Mastoid Research Articles

Association between morphological features in the cochlear promontory and mastoid Process: Implications for Identifying middle ear diseases in human skeletal remains

Infectious Middle Ear Disease (IMED) is a group of infections that frequently afflict individuals across all age groups worldwide. Although in today’s clinical practice IMED is efficiently managed, in the past it probably caused severe complications (e.g., hearing loss, balance problems, and facial nerve paralysis), heavily impacting the everyday life of many people. However, despite the valuable insights that studying ear infections in the past can bring, bioarcheology presently lacks a standardized methodology to assess their prevalence in skeletal populations. This can lead to several issues, including incomparability of results, difficulties in replications, and methodological biases.Recently, straightforward and accessible criteria for the observation of the cochlear promontory were presented to successfully assess IMED on skeletal remains. Yet, as otologists rarely examine the impact of ear infections on the bony structures of the middle ear, the results were not supported clinically, and could therefore not be validated. To fill this gap, we propose a study in which computed tomography (CT) of the mastoid process was utilized on the skulls of 50 individuals to verify the results obtained through gross observation of the cochlear promontory. Statistical analysis revealed significant correlation between hypopneumatization (indicative of childhood IMED) and bony changes of the promontory at the level of the individual. This suggests a potential correlation that warrants further investigation to determine whether the observation of the cochlear promontory should be used as a method for IMED assessment. Overall, our study contributes to the study of IMED in past populations, and underscores the importance of clear, standardized scoring criteria in paleopathology.

The Posterior Auricularis Muscle as Superficial Landmark for the Sigmoid Sinus and Transverse-Sigmoid Sinus Junction: An Anatomical Study

Neuronavigation systems coupled with previously reported external anatomical landmarks assist neurosurgeons during intracranial procedures. We aimed to verify whether the posterior auricularis muscle (PAM) could be used as an external landmark for identifying the sigmoid sinus (SS) and the transverse-sigmoid sinus junction (TSSJ) during posterior cranial fossa surgery. The PAM was dissected in 10 adult cadaveric heads, and after drilling the underlying bone, the relationships with the underlying SS and TSSJ were noted. The width and length of the PAM, and the distance between the muscle and reference points (asterion, mastoid tip, and midline), were measured. The PAM was identified in 18 sides (9 left, 9 right). The first 20 mm of the muscle length (mean 28.28 mm) consistently overlay the mastoid process anteriorly and the proximal half of the SS slightly posteriorly on all sides. The superior border was a mean of 2.22 mm inferior to the TSSJ, and, especially when the muscle length exceeded 20 mm, this border extended closer to the transverse sinus; it was usually found at a mean of 3.11 mm (range 0.0-13.80 mm) inferior to the distal third of the transverse sinus. Superficial landmarks give surgeons improved surgical access, avoiding overexposure of deep neuro-vascular structures and reducing brain retraction. On the basis of our cadaveric study, the PAM is a reliable and accurate direct landmark for identifying the SS and TSSJ. The PAM could potentially be used for guiding the retrosigmoid approach.

Generation and applications of synthetic computed tomography images for neurosurgical planning.

