Nihal GÜRLEK ÇELİK, Burcu AKMAN

Anatomical Analysis of Foramen Magnum: A 3D Slicer CT Study

Aim: To analyze the anatomical structure of foramen magnum in healthy individuals according to age/gender. Material and Methods: Cranial Computed Tomography (CT) images of 130 healthy individuals (60 female, 70 male) the 18-84 age were included in our study. Using the 3D Slicer software package on these images, the Anterior-Posterior Diameter (APD), Transverse Diameter (TD), perimeter, area, angle between the posterior edge of the foramen magnum and the clivus (FMC) value, and index were found. The shapes of the foramen magnum were analysed. Results: There was no statistical significance between age, FMC, and foramen magnum index values in both genders (p>0.05). APD, TD, perimeter, and area values of males were statistically higher (p<0.05). The average foramen magnum index was 85.61±6.5 in the whole group, 84.94±7.04 in males, and 86.29±5.67 in females. There was no statistical relationship between age and measurement parameters in the whole group (p>0.05). Seven shapes of foramen magnum have been seen. The most common was the oval shape (27.7%) and the least common was the pentagon (1.5%). Conclusion: Knowing the anatomical structure of the foramen magnum is important in terms of identity and ethnicity. We also think that our results may contribute to the surgical treatment of the foramen magnum and adjacent structures.

Keywords:

Computed Tomography, Gender, Foramen magnum Morphology, Morphometry,

PDF

___

Arıncı K, Elhan A. Anatomi. 6th edition. Günes Tıp Kitabevleri, Ankara, 2016;33-57.
Chethan P, Prakash KG, Murlimanju BV et al. Morphological analysis and morphometry of the foramen magnum: an anatomical investigation. Turk Neurosurg. 2012;22:416-9.
Kumar R, Harode HA, Vora R, Javia M. Variations in the shape of foramen magnum at the base of human skulls among Indians in Rajasthan. Bioinformation. 2022;31:18:488-91.
Aljarrah K, Packirisamy V, Al Anazi N, Nayak SB. Morphometric analysis of foramen magnum and occipital condyle using CT images for sex determination in a Saudi Arabian population. Morphologie. 2022;106:260-70.
Richards GD, Jabbour RS. Foramen magnum ontogeny in Homo sapiens: a functional matrix perspective. Anat Rec (Hoboken). 2011;294:199-216.
Govsa F, Ozer MA, Celik S, Ozmutaf NM. Three-dimensional anatomic landmarks of the foramen magnum for the craniovertebral junction. J Craniofac Surg. 2011;22:1073-6.
Uthman AT, Al-Rawi NH, Al-Timimi JF. Evaluation of foramen magnum in gender estimation using helical CT scanning. Dentomaxillofac Radiol. 2012;41:197-202.
Mays S, Cox M. Sex determination in skeletal remains. In: Cox M, Mays S, eds, Human osteology in archaeology and forensic science. London: Greenwich Medical Media Ltd. 2000;117-130.
Milhorat TH, Nishikawa M, Kula RW, Dlugacz YD. Mechanisms of cerebellar tonsil herniation in patients with Chiari malformations as guide to clinical management. Acta Neurochir (Wien). 2010;152:1117-27.
Isik N. Chiary malformation and syringomyelia. Türk Nöroşirürji Dergisi. 2013;23:185-94.
Tunis TS, Sarig R, Cohen H, et al. Sex estimation using computed tomography of the mandible. Int J Legal Med. 2017;131:1691-700.
Fedorov A, Beichel R, Kalpathy-Cramer J, et al. 3D slicer as an image computing platform for the quantitative imaging network. Magn Reson Imaging. 2012;30:1323-41.
Martin R, Saller K. Lehrbuch der Antropologie (Band I). Gustav Fischer Verlag, Stuttgart, 1957;492.
Chan YH. Biostatistics 104: correlational analysis. Singapore Med J. 2003;44:614-9.
Gruber P, Henneberg M, Böni T, Rühli FJ. Variability of human foramen magnum size. Anat Rec (Hoboken). 2009;292:1713-9.
Manoel C, Prado FB, Caria PHF, Groppo FC. Morphometric analysis of the foramen magnum in human skulls of brazilian individuals: its relation to gender. Braz J Morphol Sci. 2009;26:104-8.
Ganapathy A, Sadeesh T, Rao S. Morphometric analysis of foramen magnum in adult human skulls and CT images. Int J Cur Res Rev. 2014;6:11-5.
Vinutha SP, Suresh V, Shubha R. Discriminant function analysis of foramen magnum variables in south indian population: a study of computerised tomographic images. Anat Res Int. 2018;2018:2056291.
Güneş EB, Vatansever A. Relations between foramen magnum and associated structures located within the skull base of the Turkish population. Kafkas J Med Sci. 2018;8:207-13.
Pires LAS, Teixeira ÁR, Leite TFO, et al. Morphometric aspects of the foramen magnum and the orbit in Brazilian dry skulls. Int J Med Res Health Sci. 2016;5:4:34-42.
Meral O, Belkıs Toklu B, Meydan R, et al. Sex estimation from foramen magnum parameters in adult Turkish population: A computed tomography study. Leg Med (Tokyo). 2020;47:101775.
Tellioglu AM, Durum Y, Gok M, et al. Suitability of foramen magnum measurements in sex determination and their clinical significance. Folia Morphol (Warsz). 2018;77:99-104.
Botelho RV, Ferreira ED. Angular craniometry in craniocervical junction malformation. Neurosurg Rev. 2013;36:603-10.
Ferreira JA, Botelho RV. The odontoid process invagination in normal subjects, Chiari malformation and Basilar invagination patients: pathophysiologic correlations with angular craniometry. Surg Neurol Int. 2015;8:6:118.
Furtado SV, Thakre DJ, Venkatesh PK, et al. Morphometric analysis of foramen magnum dimensions and intracranial volume in pediatric chiari I malformation. Acta Neurochir (Wien). 2010;152:221-7.
Taib AA, Greiw AS, Leias EA, et al. Morphometric evaluation of foramen magnum by using computerised tomographic images. International Journal of Clinical Skills. 2019;13:273-7.