Evaluation of Anatomoradiological Findings on Trigeminal Neuralgia Patients Using Computed Tomography and Cone-Beam Computed Tomography

The study aimed to establish and evaluate anatomoradiological landmarks in trigeminal neuralgia patients using computed tomography (CT) and cone-beam CT. CT images of 40 trigeminal neuralgia (TN) and 40 healthy individuals were retrospectively analyzed and enrolled in the study. The width and length of the foramen rotundum (FR), foramen ovale (FO), foramen supraorbitale, and infraorbitale were measured. The distances between these foramen, between these foramen to the median plane, and between the superior orbital fissure, FO, and FR to clinoid processes were also measured bilaterally. Variations were evaluated according to groups. Significant differences were found for width and length of the foramen ovale, length of the foramen supraorbitale, and infraorbitale between TN and control subjects (p < 0.05). On both sides, FO gets narrower and the length of the infraorbital and supraorbital foramen shortens in the TN group. In most of the control patients, the plane which passes through the infraorbital and supraorbital foramen intersects with impression trigeminale; 70% on the right-side, and 67% in the left-side TN groups. This plane does not intersect with impression trigeminale and deviates in certain degrees. The determination of specific landmarks allows customization to individual patient anatomy and may help the surgeon achieve a more selective effect with a variety of percutaneous procedures in trigeminal neuralgia patients.

Three-dimensional study of the orbit-related structures according to sex, age and skeletal deformities

Objective: This study aimed to evaluate the relations between orbit-related structures and sex, age and skeletal deformities using cone-beam computed tomography (CBCT). Methods: This retrospective study evaluated 216 consecutive CBCT scans of patients, who were divided according to: sex (male, n=105; female, n=111), age (A1: 18-32 years, n=71; A2: 33-47 years, n=78; A3: 48-62 years, n=67), and skeletal deformities (Class I, n=70; Class II, n=75; Class III, n=71). The supraorbital foramen (SOF) location, volume of orbit, optic canal (OC) and infraorbital canal (IOC) were evaluated. Results were analyzed using the Gamma model test. The Tukey-Kramer post-hoc test was used to compare the variables with three factors (p<0.05). Results: The IOC volume showed higher values for male, A3 and class I patients. The SOF location and the orbital volume also showed higher values for male patients. Regarding the volume of CO, it showed higher values ​​for male and class I patients. Conclusions: According to our results, sex has been shown to have a significant influence on orbit-related structures. Age and skeletal deformities also influenced the volume of IOC and OC. These results eventually help the clinical practice, being useful for orbital reconstruction surgeries, anthropological studies, gender identification and identification of susceptibility to pathological conditions related to sexual dimorphism.

ANATOMICAL MODELING OF SUPER-, SUB-EYE PATCH AND CHIN OPENINGS IN FRUITS AND NEWBORN

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.

Efficacy and Safety of Radiofrequency Thermocoagulation with Different Puncture Methods for Treatment of V1 Trigeminal Neuralgia: A Prospective Study

BACKGROUND: Radiofrequency thermocoagulation through the supraorbital foramen with a different puncture method is a new approach for the treatment of ophthalmic division trigeminal neuralgia. OBJECTIVES: To compare the efficacy of the vertical puncture method and the transverse puncture method in the treatment of ophthalmic division trigeminal neuralgia during radiofrequency thermocoagulation through the supraorbital foramen. STUDY DESIGN: Randomized, longitudinal prospective, clinical research study. SETTING: Department of Anesthesiology and Pain Medicine, Jiaxing, China. METHODS: A total of 57 patients with ophthalmic division trigeminal neuralgia were enrolled in the study between October 2011 and April 2018, and prospectively randomized into the vertical puncture group (n = 29) or transverse puncture group (n = 28). All these patients received computed tomography guided radiofrequency thermocoagulation through the supraorbital foramen. Patients in the vertical puncture group were treated with a vertical puncture method; patients in the transverse puncture group received a transverse puncture method. Facial pain was evaluated using the Numeric Rating Scale preoperatively and at 1 day, 6 months, 1 year, and 2 years after treatment; facial numbness degree was analyzed at 1 day and 2 years after the treatments were recorded. The short-term and long-term complications during the period of postoperative follow-up were recorded. RESULTS: All surgical procedures were successfully completed. The Numeric Rating Scale scores at 6 months, 1 year, and 2 years after the treatment were significantly lower in the transverse puncture group compared to the vertical puncture group (P < 0.05), while no difference was observed on day one after the treatment (P > 0.05). The numbness degree at 2 years was significantly decreased compared to day one in both groups (P < 0.05). The radiofrequency thermocoagulation for ophthalmic division trigeminal neuralgia in the transverse puncture group showed better long-term outcomes than those in the vertical puncture group (P < 0.05). No short-term or long-term postoperative complications were observed in any of the groups. LIMITATIONS: Additional clinical data should be collected to preserve the results in future work. CONCLUSION: The transverse puncture method during radiofrequency thermocoagulation through the supraorbital foramen had better efficacy and fewer complications in comparison with the vertical puncture method when treating ophthalmic division trigeminal neuralgia. KEY WORDS: Trigeminal neuralgia, radiofrequency thermocoagulation, supraorbital foramen