CT and MRI are synergistic in the information provided for neurosurgical planning. While obtaining both types of images lends unique data from each, doing so adds to cost and exposes patients to additional ionizing radiation after MRI has been performed. Cross-modal synthesis of high-resolution CT images from MRI sequences offers an appealing solution. The authors therefore sought to develop a deep learning conditional generative adversarial network (cGAN) which performs this synthesis. Preoperative paired CT and contrast-enhanced MR images were collected for patients with meningioma, pituitary tumor, vestibular schwannoma, and cerebrovascular disease. CT and MR images were denoised, field corrected, and coregistered. MR images were fed to a cGAN that exported a "synthetic" CT scan. The accuracy of synthetic CT images was assessed objectively using the quantitative similarity metrics as well as by clinical features such as sella and internal auditory canal (IAC) dimensions and mastoid/clinoid/sphenoid aeration. A total of 92,981 paired CT/MR images obtained in 80 patients were used for training/testing, and 10,068 paired images from 10 patients were used for external validation. Synthetic CT images reconstructed the bony skull base and convexity with relatively high accuracy. Measurements of the sella and IAC showed a median relative error between synthetic CT scans and ground truth images of 6%, with greater variability in IAC reconstruction compared with the sella. Aerations in the mastoid, clinoid, and sphenoid regions were generally captured, although there was heterogeneity in finer air cell septations. Performance varied based on pathology studied, with the highest limitation observed in evaluating meningiomas with intratumoral calcifications or calvarial invasion. The generation of high-resolution CT scans from MR images through cGAN offers promise for a wide range of applications in cranial and spinal neurosurgery, especially as an adjunct for preoperative evaluation. Optimizing cGAN performance on specific anatomical regions may increase its clinical viability.

INTERMASTOID DISTANCE OF THE HUMAN SKULL: PATTERNS OF INDIVIDUAL VARIABILITY

Sexual dimorphism of the mastoid processes of the temporal bones, namely their linear dimensions, size and shape, and the distance between them, are used in research aimed at determining the gender of the skulls. The distance between the mastoid processes is measured either as intermastoidale distance, or as the intermastoid lateral surface distance, IMLSD. Both indicators aff ect the determination of the sex of skulls better than linear dimensions. At the same time, in previous studies of gender diff erences in the intermastoid distance, the relationships between intermastoid distance and morphometric indicators characterizing the size of the skull were not taken into account. The purpose of the study: to establish the patterns of individual variability of the intermastoid lateral surface distance, namely, its relationship with the variability of the width of the skull base, the distance between asterions and the width of the cerebral cranium (transverse diameter of the skull). The study was conducted on 50 skulls (33 male and 17 female) from the craniological collection of the Department of Human Anatomy of KhNM U.It was established that the intermastoid lateral surface distance in men is signifi cantly greater than in women (M±: 127,4±5,6 and 118,5±3,5, respectively; p<0,05). This is explained by the larger size of the male skull compared to the female one and the peculiarities of the somatotypes of male and female organisms. In men, there are statistical relationships between the intermastoid lateral surface distance, on the one hand, and the width of the skull base (y=0.6x+56.5; r=0.6), the distance between asterions (y=0.5x+67.3; r=0.6), the transverse diameter of the skull (y=0.4x+72.3; r=0.4), on the other hand, are noticeable and statistically signifi cant (p<0.05), while in women they are much smaller (respectively, y=0.3x+87.6; r=0.3; y=0.3x+84.9; r=0.2; p<0.05; and y=0.4x+61.6; r=0.3, p>0.05). The shape of the skull does not aff ect the distance between the mastoid processes, both in men and in women.

INPATIENT DISEASE PATTERNS AT PHAM NGOC THACH TRADITIONAL MEDICINE HOSPITAL LAM DONG

The article presents the disease pattern of inpatients at Pham Ngoc Thach Traditional Medicine Hospital in Lam Dong from 2021 to 2023. The study was conducted using a cross-sectional, retrospective descriptive method, utilizing data from the hospital's medical records system and statistical reports from 2021 stored in the hospital's archives. Information was collected from patient records following predefined selection criteria, encompassing all adequately documented cases during the inpatient treatment period from January 1st, 2021 to August 31st, 2023. The research findings revealed that the group of diseases related to musculoskeletal and connective tissue accounted for the highest proportion at 57.79%, followed by circulatory diseases at 24.18%, and nervous system diseases at 7.75%. Other groups of diseases such as digestive, trauma, and respiratory systems also appeared, albeit with lower proportions. Particularly, rare disease groups like ear and mastoid bone diseases, and skin and subcutaneous tissue diseases were noted. These results provide a comprehensive overview of the disease distribution, supporting decision-making and the development of effective treatment strategies for inpatients in the upcoming period.

