mid-facial and canine fossa regions were documented. The data obtained was qualitative and was statistically analysed with SPSS v26 statistical analysis software. Frequency and contingency tables, along with Chi-squared analysis and Fischer's Exact test, were used for quantitative data analysis.
Results
While high levels of variation in the neurovascular elements were documented, there was no statistically significant variation between the sexes. A sex variation was only observed for the terminal branches of CN VII with females displaying a lower number of buccal nerve terminal branches than males.
Conclusion
While only one sex difference of significance was found in the highly variable neurovascular structures resident in the region of the canine fossa, the variability of the neurovascular elements is of importance to surgeons.
