MRI differentiates femoral condylar ossification evolution from osteochondritis dissecans. A new sign

Objective  

To determine if MRI (magnetic resonance imaging) of the femoral condyles in children can differentiate variations in ossification from osteochondritis dissecans (OCD).     

The Influence of Heterotopic Ossification on Functional Status of Hip Joint Following Total Hip Arthroplasty

Purpose:  

The functional failure induced by heterotopic ossification (HO) following total hip arthroplasty (THA) was analyzed and correlated to the radiologic failure.     

Positive predictive value for polyps detected at screening CT colonography

Purpose  

To determine the positive predictive value (PPV) for polyps detected at CT colonography (CTC).     

Neurogenic heterotopic ossification: epidemiology and morphology on conventional radiographs in an early neurological rehabilitation population

Objective  

To retrospectively evaluate neurogenic heterotopic ossification in an early neurological rehabilitation population (phases B and C) with respect to epidemiology and morphology on conventional radiographs.     

Ossifikationsvorgänge des Trochanter major femoris

Background

Despite a relatively minimal level of radiation exposure, the use of x-ray radiation for the forensic estimation of chronological age of individuals is often subject to public criticism. In the recent past this has encouraged the scientific investigation of alternative imaging procedures with which the radiation-free assessment of the skeletal maturation process is possible.

Aim

The present study investigated the applicability of ultrasound diagnostics for assessing the ossification processes of the epiphysis of the greater trochanter.

Material and methods

For this purpose the epiphyseal ossification stages of 307 female and 309 male test persons between 10 and 25 years of age were determined.

Results

In the female subjects ossification stage II was found at the earliest at 10.1 years (x??=?12.2 years), ossification stage III at the earliest at 12.5 years (x??=?15.1 years) and ossification stage IV at the earliest at 13.4 years (x??=?20.8 years). In the male subjects ossification stage II was observed from 10.0 years (x??=?12.8 years), ossification stage III from 13.8 years (x??=?16.0 years) and ossification stage IV from 14.5 years (x??=?21.3 years).

Conclusion

With the legal basis as it stands at present, the sonographic examination of the femoral trochanter epiphysis allows individual radiation exposure to be kept to a minimum in the use of x-rays on humans in the forensic age estimation practice of living individuals. In areas of application where there is no legal authorization basis for radiological examinations, including a skeletal maturity criterion can increase the accuracy and reliability of age estimation.     

Ossification variants of the femoral condyles are not associated with osteochondritis dissecans

Purpose

To determine if ossification variants of the femoral condyles involving the subchondral bone plate are associated with osteochondritis dissecans (OCD).

Materials and methods

The prevalence of ossification variants of the unaffected femoral condyle in 116 patients (aged 9–14 years) with unicondylar OCD on MRI (magnetic resonance imaging) of the knee was compared to a control group of 579 patients (aged 9–14 years) without OCD. The evolution of the ossification variants in both groups was studied by reviewing follow-up MR imaging side by side with the baseline study.

Results

The prevalence of ossification variants in the unaffected condyle in patients with OCD (12.9%) and in the control group of patients without OCD (12.6%) was similar (p = 0.88).Evolution of ossification variants to OCD was not seen on follow-up MRI examinations. All variants had decreased in size or were no longer visible.

Conclusion

Ossification variants of the femoral condyle that involve the subchondral bone plate are not associated with OCD.

Clinical relevance statement

Ossification variants are not associated with OCD, indicating that routine MRI follow-up in affected children is not mandatory.     

Contrast coating for the surface of flat polyps at CT colonography: a marker for detection

Objectives

To assess the frequency of oral contrast coating of flat polyps, which may promote detection, and influencing factors within a screening CT colonography (CTC) population.

Methods

This was a retrospective, observational study performed at one institution. From 7,426 individuals, 123 patients with 160 flat polyps were extracted. Flat polyps were defined as plaque-like, raised at most 3 mm in height and reviewed for contrast coating. Factors including demographic variables such as age and sex, and polyp variables such as polyp size, location and histology were analysed for effect on coating.