Sensorineural correlates of failed functional recovery after natural regeneration of vestibular hair cells in adult mice.

Vestibular hair cells (HCs) are mechanoreceptors that sense head motions by modulating the firing rate of vestibular ganglion neurons (VGNs), whose central processes project to vestibular nucleus neurons (VNNs) and cerebellar neurons. We explored vestibular function after HC destruction in adult Pou4f3+/DTR (DTR) mice, in which injections of high-dose (50 ng/g) diphtheria toxin (DT) destroyed most vestibular HCs within 2 weeks. At that time, DTR mice had lost the horizontal vestibulo-ocular reflex (aVORH), and their VNNs failed to upregulate nuclear cFos expression in response to a vestibular stimulus (centrifugation). Five months later, 21 and 14% of HCs were regenerated in utricles and horizontal ampullae, respectively. The vast majority of HCs present were type II. This degree of HC regeneration did not restore the aVORH or centrifugation-evoked cFos expression in VNNs. The failure to regain vestibular pathway function was not due to degeneration of VGNs or VNNs because normal neuron numbers were maintained after HC destruction. Furthermore, sinusoidal galvanic stimulation at the mastoid process evoked cFos protein expression in VNNs, indicating that VGNs were able to regulate VNN activity after HC loss. aVORH and cFos responses in VNNs were robust after low-dose (25 ng/g) DT, which compared to high-dose DT resulted in a similar degree of type II HC death and regeneration but spared more type I HCs in both organs. These findings demonstrate that having more type I HCs is correlated with stronger responses to vestibular stimulation and suggest that regenerating type I HCs may improve vestibular function after HC loss.

Postural Control and Sensory Processing in Preschool Children with Autistic Spectrum Disorder: A Cross-Sectional Study.

The role of sensory processing in maintaining postural control (PC) among preschool-aged children with autism spectrum disorder (ASD) remains underexplored despite its potential implications for their developmental trajectory. This study aimed to assess the utilization of sensory information for PC maintenance while standing in preschool-aged children with ASD and to examine its correlation with PC during functional tasks using a standardized tool. The cross-sectional study recruited 27 children, aged between 3 and 6 years, diagnosed with ASD. Participation indexes for somatosensory, vestibular, visual, and visual preference were computed during a modified Clinical Test of Sensory Integration and Balance (m-CTSIB), based on sagittal plane body sway analyzed via video with Kinovea® software (version 0.9.4). Additionally, scores from the Pediatric Balance Scale (PBS) were analyzed. Statistical analysis of data derived from lateral malleolus and mastoid process sway using the Friedman test revealed significant differences in the utilization of various sensory systems involved in PC during the m-CTSIB (p < 0.001). There was a pronounced reliance on somatosensory information, coupled with increased instability in the absence or with the variability of visual information. The mean PBS score was 50.44 ± 2.74, exhibiting a significant negative correlation with the vestibular index (p < 0.05). Preschool-aged children with ASD demonstrated challenges in maintaining PC while standing under different sensory conditions, indicating a heightened dependence on somatosensory cues, particularly in the absence or with the variability of visual stimuli. While these challenges were not reflected in PBS scores, they were negatively correlated with the vestibular index.

Аналіз частоти маніфестації деяких ізольованих та поєднаних вад розвитку опорно-рухового апарату в дітей молодшого шкільного віку