STUDY OF ACCESSORY SUPRAORBITAL FORAMEN IN NORTH INDIAN HUMAN SKULL

Objective: This research was aimed at telling the anatomical characteristics of the accessory supraorbital foramen (ASOF) in relation to the main supraorbital foramen (SOF), which is necessary in clinical situations that require regional surgical procedures. Methods: A total dedicated to the presence and location of 72 dry Indian adults of unknown age and sex were investigated. In each skull, the ASOF location was measured on both sides with a Vernier caliper metal case, with the SOF as the reference point. The total number of accessory foramen was also noted. Results: Accessory infraorbital foramens (IOFs) were seen only in 4.16% in our study and all seen were single in number. Half of those accessory foramen were present on medial and rest half were present on superomedial position as compared to the main IOF. Half among present accessory foramens were located at a distance of <2 mm and half were located at a distance of more than 2 mm. The mean location of accessory IOF was at 7.07 mm from main IOF. Conclusion: Knowledge of the anatomical characteristics of ASOF can have major effects on surgical and local anesthetic preparation blockage of the super orbital nerves. Additional guidance for surgeons may be provided with information on the foramens obtained from this study. The surgeons should note this during the nerve block as damage to either branch will lead to sensory impairment and incomplete blocking of the nerve.

Sex Wise Morphometrical Studies on Orbital Cavity and Foramina of Skull of Adult Blue Bull (Boselaphus tragocamelus)

Background: The Blue bull (Boselaphus tragocamelus) is one of the biggest antelopes in Asia and is widely distributed in both the forests and adjoining villages with enough green grass.Methods: The present study was carried out on the orbital cavity and foramina of skull of six specimens of adult Blue bull (Boselaphus tragocamelus) of either sex. The biometrical parameters were measured by scale, graduated tape and digital Vernier’s caliper.Result: The average left cranio-caudal orbital diameter was found to be 5.7±0.11 cm in female, which was significantly less (p less than 0.05) than that of males, where it was recorded as 5.3±0.08 cm. Similarly, the average left orbital depth was found to be 5.7±0.08 cm in female, which was significantly less (p less than 0.05) than that of males, where it was recorded as 5.3±0.06 cm. The average length of left orbital process of frontal bone was found to be 5.1±0.05 cm in female, which was significantly less (p less than 0.05) than that of males, where it was recorded as 5.3±0.07 cm. The average diameter of left supraorbital foramen was found to be 0.31±0.001 cm in female, which was significantly less (p less than 0.05) than that of males, where it was recorded as 0.7±0.003 cm. Similarly, the average maximum distance between two cranial palatine foramina was found to be 1.8±0.05 cm in female, which was significantly less (p less than 0.05) than that of males, where it was recorded as 3.3±0.12 cm. Conclusion: Most of the biometrical observations on different parameters of orbital cavity and different foramina of skull of Blue bull were having significantly (p less than 0.05) more values in males than females. The present gross and biometrical studies would be useful to the wild life professionals for determination of sex of this animal and solving vetero-legal cases related with this species.

Effects of Supraorbital Foramen Variations on the Treatment Efficacy of Radiofrequency Therapy for V1 Trigeminal Neuralgia: A Retrospective Study

Background. Primary V1 trigeminal neuralgia is a common refractory neuralgia in clinical practice, lacking effective treatments. Radiofrequency therapy has certain treatment efficacy, but its long-term efficacy remained poor and the disease might relapse. Objective. To compare the effects of different types of supraorbital foramen variations on the treatment efficacy of radiofrequency therapy for V1 trigeminal neuralgia. Methods. Data of 54 patients with V1 trigeminal neuralgia who underwent treatment in the First Hospital of Jiaxing, Zhejiang, were retrospectively analyzed. All these patients received CT-guided radiofrequency thermocoagulation of supraorbital nerve. According to the CT images, the supraorbital foramen of the patients was categorized as holes (hole group) or notches (notch group). The patient characteristics, including Numerical Rating Scale (NRS) score and effective treatment rates before and 1 d, 0.5 y, 1 y, and 2 y after operation, and numbness degree at day 1 and 2 y after the operation were compared. The short- and long-term complications during postoperative follow-up period were also recorded. Results. Among the 54 patients, 25 patients were grouped into the hole group and 29 into the notch group. The NRS scores before and at 1 d, 0.5 y, 1 y, and 2 y after operation showed no significant differences between the two groups. However, the NRS scores at the remaining time points after operation were significantly decreased when compared with scores before operation (P<0.05). The numbness and numbness degree after operation showed no significant differences between the two groups. The numbness degree at 2 y after operation was significantly lower than 1 d after operation (P<0.05). The effective rate at 1 d, 0.5 y, and 1 y after operation showed no significant differences between the hole and notch groups. However, the effective rate at 2 y after operation was significantly lower in the notch group than hole group (P<0.05). No severe short- or long-term complications were found in either group. Conclusion. The short- and long-term effective rates of radiofrequency therapy during V1 trigeminal neuralgia treatment are relatively high in patients with different types of supraorbital foramen variations. However, the effective rate is even higher in patients with hole-type supraorbital foramen. No other severe complications, except numbness, were found, and the acceptability rate remained high in patients.

