Morphometric study of mandibular foramen in macerated skulls to contribute to the development of sagittal split ramus osteotomy (SSRO) technique

Purpose

The aim of this study was to provide morphometric data, obtained from macerated mandibles, which might facilitate the topographic location of the mandibular foramen, considering aspects such as gender, age and ethnicity.

Materials and methods

One hundred and eighty-five macerated mandibles of adult black and white individuals of both sexes were analyzed. Initially, 5 points were established: MF, the lowest point of the mandibular foramen; S, greatest concavity of the mandibular notch; A, anterior margin of the ramus of mandible; P, posterior margin of the ramus of mandible; and Go, gonion. Then the following measurements were performed bilaterally: MF-S, MF-A, MF-P and MF-Go.

Results

The following mean values were found: MF-S: 21.02 mm for white females (WF) and 22.00 mm for black females (BF); 24.40 mm for white males (WM) and 24.35 mm for black males (BM); MF-A: 17.05 mm for WF and 18.09 mm for BF; 17.18 mm for WM and 18.11 mm for BM; MF-P: 11.11 mm for WF and 12.24 mm for BF; 13.10 mm for WM and 14.15 mm for BM; MF-Go: 19.00 mm for WF and 19.44 mm for BF; 23.13 mm for WM and 22.12 mm for BM.

Conclusions

The values found in this study, considering gender, age and ethnic group, can be used as a parameter to carry out the sagittal split ramus osteotomy technique, making it more predictable and with less risk of complications.     

Geometry of the Clavicle and Reliability of Measurement using PACS

Purpose

To investigate the geometry of the clavicle and to assess the reliability of Picture Archiving Communication System (PACS) for its measurement.

Methods

One hundred pairs of dry clavicles from 78 males and 22 females were measured on radiographs using PACS. Measurements included all of the following parameters: length, width, medial and lateral angulation. The intraclass correlation coefficient (ICC) for the inter-observer and intra-observer reliability was calculated.

Results

The mean left clavicle length among males and females was 149.25 ± 9.64 and 133.30 ± 8.32 mm, respectively. The respective mean right clavicle length among the males and females was 147.77 ± 9.99 and 132.08 ± 6.92 mm. The clavicles from male cadavers were significantly longer, wider and thicker than those from females, on both the left and right (P < 0.05). Among both the male and female clavicles, the left side was significantly longer than the right (P < 0.05). There was good to excellent intra-observer reliability (ICC > 0.70) for all parameters. Inter-observer reliability was also found good to excellent for all parameters except for medial clavicular angulation; for which there was fair reliability (ICC = 0.697).

Conclusion

The geometry of the clavicle is influenced by sex and side. Use of PACS as a measurement tool is reliable. Data from this study will be useful for pre-contouring plate or improving future designs of the anatomical plate of the clavicle.     

Inguinal lymph nodes: size,number, and other characteristics in asymptomatic patients by CT

Purpose

The purpose of this study was to establish normative data for the CT appearance of inguinal lymph nodes.

Materials and methods

After Institutional Review Board approval, search of the radiology information system identified 500 consecutive CT examinations of the pelvis. Patients were included if no lower extremity or perineum pathology, or history of malignancy at the time of CT examination, and a clinical note documenting no tumor at least 2 years after the CT. The final study group was 77 patients. CT examinations were retrospectively reviewed and bilateral inguinal lymph nodes were characterized by size (short axis and largest size in general), number, and presence of fat attenuation.

Results

The mean short-axis inguinal lymph node size was 5.4 mm (range 2.1–13.6 mm), measured at 8.8 mm two standard deviations above the mean. The mean number of superficial and deep inguinal lymph nodes was 10.7 (range 3–18) and 1.2 per patient (range 1–2), respectively. Superficial and deep inguinal nodes showed internal fat attenuation in 85 and 78 % of nodes, and were oval in shape in 95 and 78 %, respectively.

Conclusion

Inguinal lymph nodes in asymptomatic patients have a mean short axis of 5.4 mm, a short axis of 8.8 mm at two standard deviations above the mean, and are multiple and symmetric in size and number (4–20 per patient). Normal inguinal lymph nodes were commonly oval in shape and contained fat, although such findings may be absent in smaller lymph nodes.     

Prevalence and variance of the sternalis muscle: a study in the Chinese population using multi-detector CT

Objective

To analyze the prevalence, anatomical features, as well as variance of the sternalis muscle in the Chinese population using multi-detector computed tomography (MDCT).