Over the past few decades, there has been a significant decrease in the number of healthy children, while the number of children with chronic illnesses, developmental disorders, various forms of postural issues, and scoliosis has significantly increased. Purpose - to determine the frequency of manifestation of developmental abnormalities in the spine, chest, foot, and lower jaw, as well as detection of variations and characteristics of their combinations in younger school children to develop new and improve existing criteria for early diagnosis of musculoskeletal development disorders and the correct selection of methods for their correction. Materials and methods. In order to conduct the study as part of preventive check-ups with parental informed consent, 200 children (100 boys and 100 girls) aged 6-9 years were examined. The working group was formed using the randomization method. The groups of boys and girls were further divided into 4 age groups, (6 years, 7 years, 8 years and 9 years) each consisting of 25 children. We determined the shape of the chest , the symmetry of processus mastoideus, claviculae and fossa supraclaviculare, scapulae, cristae illiacae, maleolus medialis, the condition of the foot arch and the lower jaw development. Results. Among the total number of examined children, isolated or combined variations of the following developmental abnormalities of the musculoskeletal system were found in 21.5% of cases. Isolated developmental abnormalities of the musculoskeletal system were found in 10% of examined boys and 8% of examined girls. Various combinations of detected abnormalities were found to manifest in 13% of boys and 12% of girls. Thoracic scoliosis is present in 16% of boys and 14% of girls; developmental issues of the lower jaw affect 9% of boys and 8% of girls, scoliosis of the cervical spine affects 4% of boys and 3% of girls; 6% of boys and 5% of girls have chest deformities and lumbar spine scoliosis. Conclusions. Developmental musculoskeletal abnormalities were found in 21.5% of children of. The frequency of combined developmental abnormalities increases with age. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Study of Topography of Stylomastoid Foramen With Respect to Nearby Landmarks to Carry Out Facial Nerve Block With Minimum Complications.

Nadbath facial nerve block is the most common procedure to anesthetize the facial nerve at stylomastoid foramen in intraocular surgeries, but it is associated with complications. Also, this foramen exhibits ethnic and racial variations with regard to its location. There is scanty literature describing the topographical location of this foramen. So, the study is carried out. The purpose of the study is to describe the topography of stylomastoid foramen from the surrounding landmarks so that Nadbath facial nerve block can be performed with minimum complications. The study was conducted using 80 adult dry skulls of unknown age and sex, and the distance of this foramen was measured from the tip, upper end, and lower end of the anterior border of the mastoid process and jugular foramen. The statistical analysis consisting of mean, SD, median, range mode, and t test was calculated. Mean distances of stylomastoid foramen from the upper end, the lower end of anterior border and tip of mastoid process and jugular foramen on right side were 1.5±0.16, 1.02±0.09, 0.84±0.09, and 0.49±0.06cm and those on left side were 1.5±0.16, 1.02±0.09, 0.84±0.09, and 0.5±0.06cm, respectively. The mode of these distances was 1.5, 1, 0.8, and 0.5, both on the right and left sides. The topographic information about stylomastoid foramen given in this study is useful to anesthetists to carry out Nadbath facial nerve block successfully with minimum complications.

Uncommon bilateral orbital lesion in leukemic patient: is it cutis leukemia, celullitis or both?

Introduction : Acute Myeloblastic Leukemia can infiltrate any parts of the body including the orbit and periocular area. This article was aimed to report uncommon sign of cutis leukemia representing as orbital cellulitis.&#x0D; Case Illustration : Male, 35 yo with chief complained progressive lesion in his bilateral upper and lower eyelid since 4 days before admission. He felt pain and stingy sensation around lesion. There was history of toothache. He was diagnosed with acute myeloblastic leukemia since 2 month before. Ophthalmology examination showed his visual acuity was 6/6 in both eyes with good ocular motility.His bilateral upper and lower eyelid were edematous and spasm with multiple vesicles, papule and pustule. Conjunctival injection was found in both eyes. The reminder of ophthalmology examination was unremarkable. There were other hyperemic nodules in left mandibulae and right mastoid bone. Laboratory examination showed increased leukocyte, procalcitonin and C-Reactive Protein level. Orbital CT scan revealed edema in cutis and subcutis area in both superior and inferior bilateral palpebra. Board spectrum and anaerobe antibiotic along with steroid were administered intravenously. Biopsy was performed. After two weeks medication, lesion around both palpebra was decreased. Unfortunately, because of his poor systemic condition, he was readministered to our hospital and hospitalized in ICU. He was passed away after 8 days of hospitalization.&#x0D; Discussion : Male patient is more likely to develop orbital infiltration of leukemia, and it necessitates significant morbidity and mortality condition.&#x0D; Conclusion : Leukemia with orbital invasion should bring more awareness from both ophthalmologist and hematooncologist as it indicates more mortality and morbidity.

