Complete Ossification Research Articles

"Evaluation of palatal bone regeneration in cleft palate patients following a two-stage palatoplasty using a modified Furlow procedure".

A palatal cleft can be reconstructed using various palatoplasty techniques. Many techniques use local mucoperiosteal flaps to close the hard palate cleft, without closing the underlying bone defect. The purpose of this study was to explore the possibility of spontaneous bone regeneration in the remaining bone defect following a two-stage palatoplasty. Furthermore, the effect of this bone regeneration on transverse maxillary growth was studied. A retrospective study of unilateral cleft lip and palate patients was performed. Cleft size was measured at the hard-soft palate junction on plaster models obtained during palatoplasty. Residual bony cleft was evaluated at the time of alveolar process reconstruction using CBCT images. The presence of crossbites was evaluated through clinical photographs to evaluate transverse maxillary growth. Forty-six patients were included in this study. Thirteen patients (28%) presented with complete ossification of the hard palate at the age of six years. Six patients (13%) had no ossification, while twenty-seven patients (59%) demonstrated partial closure, averaging 75% of the total hard palate length. All patients with complete closure and 89% of patients with partial closure presented without lateral crossbites. Statistical analysis revealed no significant correlation between lateral crossbites and the extent of hard palate ossification (p = 0.4314). 87% of children presented with at least partial ossification of the hard palate after a two-stage palatoplasty, indicating the potential for spontaneous bone regeneration. Importantly, lateral crossbites demonstrated no correlation with palatal ossification (p = 0.1819), suggesting no detrimental impact of regenerated bone on transverse maxillary growth.

A new insight for investigating the prenatal and postnatal ossification centers of pelvic and femur bones in white New Zealand rabbits (Oryctolagus cuniculus) using 3D CT, double stain technique, and morphometry

BackgroundThe ossification centers in rabbit limbs are related to fetal age and bone maturation. Objective: To address the limited studies on ossification in the hind limbs of New Zealand rabbits, we investigated the prenatal and postnatal development of the pelvic and femur bones. MethodsDouble staining with Alcian Blue and Alizarin Red, computed tomography (CT), and 3D reconstruction were employed to visualize and analyze ossification centers in detail. ResultsUsing double staining, we observed these patterns: At prenatal days 18 and 21, ossification centers appeared in the ilium. By prenatal days 23 and 25, ossification began in the ischium. On postnatal day 1, ilium ossification centers spread across most of the ilium wings, except for the iliac crest, and new centers appeared in the pubis and cotyloid bones. Most bones had ossified by the third week and one month postnatal, except for the iliac crest and ischial tuberosity. At 1.5 months, both were fully ossified. On day 18 post coitum, an ossification center was visible in the middle of the femur shaft. By day 28 post coitum, ossification extended through the shaft, and postnatally, new ossification spots appeared at the extremities by day one and week one. By the third week, complete ossification of the femur head, lesser trochanter, third trochanter, medial condyle, and lateral condyle was observed. At 1.5 months, the entire proximal extremity was ossified. Conclusion3D CT provided clear imaging of ossification progression in the pelvic and femur bones. This study enhances our understanding of vertebrate skeletal development.

Revisiting morphology of xiphoid process of the sternum in human: a comprehensive anatomical study.