Methods

We retrospectively reviewed 6,000 adult axial MDCT images to determine the overall and gender prevalence of the sternalis muscles. We also analyzed the side prevalence and anatomical features, including shape, size, location and course.

Results

The sternalis muscle was present in 347 (5.8 %) of 6,000 adults. This muscle was more common in males (6.0 %, 187/3091) than in females (5.5 %, 160/2909). Among the 347 adults, 118 (34.0 %) had bilateral sternalis muscles; 148 (42.7 %) had right sternalis muscles; and 81 (23.3 %) had left sternalis muscles. The sternalis muscle was either flat or nodular and located superficial to the major pectoral muscles on CT axial transverse images. According to the muscle morphology and course, we classified sternalis muscles as three different types and nine subtypes. The muscles appeared with a single head and single belly in 58.5 %, double or multiple heads in 18.1 %, and double or multiple bellies in 23.4 %. The mean length, width and thickness were 111.1 ± 33.0, 17.7 ± 9.9 and 4.1 ± 1.7 mm measured on MDCT.

Conclusion

The sternalis muscle was highly prevalent in normal Chinese adults. MDCT is an effective method to demonstrate this muscle in vivo.     

Smaller insertion area and inefficient mechanics of the gluteus medius in females

Purpose

Tears of the gluteus medius are most prevalent in middle-aged females. Recently, focus has been placed on diagnosis and treatment of tears, but an explanation for the increased prevalence still eludes researchers. We compared the area of insertion of the gluteus medius on the femur as well as three separate moment arm measures between males and females to determine if a smaller insertion area and/or decreased hip efficiency existed in females.

Methods

The gluteus medius was dissected on 37 embalmed cadaveric hips (23 M, 14 F; mean age 66.4 years) to expose its insertion on the femur, which was then outlined. Three-dimensional scans were taken of each insertion, and area measurements calculated. Reference points were placed on analogous structures within each hip, and moment arms were calculated using the x, y, z coordinates of these points. The gluteus medius insertion and three moment arm lengths were compared between the genders.

Results

Gluteus medius insertion area was found to be smaller in females (M 602.35 ± 116.01 mm, F 534.96 ± 98.60 mm, p = 0.034). The gluteal moment arms were also shorter in females (GMA1, M 69.87 ± 7.03 mm, F 63.22 ± 4.64 mm, p = 0.001) (GMA2, M 83.18 ± 6.69 mm, F 75.06 ± 6.23 mm, p = 0.000) with pelvic moment arms being comparable between the genders. Stature and age were not found to influence these outcomes.

Conclusions

Our results suggest that in an equally massive male and female, the female will place greater mechanical demands on the gluteus medius, due to decreased efficiency as well as a relatively smaller insertion area.     

Presurgical CBCT assessment of maxillary neurovascularization in relation to maxillary sinus augmentation procedures and posterior implant placement

Purpose

To provide more information to clinicians planning sinus grafting and maxillofacial surgical interventions, the present study evaluated the prevalence, diameter and location of the superior alveolar canals (SAC) using CBCT images.

Methods

The maxillary sinus CBCT scans (i-CAT Classic^®, ISI, USA) of 100 adult patients (67 women and 33 men) aged 20–79 years [mean (SD) 40 (15)] were examined. A dentomaxillofacial radiologist observed the SAC based on CBCT image data and more specifically the parasagittal views to assess SAC’s diameter and location.

Results

The anterior and posterior SAC, double ASAC, intraosseous anastomoses and the extension of the anterior SAC to the piriform aperture were observed in 100, 73, 24.5, 38.5 and 84 % of the cases, respectively. The anastomosis was located between canine and first premolar in 43 % of the cases. The SAC diameters were in 80 % of the cases ≤1 mm, remaining canals had a diameter between 1 and 2 mm. The distance of the SAC to the alveolar crest ranged between 2.42 and 44.6 mm. The anterior SAC was more prevalent in the upper (53 %) and middle (44 %) thirds of the maxillary sinus, while the posterior SAC was more prevalent in the middle (36 %) and lower thirds (64 %). The distance was significantly bigger in men in some tooth positions.

Conclusions

Based on the present findings, one-fifth of the patients may have a diameter of the SAC >1 mm, large enough to cause bleeding and/or paraesthesia. CBCT imaging may assist surgeons to plan grafting and osteotomy procedures, while avoiding these neurovascular structures.     