Health dynamics of children and adolescents in the Far Eastern federal district in 2013–2020

Aim. To identify trends in the primary morbidity of children and adolescents in the Far Eastern Federal District.Materials and methods. A retrospective analytical study of the dynamics of primary morbidity in children and adolescents by disease class was conducted.Results. Among the children population, a very high and high stability of the decrease in morbidity rates was established (R = -0.714– (-1.0)) for all classes of diseases. Among the adolescent population, a weak stability in the decrease in morbidity rates was characteristic of VII Diseases of the eye and adnexa (R = -0.262) and X Respiratory diseases (R = -0.262); a moderate stability of IV Diseases of the endocrine system, nutritional disorders, and metabolic disorders (R = -0.333); a moderate stability of IX Diseases of the circulatory system (R = -0.623); and a high stability among all other classes (R= -0.738 – (-0.928)). In the older age group, weak resistance to growth dynamics was determined in classes III Diseases of the blood, hematopoietic organs, and certain disorders involving the immune mechanism (R = 0.024) and VIII Diseases of the ear and mastoid process (R = 0.095).Conclusion. The data obtained forms a basis for further research into regional risk factors that contribute to poor health of the population. The findings can also be used to predict the health status of younger generations.

Using Galvanic Vestibular Stimulation to Induce Post-Roll Illusion in a Fixed-Base Flight Simulator.

INTRODUCTION: The illusions of head motion induced by galvanic vestibular stimulation (GVS) can be used to compromise flight performance of pilots in fixed-base simulators. However, the stimuli used in the majority of studies fail to mimic disorientation in realistic flight because they are independent from the simulated aircraft motion. This study investigated the potential of bilateral-bipolar GVS coupled to aircraft roll in a fixed-base simulator to mimic vestibular spatial disorientation illusions, specifically the "post-roll illusion" observed during flight.METHODS: There were 14 nonpilot subjects exposed to roll stimuli in a flight simulator operating in a fixed-base mode. GVS was delivered via carbon rubber electrodes on the mastoid processes. The electrical stimulus was driven by the high-pass filtered aircraft roll rate to mimic the semicircular canals' physiological response. The post-roll test scenarios excluded outside visual cues or instruments and required subjects to actively maintain a constant bank angle after an abrupt stop following a passive prolonged roll maneuver. The anticipated outcome was an overshot in roll elicited by the GVS signal.RESULTS: The responses across subjects showed large variability, with less than a third aligning with the post-roll illusion. Subjective ratings suggest that the high-pass filtered GVS stimuli were mild and did not induce a clear sense of roll direction. However, uncontrolled head movements during stimulation might have obscured the intended effects of GVS-evoked illusory head movements.CONCLUSION: The mild and transient GVS stimuli used in this study, together with the uncontrolled head movements, did not convincingly mimic the post-roll illusion.Houben MMJ, Stuldreher IV, Forbes PA, Groen EL. Using galvanic vestibular stimulation to induce post-roll illusion in a fixed-base flight simulator. Aerosp Med Hum Perform. 2024; 95(2):84-92.

Acute coalescent mastoiditis in a 16-month-old child due to Streptococcus pneumoniae infection