Results

Of 160 flat polyps (mean size 9.4 mm?±?3.6), 78.8 % demonstrated coating. Mean coat thickness was 1.5 mm?±?0.6; 23.8 % (n?=?30) demonstrated a thin film of contrast. Large size (≥10 mm) and proximal colonic location (relative to splenic flexure) were predictive variables by univariate logistic regression [OR (odds ratio) 3.4 (CI 1.3–8.9; p?=?0.011), 2.0 (CI 1.2–3.5; p?=?0.011), respectively]. Adenomas (OR 0.37, CI 0.14–1.02; p?=?0.054) and mucosal polyps or venous blebs (OR 0.07, CI 0.02–0.25; p?<?0.001) were less likely to coat than serrated/hyperplastic lesions. Age and sex were not predictive for coating (p?=?0.417, p?=?0.499, respectively).

Conclusions

Surface contrast coating is common for flat polyps at CTC, promoted by large size, proximal location and serrated/hyperplastic histology. Given the difficulty in detection, recognition may aid in flat polyp identification.

Key points

? Oral contrast coats the surface of most flat colorectal polyps at CT colonography. ? Large size, proximal colonic location and serrated/hyperplastic histology increase polyp coating. ? Contrast coating increases diagnostic confidence for flat polyps. ? Contrast coating may help in flat polyp detection at CTC.     

Diagnostic accuracy of translucency rendering to differentiate polyps from pseudopolyps at 3D endoluminal CT colonography: a feasibility study

Purpose

The aim of this study was to assess the accuracy of translucency rendering (TR) in computed tomographic (CT) colonography without cathartic preparation using primary 3D reading.

Materials and methods

From 350 patients with 482 endoscopically verified polyps, 50 pathologically proven polyps and 50 pseudopolyps were retrospectively examined. For faecal tagging, all patients ingested 140 ml of orally administered iodinated contrast agent (diatrizoate meglumine and diatrizoate sodium) at meals 48 h prior to CT colonography examination and two h prior to scanning. CT colonography was performed using a 64-section CT scanner. Colonoscopy with segmental unblinding was performed within 2 weeks after CT. Three independent radiologists retrospectively evaluated TRCT clonographic images using a dedicated software package (V3D-Colon System). To enable size-dependent statistical analysis, lesions were stratified into the following size categories: small (≤5 mm), intermediate (6–9 mm), and large (≥10 mm).

Results

Overall average TR sensitivity for polyp characterisation was 96.6%, and overall average specificity for pseudopolyp characterisation was 91.3%. Overall average diagnostic accuracy (area under the curve) of TR for characterising colonic lesions was 0.97.

Conclusions

TR is an accurate tool that facilitates interpretation of images obtained with a primary 3D analysis, thus enabling easy differentiation of polyps from pseudopolyps.     

CT colonography: effect of computer-aided detection of colonic polyps as a second and concurrent reader for general radiologists with moderate experience in CT colonography

Objectives

To assess the effectiveness of computer-aided detection (CAD) as a second reader or concurrent reader in helping radiologists who are moderately experienced in computed tomographic colonography (CTC) to detect colorectal polyps.

Methods

Seventy CTC datasets (34 patients: 66 polyps ≥6 mm; 36 patients: no abnormalities) were retrospectively reviewed by seven radiologists with moderate CTC experience. After primary unassisted evaluation, a CAD second read and, after a time interval of ≥4 weeks, a CAD concurrent read were performed. Areas under the receiver operating characteristic (ROC) curve (AUC), along with per-segment, per-polyp and per-patient sensitivities, and also reading times, were calculated for each reader with and without CAD.