Assessment of bone channels other than the nasopalatine canal in the anterior maxilla using limited cone beam computed tomography

Purpose

The anterior maxilla, sometimes also called premaxilla, is an area frequently requiring surgical interventions. The objective of this observational study was to identify and assess accessory bone channels other than the nasopalatine canal in the anterior maxilla using limited cone beam computed tomography (CBCT).

Methods

A total of 176 cases fulfilled the inclusion criteria comprising region of interest, quality of CBCT image, and absence of pathologic lesions or retained teeth. Any bone canal with a minimum diameter of 1.00 mm other than the nasopalatine canal was analyzed regarding size, location, and course, as well as patient gender and age.

Results

A total of 67 accessory canals ≥1.00 mm were found in 49 patients (27.8 %). A higher frequency of accessory canals was observed in males (33.0 %) than in females (22.7 %) (p = 0.130). Accessory canals occurred more frequently in older rather than younger patients (p = 0.115). The mean diameter of accessory canals was 1.31 ± 0.26 mm (range 1.01–2.13 mm). Gender and age did not significantly influence the diameter. Accessory canals were found palatal to all anterior teeth, but most frequently palatal to the central incisors. In 56.7 %, the accessory canals curved superolaterally and communicated with the ipsilateral alveolar extension of the canalis sinuosus.

Conclusions

The study confirms the presence of bone channels within the anterior maxilla other than the nasopalatine canal. More than half of these accessory bone canals communicated with the canalis sinuosus. From a clinical perspective, studies are needed to determine the content of these accessory canals.     

Differences in conductive foot cooling: a comparison between males and females

Purpose

This study investigated possible sex-related and intra-menstrual differences in local vascular and skin temperature responses when conductive cooling was applied to the soles of the feet.

Method

Twelve females and twelve males exposed the soles of their feet to a cooling plate (which cooled from 35 to 15 °C) on two occasions 12–15 days apart. For females, sessions took place during their inactive and active contraceptive pill phases. Tip of Great toe temperature and Great toe skin blood flow were recorded throughout.

Results

Females’ feet cooled to a greater extent than males’ (P = 0.001). Sensitivity of toe skin blood flow to changes in skin temperature (1 or 2 °C) was not different between males and females. Dimensions of males’ feet were larger than females’ (P < 0.05) and correlations between foot dimensions and toe skin cooling were found (r = 0.728, P < 0.001). Analysis of the residual variance showed that foot volume, contact area and skin blood flow correlated with the rate of toe skin cooling (r = 0.812, r ² = 0.659, P < 0.001). No intra-menstrual differences were found.

Conclusion

The feet of females cooled at a faster rate than those of males in response to the same conductive cooling stimulus to the soles of the feet. However, similar reductions in skin blood flow were found for the same change in toe skin temperature. Therefore, sex related differences may be due to the differing dimensions of the feet, but further research including males and females matched for foot dimensions are required to confirm this mechanism.     

Thermal sensitivity to warmth during rest and exercise: a sex comparison

Purpose

The study aimed to compare thermal sensation in response to a fixed warm stimulus across 31 body locations in resting and active males and females.

Methods

Twelve males (20.6 ± 1.0 years, 78.1 ± 15.6 kg, 180 ± 8.9 cm, 34.4 ± 5.2 ml kg^?1 min^?1) and 12 females (20.6 ± 1.4 years, 62.9 ± 5.5 kg, 167 ± 5.7 cm, 36.5 ± 6.6 ml kg^?1 min^?1) rested in a thermoneutral (22.2 ± 2.2 °C, 35.1 ± 5.8 % RH) room whilst a thermal probe (25 cm²), set at 40 °C was applied in a balanced order to 31 locations across the body. Participants reported their thermal sensation 10 s after initial application. Following this, participants began cycling at 50 % \(\dot{V}{\text{O}}_{{ 2 {\text{max}}}}\) for 20 min, which was then lowered to 30 % \(\dot{V}{\text{O}}_{{ 2 {\text{max}}}}\) and the sensitivity test repeated.

Results

Females had significantly warmer magnitude sensations than males at all locations (4.7 ± 1.8 vs 3.6 ± 2.2, p < 0.05, respectively). Regional differences in thermal sensation were evident but were more prominent for females. Thermal sensation was greatest at the head then the torso and declined towards the extremities. In comparison to rest, exercise caused a significant reduction in thermal sensation for males (?thermal sensation; 0.86 ± 0.3, p < 0.05), but only at select locations in females (0.31 ± 0.56, p > 0.05).