Rationale: Acute otitis media is a common disease in early childhood, and is usually caused by Streptococcus pneumoniae (S. pneumoniae). Acute mastoiditis is a complication of acute otitis media and can involve not only the mucoperiosteum of the middle ear but can also spread to the periosteum by destroying the mastoid bone (acute coalescent mastoiditis). In addition, the infection can extend through the surrounding bones or the emissary veins beyond the mastoid's air cells, leading to subperiosteal abscesses. Patient's Concern: A 16-month-old female patient was hospitalized due to the purulent discharge of the left ear and the symptoms of right mastoiditis (swelling and redness of the skin). Diagnosis: Bilateral acute coalescent mastoiditis caused by S. pneumoniae infection. The computer tomography revealed bilateral bone destruction of the mastoid and abscesses found behind the auricle on both sides. Interventions: The patient underwent intravenous antibiotic therapy and surgical treatment. Outcomes: The patient was discharged 14 days after hospitalization with an improved condition. Lessons: Improperly treated acute coalescent mastoiditis can lead to extracranial and intracranial complications, sometimes serious and even life-threatening. Complications are prevalent in children under 2 years, in whom the disease progresses more rapidly and severely. The vaccination with a 13-valent vaccine may not result in sufficient immunity against S. pneumoniae, a predominant pathogen in children affected by acute coalescent mastoiditis.

Specialist consensus on endoscopic surgery of the middle ear mastoid

This article discusses otoscopic middle ear mastoid surgery from multiple perspectives. Firstly, it discusses the indications and contraindications for surgery from the nature of the lesion and the imaging manifestations; secondly, it recommends the applicable equipment and describes the surgical approach in detail; finally, it summarizes the principles of the management of the operative cavity of the mastoid process in the middle ear from the perspectives of function and reconstruction. The purpose of this article is to illustrate otoscopic middle ear mastoid surgery with the aim of providing reference or guidance for performing related surgeries.

Infratemporal Fossa Schwannoma Surgery via a Combined Prelacrimal Recess, Caldwell-Luc, and Distal Intraoral Approach.

The deep location of infratemporal fossa (ITF) combined with the abundant vascular plexus in it increased the difficulty of removing the mass in ITF through endoscope surgery approach. However, under appropriate circumstances, the excision of ITF tumors through a combined prelacrimal recess, Caldwell-Luc, and distal intraoral approach can be safely performed with minimal impact on the surrounding tissues. The Department of Neurology received a 69-year-old male patient who had been experiencing headache, dizziness, and numbness from the mastoid region of his left ear to the corner of his mouth for a duration of 22 days. Cranial magnetic resonance imaging revealed the presence of a tumor located in the ITF. Following transfer to our department, surgical intervention was performed using a combined approach involving the prelacrimal recess, the anterior wall of maxillary sinus, and lateral ITF to successfully remove the tumor. Postoperative pathologic examination confirmed schwannoma as its nature. The patient was discharged in excellent condition without any functional impairment. On the basis of this case, the authors believe that this combined approach can offer a distinct endoscopic perspective and adequate surgical workspace, which is crucial for tumor removal while preserving the integrity of surrounding normal tissues. Moreover, the utilization of multiple small incisions has minimal impact on postoperative recovery.

150 years ago: Schwartze's 1873 mastoidectomy and its implementation over the following 2years.

In 1873, Hermann Schwartze and Adolf Eysell described anew surgical technique for treating mastoid disease using amallet, chisels, and gouges of various sizes instead of trephines or drill instruments also called "modern mastoidectomy." On the 150th jubilee of this landmark article, we pay tribute by studying the reception and implementation of mastoidectomy in the 2years following its publication. The commentaries published in the otological and medical literature between the second part of 1873 to the end of 1875 were studied with an emphasis on the three specialized otological journals and the otological textbooks that existed during this period. The princeps paper Ueber die künstliche Eröffnung des Warzenfortsatzes ("On the artificial opening of the mastoid process") by Hermann Schwartze and Adolf Eysell published in 1873 was rapidly disseminated in the medical literature for nearly 1year, and then entered aphase of evaluation followed by aphase of extension and implementation, before finding its definitive place in the history of mastoid process surgery.