The xiphoid process (XP) in animals such as sheep and rats are well known to have cartilage called xiphoidal cartilage (XC). In humans, the cartilage in the xiphoid process is considered an anatomical variant and is not well understood. The aim of this study was to investigate the morphology of the XP. A total of twenty embalmed European descendant cadaveric sterna (aged 52 to 98 years) were used. Transilluminated XPs and midsagittal sections of XPs were used to examine the bone and cartilage. Subsequently, a sagittally-sectioned XP was harvested for histology and stained with Masson's trichrome. The results of the transillumination and histological examinations were compared qualitatively. The dark area visible in transilluminated XPs was consistent with the bony part in the midsagittal XP sections, which contained bone marrow; the bright area was consistent with the cartilage part in the midsagittal XP sections. This was all demonstrated histologically. Most of the XPs (85%) had some portion of cartilage. The XP was classified into four types based on its proportions of bone and cartilage: Type I, no ossification (< 1/3 ossification) 45%; Type II, minor ossification (1/3 - 1/2 ossification) 20%; Type III, major ossification (1/2-2/3 ossification) 20%; Type IV, complete ossification (> 2/3 ossification) 15%. Most of the XPs (85%) had bone and cartilage, which could have been overlooked in studies using skeletons or CT. Previous studies probably underestimated or overestimated the size of the XP. The XC needs to be considered as normal anatomy.

Spontaneous ping-pong fracture in a full-term neonate—a case report

BackgroundNon-traumatic depressed skull fracture in a neonate delivered by cesarean section is a rare phenomenon. The incidence reported in literature varies between 1 and 2.5 in every 10,000 live births. The skull is transformed from its normal convex shape to a more concave form due to easy malleability. This is secondary to the lack of complete ossification in the neonatal period. Hence, it is commonly known as ping-pong fracture. The clinical presentation may vary depending on the severity of the fracture and underlying parenchymal injury. Most cases reported in literature have been managed conservatively. However, surgical elevation and the use of medical devices may be advised in severe cases.Case presentationWe report the presentation, course, and management of a term female neonate with a spontaneous ping-pong fracture. The neonate had no history suggestive of antenatal insult, difficult labor, or trauma due to instrumentation during delivery. The infant was thoroughly investigated for underlying parenchymal injury, observed for neurological abnormality, and managed conservatively.ConclusionThus, ping-pong fractures or spontaneous neonatal skull fractures are rare but can be encountered in clinical practice. A thorough clinical examination and neurological assessment can aid management decisions.

The Early Allometric Growth and Osteological Ontogeny of Pot-Bellied Seahorse (Hippocampus abdominalis, L. 1827) under Mass-Scale Captive Breeding Conditions in North China

Seahorses are valuable species for their use in traditional Chinese medicine, as well as for the aquarium trade as ornamentals and curiosities. To balance market demand and reduce pressure on wild populations, many countries have undertaken commercial seahorse cultivation. Skeletal development plays a crucial role in fish fry culture, affecting external morphology, feeding, and movement. This study investigated the ontogeny allometry, timing, and progression of skeletal development in H. abdominalis from DAB (day after birth) 1 to DAB 100 under mass-scale captive breeding conditions in north China. The results of this study revealed the growth rate was significantly increased between DAB 30 and DAB 54. Allometry analysis revealed that in the early stage, the head, trunk, and tail demonstrated almost isometric growth. However, in the later stage, the head and trunk exhibited negative isometric growth, whereas the tail displayed positive isometric growth. Skeletal staining results showed that newborn seahorses do not have ossified bones until DAB 11 (SL 28.14 ± 2.94 mm). Ossification was primarily observed in the jaw region and the tubular nasal structure of the cranium, which indicated the importance of the early development of feeding organs. The initial formation of ossified vertebral columns was observed at DAB 13 (SL 26.48 ± 0.63 mm), with the complete ossification of all vertebrae occurring by DAB 45 (SL 54.87 ± 4.70 mm). Furthermore, the cranium, rings, and plates were all fully ossified by DAB 30. Ossification of the fins began at DAB 23 (SL 31.27 ± 4.05 mm). However, neither of them were fully ossified by DAB 100. The pelvic fin and the complete structure of the caudal fin were not observed, possibly because of caudal fin ray structure degeneration within the pouch. In addition, no skeletal deformities were observed in all the tested samples. The results of this study provide valuable information on the developmental biology of H. abdominalis, enriching our understanding of their growth and offering insights for optimizing fish fry breeding technologies.