Conclusion

The data provide evidence that the thermal sensation response to warmth varies between genders and between body regions and reduces during exercise. These findings have important implications for clothing design and thermophysiological modelling.     

Cone-beam computed tomography analysis of the shape,height, and location of the mandibular lingula

Objectives

The precise anatomic location of the lingula is clinically significant because it is subject to injury during a variety of oral and maxillofacial surgical procedures. This is the first study to identify and classify the different morphological shapes of the mandibular lingula using cone-beam computed tomography.

Materials and methods

A retrospective study was performed to evaluate the shape, height, and location of the lingula in relation to surrounding structures using cone-beam computed tomographic images. The shape of the lingula was classified into triangular, truncated, nodular, and assimilated types. The location was determined by five distances from the lingular tip to: the anterior and the posterior borders of the mandibular ramus, the mandibular notch, the distal surface of the mandibular second molar, and the occlusal plane.

Results

Nodular shape of the lingula was most commonly found [51.2 % (422)] followed by truncated [32 % (264)]. The mean height of the lingula was 7.97 ± 1.84 mm. The mean distance of lingula from the anterior and posterior borders of mandibular ramus was 16.7 ± 2.7 and 13.0 ± 2.3 mm, respectively. The lingula was located at 15.3 ± 2.4 mm from the mandibular notch and 29.4 ± 3.9 mm from the distal side of alveolar socket of mandibular second molar tooth.

Conclusion

The present study provides new information to the literature concerning the shape, height, and location of the lingula in the Turkish population. This finding may assist surgeons to localize the lingula and avoid intraoperative complications.     

Anatomical study of the corrugator supercilii muscle and its clinical implication with botulinum toxin A injection

Purpose

Botulinum toxin A (BTX-A) injection targeting the corrugator supercilii muscle (CSM) has been widely performed to remove glabellar wrinkles. The aim of the present study was to elucidate the exact location and dimensions of the CSM in Koreans by elaborate dissections followed by accurate measurements to provide the topographic guidance for an efficient and safe manipulation of the BTX-A injection.

Methods

Thirty-five specimens from twenty fixed Korean cadavers (twelve males, eight females; mean age, 65.5 years) were examined in the present study.

Results

The CSM comprised oblique and transverse bellies, with the oblique belly being classified into narrow vertical (62.9 %) and broad triangular (37.1 %) types. The widths at the apex and base of the CSM were 10.0 ± 3.7 and 19.5 ± 5.4 mm (mean ± SD), respectively. The most-medial apical point was located 17.3 ± 3.2 mm superior to the horizontal intercanthal plane (HL) and 4.3 ± 1.9 mm lateral to the vertical midline of the face (VL). The most-lateral apical point was located 15.8 ± 2.4 mm superior to the HL and 13.9 ± 4.3 mm lateral to the VL. The most-medial basal point was located 31.2 ± 3.2 mm superior to the HL and 16.4 ± 4.8 mm lateral to the VL. The most-lateral basal point was located 28.6 ± 4.9 mm superior to the HL and 35.3 ± 4.3 mm lateral to the VL.

Conclusion

The topographic data on the CSM presented here in will be helpful for the accurate and safe implementation of BTX-A injection to the forehead in Koreans.     

Morphometric variability of pyramidalis muscle and its clinical significance

Purpose

The goal of the study is to analyze the morphometric diversity of the pyramidalis muscle (PM) and to evaluate how it is affected by gender and side of occurrence.

Materials and methods

Ninety-six (50 male and 46 female) formalin-embalmed Greek cadavers were dissected.

Results

The PM was present in 93.8 %, usually bilaterally (79.2 %) than unilaterally (14.6 %) (p = 0.003) and more frequently in females (91.3 %) than in males (68 %) (p = 0.0001). Side symmetry was detected. The mean length of PM in males and females was 8.37 ± 2.80 and 6.18 ± 1.64 cm on the right and 7.50 ± 2.66 and 6.56 ± 1.68 cm on the left side. Male predominance existed on the right and left-sided PM lengths (p = 0.0001 and p = 0.054). The mean width of the right-sided PMs in males and females was 1.61 ± 0.55 and 1.50 ± 0.44 cm and the left-sided 1.56 ± 0.53 and 1.55 ± 0.38 cm without gender dimorphism. The positive correlation between the PM length and width indicates a symmetrical muscle augmentation on the two dimensions.