Results

Of seven readers, 86 % and 71 % achieved a higher accuracy (segment-level AUC) when using CAD as second and concurrent reader respectively. Average segment-level AUCs with second and concurrent CAD (0.853 and 0.864) were significantly greater (p?<?0.0001) than average AUC in the unaided evaluation (0.781). Per-segment, per-polyp, and per-patient sensitivities for polyps ≥6 mm were significantly higher in both CAD reading paradigms compared with unaided evaluation. Second-read CAD reduced readers’ average segment and patient specificity by 0.007 and 0.036 (p?=?0.005 and 0.011), respectively.

Conclusions

CAD significantly improves the sensitivities of radiologists moderately experienced in CTC for polyp detection, both as second reader and concurrent reader.

Key Points

? CAD helps radiologists with moderate CTC experience to detect polyps ≥6 mm. ? Second and concurrent read CAD increase the radiologist’s sensitivity for detecting polyps ≥6 mm. ? Second read CAD slightly decreases specificity compared with an unassisted read. ? Concurrent read CAD is significantly more time-efficient than second read CAD.     

Comparison of ultrasonography with computed tomography in the diagnosis of nasal bone fractures

Objectives

The aim of this study is to compare ultrasonography with CT in the diagnosis of nasal bone fractures.

Methods

40 patients (9 female and 31 male) with mid-facial fractures, which were suspected nasal bone fractures, were included. All of the patients had mid-facial CT images. Ultrasonography with a 7.5 MHz transducer (Aloka 3500, Tokyo, Japan) was used to evaluate the nasal bone fractures. All of the sonograms were compared with CT findings for sensitivity, specificity and predictive values. A χ² test was applied to the data to assess statistical significance.

Results

CT diagnosed nasal bone fractures in 24 of the 40 patients (9 unilateral fractures and 15 bilateral fractures) while ultrasonography diagnosed the fractured bones in 23 patients (9 unilateral fractures and 14 bilateral fractures). Ultrasonography missed one fractured bone in a bilateral fractured case and a unilateral fracture was also missed (two false-negative results). The sensitivity and specificity of ultrasonography in assessing nasal bone fracture in comparison with CT were 94.9% and 100%, respectively. The positive predictive value (PPV) and the negative predictive value (NPV) of ultrasonographic evaluation of the nasal bone fractures were 100% and 95.3%, respectively. The χ² test did not show any significant difference between CT and ultrasonography in diagnosis of nasal bone fractures (P = 0.819).

Conclusion

Ultrasonography can be used as a first line of diagnostic imaging for evaluating nasal bone fractures, especially in children and pregnant women.     

Skeletal development of the glenoid and glenoid–coracoid interface in the pediatric population: MRI features

Objective

To assess the MRI appearance of normal skeletal development of the glenoid and glenoid–coracoid interface in the pediatric population. To the best of our knowledge, this has not yet been studied in detail in the literature.

Materials and methods

An IRB-approved, HIPAA-compliant retrospective review of 105 consecutive shoulder MRI studies in children, ages 2 months to 18 years was performed. The morphology, MR signal, and development of the following were assessed: (1) scapular-coracoid bipolar growth plate, (2) glenoid and glenoid–coracoid interface secondary ossification centers, (3) glenoid advancing osseous surface.

Results

The glenoid and glenoid–coracoid interface were identified in infancy as a contiguous, cartilaginous mass. A subcoracoid secondary ossification center in the superior glenoid was identified and fused in all by age 12 and 16, respectively. In ten studies, additional secondary ossification centers were identified in the inferior two-thirds of the glenoid. The initial concavity of the glenoid osseous surface gradually transformed to convexity, matching the convex glenoid articular surface. The glenoid growth plate fused by 16 years of age. Our study, based on MRI, demonstrated a similar pattern of development of the glenoid and glenoid coracoid interface to previously reported anatomic and radiographic studies, except for an earlier development and fusion of the secondary ossification centers of the inferior glenoid.

Conclusions

The pattern of skeletal development of the glenoid and glenoid–coracoid interface follows a chronological order, which can serve as a guideline when interpreting MRI studies in children.     