Use of chin sling for conservative treatment of mandibular fracture in a guinea pig (Cavia porcellus).

To describe a treatment for a mandibular fracture in a guinea pig (Cavia porcellus). A 6-month-old sexually intact male guinea pig referred for a 24-hour history of hyporexia. Physical examination showed lateral displacement of the incisors and inflammation and crepitation during mandible lateralization. Imaging tests revealed a minimally displaced complete oblique fracture of the left mandible with fracture of the left mandibular first premolar tooth and incisor tooth. Conservative treatment was established by placing a chin sling (CS) to immobilize the jaw and a nasogastric tube for nutritional support. Imaging tests repeated 3 weeks later showed initial callus formation, and the conservative treatment was discontinued. Follow-up examinations showed appetite and progressive weight gain. Five months later, the clinical crown of the left mandibular incisor was absent and a resorptive lesion on the left mandibular first premolar tooth was detected. Complete ossification of the fracture without premolar and moler teeth elongation was observed on control imaging tests. Ten months after initial examination, the patient was reportedly healthy with no signs of pain or dental disease. Jaw fracture treatments in guinea pigs are poorly described in the literature. Surgical treatment can be challenging in this species due to its skull and dental anatomy. Although CS was originally employed to increase the congruency of premolar and molar teeth after coronal reduction, this device yielded satisfactory results as a noninvasive, inexpensive treatment of a mandibular fracture in this guinea pig. Alopecia on the back of the head was the only undesired adverse effect associated with the CS.

An unusual presentation of ossified spinal meningioma: case report and literature review.

Spinal meningioma is a common intraspinal tumor, which mainly occurs in the thoracic spine. Ossified meningioma (OSM) is an extremely rare histological variant. Our article reports a rare patient with dorsal complete OSM and reviews this subject. A 68-year-old woman presented with a one-year history of progressive weakness in both lower limbs with gait disturbance. Physical examination revealed hypoesthesia with a sensory level below T10. Babinski and pathological signs on both sides were weakly positive. Magnetic resonance imaging (MRI) showed a mass at the T10 to T11 level causing severe compression of the spinal cord. Computed tomography (CT) showed complete ossification of the mass. 18F-Fluoro-deoxy-glucose positron emission tomography CT (18F-FDG PET/CT) scan combined with MRI revealed that the mass was an intradural extramedullary high-density ossified nodule. The patient underwent a gross total resection of the mass and pathologic examination indicated that the mass was a meningioma with diffused psammomatous bodies. We identified a rare case of dorsal complete OSM occurring in a 68-year-old woman. After complete surgical resection, although there were complications such as cerebral fluid leakage and fever, the patient finally recovered with a satisfactory result.

A large mixed pattern aneurysmal bone cysts: An extremely rare case with unusual radiological findings and management sequela

A mixed pattern of aneurysmal bone cysts (ABCs) is an extremely rare anatomic subtype. Typical ABCs usually arise in the metaphysis of long bones, predominantly in childhood-age patients. Here, we report a case of a 37-year-old female presenting with the left leg pain and mass for 2 years. Conventional radiographs and computed tomography scans revealed a well-demarcated expansile lytic lesion at the diaphysis of the left tibia. Magnetic resonance imaging showed fluid-fluid levels with associated bone edema. These findings were suggestive of ABC. An open incisional biopsy was done and was confirmatory. After 8 months, the patient showed radiographic complete ossification of the lesion with persistent symptoms. Excision and intralesional curettage of the lesion was performed and supported with a tibia locking plate. On 18 months of follow-up, the patient was asymptomatic, with no recurrence observed on conventional radiographs.