Anatomical and Radiographic Study on the Skull and Mandible of the African Lion (Panthera leo)

Objective The taxonomic affiliations can be detected via the skull morphology. The objective of this study was to give a detailed gross anatomical and radiographic description of the bones and foramina of the skull and mandible of the lion. This information could be used in the identification of the skull and mandible of the lion, which is of great importance in taxonomic affiliation and to help the zoo veterinarians to detect, diagnose, and treat head conditions. Materials and Methods The current work was conducted on two skulls and mandibles of lions. The skulls and mandible were prepared using standard boiling and maceration technique. The gross and radiographic photos of the bones and foramina of the skull and mandible were taken using a Kodak digital camera and Siemens mobile full wave X-ray machine (Siemens Medical Solutions, Erlangen, Germany). Results The skull of the lion comprised of facial and cranial parts. The nasal openings were large, and the bony orbit was incomplete. The supraorbital foramen was absent. The zygomatic arch was large. The frontal region had a deep longitudinal depression dorsally. The mandible was a paired bone with movable articulation, and it had strongly excavated masseteric fossa with a well-developed crest. The dental formula was 30 teeth consisting of small incisors, long canines and carnassial premolars. Conclusion The current study showed that the osteology and foramina of the skull and mandible of the lion were similar to those of other mammals. The information is important for taxonomic affiliation, and wildlife forensic as well as to help the zoo veterinarians to manage clinical head diseases in this species.

OSTEOMETRIC ANALYSIS OF SUPRAORBITAL FORAMEN AND NOTCH IN MALAYSIAN CRANIA

Objective: A clear knowledge of the location of supraorbital foramen (SOF) is vital for the surgeons, particularly in endoscopic surgery and regional block in crania. The aim of this study was to analyze SOF and notch in skulls of various ancestries. Methods: The anatomical variations of SOF and notch were examined in 100 adults skulls (55 males and 45 females) of the Malay, Chinese, and Indian ancestries by traditional measurement made with the Osirix software. The parameters included distance between supraorbital structure and nasal midline, shape, and transverse diameter of the SOF. Results: It was manifested that bilateral supraorbital notch (SON) was the most prevalent combination in both sexes and ancestries (61%), while combined SON and foramen (11%) were the least prevalent characteristic. The mean distances of supraorbital structure from nasal midline bilaterally in males were slightly greater than females. The horizontal diameter of SOF, notch and their distances from the nasal midline showed no difference between ancestries. Conclusion: This study would serve as a guide for the surgeons when surgery is performed on the scalp. It can help in the precise determination of reference points for supraorbital nerve blockade for the Malaysians. In addition, the variations exhibited in supraorbital measurements inevitably revealed that sex and ancestry should be taken into consideration when choosing samples for anatomical classification of crania.

OSTEOMETRIC ANALYSIS OF SUPRAORBITAL FORAMEN AND NOTCH IN MALAYSIAN CRANIA

Objective: A clear knowledge of the location of supraorbital foramen (SOF) is vital for the surgeons, particularly in endoscopic surgery and regional block in crania. The aim of this study was to analyze SOF and notch in skulls of various ancestries.Methods: The anatomical variations of SOF and notch were examined in 100 adults skulls (55 males and 45 females) of the Malay, Chinese, and Indian ancestries by traditional measurement made with the Osirix software. The parameters included distance between supraorbital structure and nasal midline, shape, and transverse diameter of the SOF.Results: It was manifested that bilateral supraorbital notch (SON) was the most prevalent combination in both sexes and ancestries (61%), while combined SON and foramen (11%) were the least prevalent characteristic. The mean distances of supraorbital structure from nasal midline bilaterally in males were slightly greater than females. The horizontal diameter of SOF, notch and their distances from the nasal midline showed no difference between ancestries.Conclusion: This study would serve as a guide for the surgeons when surgery is performed on the scalp. It can help in the precise determination of reference points for supraorbital nerve blockade for the Malaysians. In addition, the variations exhibited in supraorbital measurements inevitably revealed that sex and ancestry should be taken into consideration when choosing samples for anatomical classification of crania.