Conclusions

The study demonstrates that the PM is almost constant in Greeks. Among populations the muscle morphometric variability, its clinical significance and its variable uses will help surgeons when intervening in the lower abdominal wall.

     

Cone-beam computed tomographic analysis of the morphological characterization of the nasopalatine canal in a pediatric population

Purpose

Knowledge of the nasopalatine canal (NPC) is necessary for understanding the morphology and pathogenesis of lesions that occur in this region. The purpose of the present study was to analyze the dimensions and anatomic characteristics of the NPC in a pediatric population using cone-beam computed tomography (CBCT).

Study design

Reformatted sagittal, coronal, and axial slices of 368 individual CBCT images were analyzed with regard to dimensions and anatomic features of the NPC.

Results

Funnel shape of the NPC was most commonly found [26.9 % (99)], followed by banana shape [19.6 % (72)]. There was no statistically significant difference (p = 0.317) between girls and boys in terms of NPC shape. The mean width of incisive foramen was found to be 2.53 mm with a significant difference (0.002). The mean NPC length was found to be 10.83 mm and the mean canal length was found to be significantly longer in boys than girls (p < 0.000).

Conclusion

The present study provides new information on the literature concerning the identification of the anatomical structure of NPC. This finding may assist clinicians in understanding the morphology and preventing possible complications in this region.     

Asymmetry of lateral lamella of the cribriform plate: a software-based analysis of coronal computed tomography and its clinical relevance in endoscopic sinus surgery

Background

Endoscopic sinus surgery is a known approach for sinonasal pathologies. Due to close proximity of sinuses to orbits and brain, surgeon should be aware of sinonasal anatomy and associated variations. The roof of ethmoid (fovea ethmoidalis) separates the ethmoidal cells from the anterior cranial fossa. Medially the fovea attaches to the lateral lamella of the cribriform plate, which is the thinnest bone of the skull base. Hence, it is at a high risk of getting damaged during surgery.

Objective

To ascertain the quantitative analysis of height of lateral lamella according to Keros classification in the computed tomographic (CT) images of patients presenting to our clinic.

Methods

It was retrospective review of 77 CT scans using computerized software known as picture archiving and communication system. The height of lateral lamella was examined for both sides and then classified according to Keros classification. Asymmetry between two sides was also reported.

Results

Keros type I was seen in 46 sides (29.8 %), type II in 75 sides (48.7 %) and type III was seen in 33 (21.4 %) sides. Keros type I was seen in 38 sides in males and 8 sides in females. Type II was seen in 46 and 29 sides in males and females, respectively. Type III was seen in 18 sides in males and in 15 sides in females.

Conclusion

Understanding of the anatomy of ethmoid roof with its possible variation is crucial to give the surgeon optimal information about the possible risk that one can face during the surgery. Hence dreadful complications can be avoided.     

Anatomical landmarks for locating the sphenoid ostium during endoscopic endonasal approach: a cadaveric study

Purpose

The sphenoid ostium (SO) provides a natural portal for entering the sphenoid sinus and beyond up to the skull base. It is not always easy to locate the ostium during the endoscopic approach. The present study was designed to establish readily identifiable anatomical landmarks for locating the sphenoid ostium.

Methods

Cadaveric dissection was performed in 30 hemisections of head and neck and various measurements were taken from fixed anatomical landmarks in the nasal cavity to the sphenoid ostium. The size, shape and position of sphenoid ostium were determined in relation to the anterior wall of the sphenoid sinus and the superior turbinate.

Results

The mean distance from the supero-lateral angle of the posterior choana to the SO was found to be 21.21 ± 6.02 mm. The mean distance of the SO from the midline was 4.85 ± 2.89 mm. In all the specimens, the SO was situated within 1 cm of the midline. The mean distance between the inferior end of the SO and the postero-inferior edge of the superior turbinate was 8.03 ± 3.52 mm. The SO was present on an average distance of 55.1 ± 3.54 mm from the limen nasi. In 93.3 % of the specimens, the SO was situated between 5 and 6 cm of the inferior end of the limen nasi. The angle between the anterior nasal spine and the SO was found to be remarkably constant. In 93.3 % of the specimens, it was from 25° to 30°.

Conclusions

The sphenoid ostium could be localized medial to the superior turbinate between 1.5 and 3 cm above the supero-lateral angle of the posterior choana, within 1 cm of the midline and within 1 cm of the postero-inferior edge of the superior turbinate.     