Use of hyaluronic acid matrix in dorsal augmentation rhinoplasty

ABSTRACT Augmentation rhinoplasty sometimes is required for patients with saddle nose deformity caused by failed rhinoplasty or facial trauma; finding appropriate grafting material remains a significant problem for this procedure. We investigated hyaluronic acid matrix as an allograft for dorsal augmentation rhinoplasty in a rabbit model. We performed an osteotomy on the nasal bones of eight rabbits. Four animals were sham operated as the control group and four were administered a mixture of saline-gelled hyaluronic acid matrix and sliced cartilage. Ultrasonography and three-dimensional reconstruction tomography were performed at the end of the experimental period. After sacrifice of the animals, nasal tissues were examined for histopathology, and both collagen scores and number of capillaries were compared between the two groups. Increased collagen and capillaries were apparent in the hyaluronic acid matrix group compared to controls. The median collagen score was significantly greater for the hyaluronic acid matrix group than for the control group. Although the number of capillaries for the hyaluronic acid matrix group was greater than for the control group, the difference was not statistically significant. Three weeks is sufficient for adhesion of ends of fractures in clinical practice; however, we found no ossification at this time in either group. A hyaluronic acid matrix may be a useful alternative supplement for dorsal augmentation rhinoplasty. Development of collagen was commensurate with membranous ossification; however, assessment of complete ossification requires a longer experimental period.

Acetabular Rim Ossification Variants Are Found in Almost 20% of Patients Presenting With Hip Pain

To determine the prevalence of 4 different types of acetabular rim ossifications, including partial labral ossification or punctate calcification, true os acetabuli, acetabular rim stress fracture, and complete labral ossification, and to determine whether different types of periacetabular ossifications are linked to demographic or radiological factors. We retrospectively reviewed the medial records of patients presenting for hip-related complaints at 2 sports medicine practices from September 2007 to December 2009. An anteroposterior radiograph of both hips and a lateral radiograph of each hip was obtained for all patients and reviewed for findings of cam and pincer femoroacetabular impingement, degenerative changes (Tönnis grade), and periacetabular calcifications for both hips. These parameters were also evaluated with respect to symptoms, sex, and age. Four hundred ninety-one consecutive patients (982 hips) presented to 2 orthopaedic surgeons at 2 centers for "hip"-related complaints. There were 223 males and 268 females (age 39 ± 14 years). The overall prevalence of periacetabular calcifications in hips was 17.6%, with 56.6% of calcifications in the symptomatic hip and 43.4% in the contralateral hip. Four basic patterns of calcification were identified: punctuate calcifications within the labrum (8.0% hips), large rounded calcifications (os acetabuli) (4.2% hip), large fragments with a vertical line of the superior-lateral acetabular rim, consistent with healed or non-healed stress fracture (2.0% hips), and complete ossification of the labrum (3.4% hips). Overall, male sex (P= .002), increased lateral center-edge angle (P= .046), and higher Tönnis grade (P < .001) statistically predicted the presence of periacetabular ossification. Punctate calcifications were more prevalent in males (P= .002). Higher Tönnis grade (P=.029) and increased alpha angle (P= .046) were more prevalent with os acetabuli. Younger age (P= .001), male sex (P= .048), increased alpha angle (P= .012), and increased lateral center-edge angle (P < .001) were more prevalent in acetabular rim fractures. No factors were statistically significant at predicting the presence of an ossified labrum. Periacetabular calcifications are not uncommon. Four particular patterns of calcification are identified: punctate labral calcifications (8%), larger rounded calcifications (i.e., os acetabuli) (4.2%), acetabular rim stress fractures (2%), and complete ossification of the labrum (3.4%) for a combined prevalence of 17.6% in patients presenting to an orthopaedic surgeon with "hip"-related complaints. Nearly half were in the asymptomatic hip. Male sex had a higher prevalence of periacetabular calcifications. An increased lateral center edge angle and higher Tönnis grade also had a higher prevalence of periacetabular calcifications. Younger male patients are more likely to have acetabular rim stress fractures. Patients with an increased alpha angle have a higher prevalence of os acetabuli and rim stress fractures. This study aims to identify, quantify, and categorize periacetabular calcifications about the hip. Their clinical relationships and relevance have been discussed, but no study has distinctly categorized the various types and their prevalence. This study provides a framework for identification and categorization.