Cerebellopontine Angle Cholesterol Granuloma: A Case Report

Cholesterol granulomas are benign growths that occur due to an inflammatory response to cholesterol and hemosiderin. These lesion typically originate in the temporal bone and middle ear, although cerebellopontine angle cholesterol granuloma is exceptionally rare. This report describes a rare occurrence of a cholesterol granuloma developing in the cerebellopontine angle. The patient exhibited unilateral hearing impairment in the left ear accompanied by tinnitus. High resonance computed tomography revealed a lobulated lesion situated at the right cerebellopontine angle, which is also causing erosion of the right mastoid bone, right posterior wall semicircular canal, and right jugular foramen. Magnetic resonance imaging demonstrated hyperintensity with peripheral hypointense haemosiderin rim on both T1-weighted and T2-weighted images. According to the authors' understanding, this is the third documented instance of cholesterol granuloma manifesting as a tumour in the cerebellopontine region. The authors provide a comprehensive description of the uncommon lesion, including its presentation, imaging findings, histological characteristics, pathophysiology, and surgical therapy.

Rare case of mastoid osteoma: a case report

Osteoma of the temporal bone is a very rare slow growing benign tumour of bone. They commonly arise from skull. Temporal bone osteomas are commonly present without symptoms, but may cause bony deformity, pain, and hearing loss depending upon the site. Osteomas may arise from external ear canals, but very rarely from mastoid bone. Aetiology is unknown and many theories are postulated like congenital, traumatic and infectious. Here, we are presenting a case of 30 years old lady, presenting with progressively enlarging hard lump behind right ear for 3 years. It was diagnosed as osteoma and confirmed by computed tomography (CT) scan. Complete excision is done until normal mastoid cortex/air cells are exposed.

EVALUATION OF THE CONDYLAR POSITION IN RELATION TO THE DIFFERENT MALOCCLUSIONS OF A STUDENT POPULATION

Studying the position of the condyle in the glenoid cavity is an important aspect of achieving the diagnosis and the treatment plan in dentistry. The posterior position of the condyle in the glenoid cavity is not a completely reliable predictor of the lack or appearance of disc displacement, although they are related (1). The TMJ is a small joint with a complex morphology surrounded by bony tissues that create a superimposition of images, especially in the petrous region of the temporal bone, the mastoid process and the articular eminence (1). Studies on the ideal position of the condyles have shown that the healthiest condyle-fossa relationship in which the condyle is centered anteriorly in the mandibular fossa. The following research aims to evaluate the condylar position in relation to different malocclusions of thirty-two students of the Faculty of Dentistry of the University of Cuenca.The research has a quantitative approach, carried out by means of numerical analysis. The population used was thirty-two students from the Faculty of Odontology in the University of Cuenca, aged between 21 and 29 years, who underwent cone beam computed tomography. The research was carried out as a descriptive retrospective sample and provides systematic information. The research used is of a primary source, using CBCT scans obtained from an image bank at the CERIOM Radiology Centre in the city of Cuenca, and the tomographic examination will be imported in DICOM format into the RadiAnt DICOM Viewer software (64-bit).

Walker's traits for sex estimation in modern Croatian population using MSCT virtual cranial database: Validation and development of population-specific standards

The present study aimed to test the applicability of Walker`s method in the Croatian population by using multi-slice computed tomography (MSCT) scans of a head from the University hospitals (UHC) in Split and Zagreb. Cranial morphological traits (nuchal crest, mastoid process, supraorbital edge, and glabella) were scored from images of 280 adult patients with balanced distribution according to sex and geographical region. Differences between Split and Zagreb samples were visible through principal component analysis (PCA) with Split individuals being more robust, that also reflected in specific differences in trait expression like mastoid process (P = 0.001) and supraorbital edge (P = 0.003) in male samples. Original equations did not perform well in our population, with accuracy ranging from 62 % to 70 % with low accuracy in females (48 % - 56 %). We developed 15 population-specific equations that comprised all possible combinations with single or multiple variables. The best performing equation was the one that included glabella and mastoid process that showed the least interregional variabilities and achieved accuracy of 86.25 %. To enable a direct application of equations developed we provided on-line app called CroWalker, available at: https://crowalker-rvhw.onrender.com/.