Assessing Reasons for School/College Dropout Among Young Adults and Implications for Awareness about STDs and HIV/AIDS: Findings from a Population-Based Study in Karachi, Pakistan

Background

Dropping out of school/college not only impedes economic prosperity but may also result in poor knowledge and awareness about sexually transmitted diseases (STDs).

Purpose

This study investigated, among young adults in Karachi, Pakistan, the risk factors associated with involuntary school/college dropout and the implications for awareness about HIV/AIDS and STDs.

Method

A population-based, cross-sectional study of 1,650 young males and females, aged 17–21 years and living in Karachi, was conducted using a structured questionnaire. Bivariate and multivariate analyses were performed separately for males and females.

Results

Females were twice as likely to drop out of school/college as males. Furthermore, migrant residential status, living in an extended family and lower socio-economic status were identified as risk factors for school/college dropout both for males and females. In the total sample, only 17% of males and 13% of females had heard of STDs (p?=?0.020). Furthermore, 26.8% of males and 20.5% of females had not heard of HIV/AIDS (p?=?0.003). The females exhibited a higher level of awareness on these matters than the males, irrespective of whether they had dropped out of school or not. While the males who dropped out were considerably less aware than those who remained at school, there was no such difference among females.

Conclusion

Young adults from poor families are at increased risk of dropping out of school/college. Among the dropouts, males were clearly at risk of ignorance about STDs while females were somewhat better informed.     

Investigation of the retrorenal colon frequency using computed tomography in patients with advanced scoliosis

Purpose

The aim of this study is to investigate the frequency of retrorenal colon in patients with advanced scoliosis.

Materials and methods

The existence of retrorenal colon was retrospectively investigated in 550 patients with vertebral scoliosis who had undergone abdominal CT scans at our institution between January 2008 and March 2012. The investigation was also carried out on a control group of 200 patients without scoliosis.

Results

Among the 550 patients with scoliosis, 100 patients had advanced scoliosis necessitating treatment. Among these 100 patients with advanced scoliosis, retrorenal colon was detected in a total of 25 patients (25 %). The variation was observed on the right side in eight patients (two males, six females) (8 %), on the left side in 15 patients (five males, ten females) (15 %), and bilaterally in two patients (both females) (2 %). In the control group consisting of 200 individuals, retrorenal colon was detected in seven subjects (3.5 %), among which six were on the left and one was on the right. The difference between the incidence of retrorenal colon observed in the patients with advanced scoliosis and those without scoliosis was found to be statistically significant (p < 0.001).

Conclusion

Since the frequency of retrorenal colon in patients with advanced scoliosis is significantly higher than the control group without scoliosis, the risk of experiencing complications during renal interventions including renal biopsy is also higher. Therefore, these patients should undergo a detailed CT examination before these procedures, and renal interventions should be planned according to findings.     

Morphology of the human xiphoid process: dissection and radiography of cadavers and MDCT of patients

Purpose

The purpose of this study was to evaluate the morphology of xiphoid process by dissection and using radiography of cadavers and multidetector computed tomography (MDCT) in patients.

Methods

The xiphoid processes of 41 cadavers were dissected and taken by radiography. Other 902 patients examined by MDCT were revealed by image post-processing used with multiple planar reconstruction, maximum intensity projection and volume rendering.

Results

Xiphoid processes displayed pointed shape in 422 cases (44.75 %), oval shape in 387 cases (41.04 %), and forked shape in 134 cases (14.21 %). The sagittal shape of the xiphoid process was observed as ventrally deviated in 217 cases (23.01 %), dorsally deviated in 191 cases (20.25 %), S-shaped (ahead ventral, then dorsal) in 21 cases (2.23 %), and resembling a hook in 14 of ventral deviated patients and in 19 of those dorsal deviated patients. The foramen of xiphoid processes was found in 544 cases (57.69 %). The pattern L (a large foramen with a diameter of more than 5 mm) appeared in 302 cases (55.51 %), pattern S (a small foramen with a diameter of no more than 5 mm) in 155 cases (28.49 %), pattern LS (a mixture of a large and a small foramina) in 37 cases (6.80 %), and pattern SS (two or more small foramina) in 50 cases (9.19 %).

Conclusion

Human xiphoid process appeared in morphological diversity. The anatomic structure and ossification degree of xiphoid process was well evaluated by MDCT. Our data may be used for diagnosis and surgical treatment of xiphoid process-related diseases.