Age Estimation Based on CT Chest Analysis of Ossification of the Xiphisternal Joint in a Living Population Aged 35-50 in a Tertiary Setup.

Introduction Age estimation has been an area of special interest in the medicolegal context because of its necessity in various criminal and civil cases like assaults, murders, rapes, inheritance, insurance claims, etc. While legal documents are useful in daily activities that require age identity, they cannot be relied on for criminal and civil proceedings because of being falsifiable and inaccessible to some people. Scientific methods of age determination like physical, dental, and radiological examinations are used for reliable age estimation due to their universal and non-falsifiable nature. The skeletal examination is of great importance here because the human skeleton provides many sites for age estimation in different age groups. The xiphisternal joint between the xiphoid process and the body of the sternum provides one such opportunity in participants of 35-50 years of age. The ossification in this joint proceeds gradually in approximately the third to fifth decade of life; this natural variation in the morphology of the joint can be leveraged for age estimation. Previous studies showed that the mean age of fusion varied with the ethnicity of individuals and environmental factors. Thus, it is critical to have statistical information for the concerned population to avoid errors. Also, the relation of gender with the mean age of complete fusion remained ambiguous with the previous studies. The xiphisternal joint can be studied by radiological techniques like computed tomography (CT) and plain radiographs. Radiological methods have the benefit that they can be used on both living and dead participants and are non-invasive. The present study aims at gathering data relevant for use in India (Maharashtra) and to find out the reference age group in which there is complete ossification of the xiphisternal joint in males and females. Methods and materials This was a cross-sectional observational study in a tertiary care setup over a period of one year. High-resolution computed tomography (HRCT) was used for assessing joint fusion due to its high spatial resolution. The participants were included in the study if they were referred for HRCT chest by a physician for some pathology, did not have any trauma or lesion of the sternum and consented to the use of their information for the purpose of this study. Results The study included a total of 384 participants, out of whom 195 (50.8%) were males and 189 (49.2%) were females. The mean age of participants was 42.87 years. The mean age of complete xiphisternal joint fusion was observed to be 46.31 years (95% CI: 45.61 to 47.00) in males and 45.57 years (95% CI: 44.73 to 46.42) in females. Similarly, the mean age of participants with an unfused xiphisternal joint was observed to be 38.42 years (95% CI: 37.47 to 39.39) in males and 37.85 years (95% CI: 37.14 to 38.57) in females. There was no statistically significant difference in the age above which males and females show complete ossification of the xiphisternal joint. Conclusion The xiphisternal joint fusion can be used to determine the chronological age of an individual. It can be estimated as lesser than or equal to 45 years if the xiphisternal joint is unossified and greater than or equal to 37 years if the joint is ossified, with a 95% level of confidence.

Prevalence, Laterality, and Classification of Ossified Petroclival Ligaments: An Anatomical and Histological Study With Application to Skull Base Surgery.

Background The petroclival ligament (PL) forms the roof of Dorello's canal (DC). In humans, partial and complete ossification of this ligament have been reported. When completely ossified, DC is transformed into a bony foramen for the abducens nerve and accompanying vascular structures. As this osteological finding might have an impact on skull base surgery, this anatomical study was performed. Methodology Using 100 adult human skulls, the presence of an ossified PL was noted and classified. The diameter of the resultant bony foramen and laterality were documented. Additionally, PL was evaluated histologically in 10 heads. Results Overall, 8% of the sides were found to have partial or complete ossification of the PL. Partial ossification (type I) was noted on 3% of the sides. Completely ossified PL was identified on 5% of the sides. Some ossified ligaments (2.5%) were seen as an ossified bridge (type II), and others (2.5%) were converted into small foramina (type III). Three skulls (3%) were found to have a completely ossified ligament bilaterally. The mean diameter of the underlying DC was 0.8 mm. Partially ossified ligaments were statistically more likely to be on the right sides, and the diameter of the underlying DC was statistically smaller in type III. Histologically, the PL was found to have bone within it on three skull sides. Conclusions An ossified ligament can be found on imaging of the skull base. Moreover, during surgical approaches to the petroclival region and, specifically, DC, skull base surgeons should be cognizant of this anatomical variation.

Ossification of Superior Transverse Scapular Ligament - Incidence, Embryology and Association with Suprascapular Neuropathy.

Suprascapular notch is present at superior border of scapula just medial to coracoid process. This is covered by superior transverse scapular ligament (STSL). Suprascapular nerve passes below this ligament while suprascapular vessels pass above it. STSL ossification is a rare finding with variable incidences in different population groups. We observed 60 dry bony scapulae, 30 prosected formalin fixed upper limbs with scapula and 10 embalmed cadavers for the presence of ossified STSL. There were complete ossification of STSL in two dried bony specimens of sacpula. Ossified STSL may be the causative factor for suprascapular neuropathy. The mainstay of management in cases of neuropathy or compression of suprascapular nerve is release of suprascapular ligament by either open or arthroscopic surgical approach. So, it is extremely important to know this type of variation to minimize any damage to related structure and plan the management accordingly.

Incidence of Ossification of Caroticoclinoid Ligament in Dry Adult Human Skulls with its Surgical Implications: A Cross-sectional Study from Telangana Region, India

Introduction: The caroticoclinoid ligament extends from the Anterior Clinoid Process (ACP) to the Middle Clinoid Process (MCP). Occasionally, it gets ossified and forms the caroticoclinoid foramen. Anterior clinoidectomy is a common surgical procedure to treat internal carotid artery aneurysms or pituitary tumours. Abnormal ossification of the caroticoclinoid ligament may lead to intraoperative or postoperative complications as it is not normally present. Aim: To find out the incidence of ossification of the caroticoclinoid ligament in adult human skulls. Materials and Methods: This was an observational crosssectional study that included 100 dry adult human skulls collected from the Department of Anatomy, Gandhi Medical College, Secunderabad; Osmania Medical College, Hyderabad; Bhaskar Medical College, Moinabad, Telangana, India, from January 2021 to February 2023. Adult human skulls with open vault were included. All the skulls were observed and skulls damaged in the clinoid regions were excluded from the study. The skulls were observed for the presence of any ossifications of the caroticoclinoid ligaments and the observations were noted. The qualitative data was presented as number and percentage was calculated. The data was recorded in MS excel version 2021. Results: The incidence of ossification of caroticoclinoid ligament was 8 (8%). The incidence was higher on right-side when compared to the left-side. Bilateral complete ossification of the caroticoclinoid ligament was observed in 2 (2%) skulls; bilateral incomplete ossification was observed in 3 (3%) skulls, unilateral complete ossification was observed in 2 (2%) skulls on the right-side. In one skull 1 (1%), complete ossification was observed on the right-side and incomplete ossification was observed on the left-side. Conclusion: Knowledge of the ossification of the caroticoclinoid ligament is important for neurosurgeons while performing anterior clinoidectomies or skull base surgeries. Radiological confirmation of the ossification of the caroticoclinoid ligament is essential to avoid complications.

Forensic age estimation in Barcelona: analysis of expert reports issued between 2011 and 2018

In recent years, there has been a notable increase of migratory movements into Europe with the arrival of not (reliably) documented young individuals within EU-Member States. Accordingly, the need for forensic age assessments likewise increased in order to administratively differentiate along the legally relevant cut-off age of 18 completed years. The objective of our study was to analyse the expert reports of forensic age estimation issued in Barcelona between 2011 and 2018. In all cases, data on the medical history, physical examination, radiology of the left hand and orthopantomography were collected. In cases without third molars and a complete ossification of the hand, a CT scan of the clavicles was also performed. A total of 2754 expert reports were evaluated; 96.7% were males, the majority were of North African origin, mainly from Morocco (63.6%), and 19.6% were sub-Saharan Africans; 65.4% had a level of bone maturation corresponding to the last three standards of Greulich and Pyle. Most cases had mineralization of the third molar corresponding to the F, G or H stages of Demirjian. In 85.9%, there was a correspondence between bone and dental age. A total of 28.8% of the subjects were evaluated as being aged over 18years; 86.2% of North Africans were considered to be younger than 18, and 82% of sub-Saharan Africans were considered to be over 18years old. In Barcelona, most of the subjects evaluated were male and North African, and 71.2% of the cases were considered to be minors.

Morphological and Morphometric study of suprascapular notch

Variation in the morphology of suprascapular notch is associated with suprascapular nerve entrapment neuropathy. So, the knowledge about different shapes of suprascapular notch is important for clinicians in understanding the source of the entrapment syndrome. The Shapes of suprascapular notch are of five in types - Deep U Shaped, shallow U Shaped, J Shaped, V Shaped &amp; indented shaped. Deep U shape is most common &amp; Indented is least common type of suprascapular notch. Suprascapular notch is semicircular in shape, situated in the superior border of the scapula just below the base of the coracoid process. Suprascapular notch is converted to the foramen by the attachment of the suprascapular ligament. Suprascapular vessels passes above the ligament &amp; Suprascapular nerve passes below the ligament. In present study morphological data were obtained and classify the suprascapular notch according to their shape. Present study was conducted on 70 dry human scapulae of both sides with unknown age &amp; sex. This study was conducted in the Department of Anatomy, Hind Institute of Medical Sciences, Barabanki. In the Present study Anatomical variation were found in suprascapular notch which included shape, partial &amp; complete ossification of superior transverse ligament.

Timing of Spheno-Occipital Synchondrosis Closure in Cleft Lip and Palate Patients in Iranian Population.

This study aimed to evaluate the chronological age range associated with each stage of spheno-occipital synchondrosis (SOS) fusion in patients with cleft lip and palate compared to the noncleft group, using cone-beam computed tomography (CBCT) images. Design: In this study, the degree of SOS fusion was assessed using a 4-stage scoring system on CBCT images of 190 individuals (92 patients with cleft lip and palate, 98 noncleft individuals). A χ2 test was performed to assess the correlation between age and fusion stage. The independent sample t tests were used to evaluate the differences in the mean values of the samples of each group and each sex, as well as the mean value of each stage (P < .05). Results The results showed that there was no significant difference in the timing of the SOS fusion stages between the patients with cleft palate and the noncleft group. Although the fusion process of SOS begins about one year earlier in females, the complete ossification occurs at the mean age of 18.5 for both sexes in the experimental group and the mean age of 19.0 in the noncleft group. Conclusions The present study found no differences in the fusion stages of the spheno-occipital synchondrosis between patients with cleft lip and palate and healthy individuals.

Preiser disease in a child before complete ossification of the scaphoid: a case report

BackgroundThe pathology of Preiser disease remains controversial, and treatment for Preiser disease has not yet been standardised. Preiser disease itself is rare, and although it can be found in children, its presentation is even rarer; therefore, the treatment of paediatric patients with Preiser disease is more unclear than adult cases.Case presentationA 10-year-old boy who complained of left wrist pain was diagnosed with Preiser disease from osteosclerosis and segmentation on plain radiography and computed tomography, and low signal intensity on both T1- and T2-weighted images on magnetic resonance imaging. Because the patient was a child whose scaphoid was immature and pre-ossified, we chose a conservative immobilisation treatment with a thumb spica cast followed by an orthosis. After 3 months of immobilisation, the distal pole of the scaphoid showed remodelling. One year after the initial visit, plain radiography showed remodelling of the whole scaphoid, although magnetic resonance T1-weighted image showed that the recovery of intensity change was only observed in the distal pole. Two years after the initial visit, both plain radiography and magnetic resonance imaging showed a normal appearance and 5 years after the initial visit; the scaphoid bone showed normal development.ConclusionsThis is the first case report of Preiser disease before complete ossification of the scaphoid; therefore, we cannot say anything definitive about the treatment strategy. However, our experience suggests that conservative treatment may provide a cure for Preiser disease in children with immature ossification of the scaphoid without carpal collapse.

Surgical Methods and Auditory Outcomes of Cochlear Implantation in Cochlear Ossification.

Background: The aim of this study was to evaluate the surgical and auditory outcomes of cochlear implantation in patients with cochlear ossification.Methods: This study comprised 54 patients with cochlear ossification who underwent cochlear implantation in the cochlear implant center of a tertiary care hospital between January 1998 and May 2019. Clinical data were evaluated including surgical findings and audiological performances. The auditory outcomes of the implanted patients were assessed through the Categories of Auditory Performance-II test and Speech Intelligibility Rating test, respectively. The outcomes of patients with cochlear ossification were compared with those of 54 patients selected for the control group who underwent implantation with no cochlear ossification.Results: Auditory outcomes were comparable between the study group and the control group. The control group obtained significantly higher scores than those of the study group when compared using the Categories of Auditory Performance-II test and Speech Intelligibility Rating test batteries. Patients with meningitis produced poorer outcomes within the group comparisons of the study group. None of the patients experienced surgical complications. The extent of ossification was analyzed in terms of its effectiveness on audiological performance. Patients with complete ossification had significantly lower Categories of Auditory Performance-II and Speech Intelligibility Rating test scores.CONCLUSION: Cochlear implantation is a safe and beneficial procedure, even in patients with cochlear ossification. The ossified cochlea may require varied drill techniques beyond traditional implantation surgery for the insertion of the electrode array. It is, however, still difficult to predict audiological outcomes in patients with cochlear ossification.

Determination of dimensions of Glenoid cavity from other scapular parameters in North Indian Population

Background: The Glenoid cavity dimensions can help to predict the incidence of glenohumeral dislocations in a population. Purpose of study: The present study involved the measurements of the body of the scapula and the glenoid cavity and to draw the relationship of them to predict the chances of glenohumeral dislocations in North Indian Population. Methods: A total number of 130 adult scapulae of unknown sex showing complete ossification and without any damage were included in the study. The various shapes of glenoid cavities both on right and left sides were noted and analysed. A digital Vernier calliper was used to measure all the dimensions of scapula as well as glenoid cavity. The data was analysed and regression formulae to estimate the glenoid cavity dimensions were drawn. Results: Most common shape of the glenoid cavity in the present study was pear shaped (52.30%) followed by inverted comma shaped (33.07%) and least common was oval shaped (14.63%). Mean maximum height of scapula (MSH) was 142.45± 2.32 mm, mean maximum width of scapula (MSW) was 102.65± 0.21mm. Mean maximum glenoid height (MGH) was 38.77± 3.15mm, mean maximum glenoid width I (MGW I) was 23.82± 2.11 mm, mean maximum glenoid width II ( MGW II) was 14.78± 9.11mm. Mean scapular index (SI) was 71.32± 0.61(60-&lt;73) % and mean glenoid index (GI) was 60.43± 5.43%( 60-69%). Bilateral differences in these parameters were statistically insignificant. Mean maximum scapular height was significantly correlated with both mean maximum glenoid height and mean maximum glenoid width. There was also found highly significant interglenoid dimension correlation. Conclusion: Glenohumeral dislocations are expected if indices are &lt;50% or &gt; 89%. A deviation from the normal relation between maximum glenoid width and maximum glenoid length also indicates glenohumeral instability. KEY WORDS: Glenoid cavity, Gleno humeral, Scapula.