Intravenous contrast enhanced computed tomography colonoscopy in children with suspected colonic polyps

Objective

The purpose of this study was to evaluate the diagnostic performance of intravenous contrast enhanced computed tomographic colonoscopy (IVCTC) in the diagnosis of clinically suspected colorectal polyps in children, using conventional colonoscopy (CC) as the gold standard.

Methods

This was a prospective study conducted between July 2008 and June 2010. 30 pediatric patients with history of rectal bleeding and clinically suspected to have colorectal polyps were enrolled. All of the patients underwent IVCTC followed by CC. 30 IVCTC and 31 CC were performed in 30 patients. The findings of IVCTC were compared with those of CC. Statistical analysis was performed to obtain diagnostic performance values of IVCTC on per polyp (sensitivity and positive predictive value) and per patient (sensitivity, specificity, positive predictive value and negative predictive value) basis.

Results

By IVCTC, 63 polyps were detected in 28 patients of which 53 polyps were eligible for inclusion in the statistical analysis. 60 polyps were detected by CC in 28 patients of which 50 polyps were eligible for inclusion in the statistical analysis. The per polyp sensitivity and positive predictive values were 94% and 88.6% respectively. The per patient sensitivity, specificity, positive predictive value, and negative predictive values were 96.4, 50, 96.4, and 50% respectively. Twenty polyps, in 10 patients, were visualized only after intravenous contrast administration of which 5 polyps, in 5 patients, were likely to have been missed in the absence of the intravenous contrast injection as these polyps were submerged in fluid. Four patients would have had a false negative CTC examination if the intravenous contrast had not been injected; while in another patient, the number of polyps would have been underestimated.

Conclusion

CTC is capable of serving as a safe and efficient non-invasive tool for evaluating children with clinically suspected colorectal polyps. Administration of intravenous contrast improves the sensitivity of polyp detection on CTC.     

Prospektive Studie zur Vermeidung heterotoper Ossifikationen nach Hüftgelenksersatz

Purpose

Two prospective trials were undertaken to assess the comparative efficacy of early postoperative irradiation with different radiation doses versus the postoperative use of nonsteroidal antiinflammatory drugs (NSAID) for prevention of heterotopic ossification (HO) following prothetic total hip replacement (THP).

Patients and Method

Between 1992 and 1994 585 patients received THP. These patients were randomwed in two longitudinal studies each with 3 treatment arms comparing postoperative irradiation with 4×3 Gy (101 patients), 1×5 Gy (93 patients), 1×7 Gy (95 patients) and the postoperative use of the NSAID indometacin for 7 days (113 patients) respectively for 14 days (90 patients) und acetyl salicyl acid (ASS) for 14 days (93 patients). Heterotopic ossification was scored according to the Brooker grading system. One hundred patients receiving no prophylactic therapy after total hip arthroplasty between 1988 and 1992 were analysed and defined as historical control group.

Results

Incidence of heterotopic ossification was 5% in the 4×3 Gy group (Brooker grade I 5%, grade II 0%, grade III 0%), 30,5% in the 1×5 Gy group (Brooker grade I 24,7%, grade II 4,1%, grade III 1.0%) and 10,5% in the 1×7 Gy group (Brooker grade I 10.5%, grade II 0%, grade III 0%). 15.9% of the indometacin-7 days-group developed heterotopic ossification (Brooker grade I 8%, grade II 6.2%, grade III 1.7%, grade IV 0%), 12.2% of the indometacin-14 days-group (Brooker grade I 8.9%, grade II 2.2%, grade III 1.1%) and 37.5% of the ASS-group (Brooker grade I 27.9%, grade II 4.3%, grade III 5.3%). The lowest incidence of heterotopic ossification was found for the 4××3 Gy and the 1×7 Gy group, but no significant difference between these two different treatments was observed.

Conclusion

Prophylactic irradiation of the operative site after hip replacement is more effective than the use of NSAID. Because no significant difference between the fractionated ingle dose irradiation was found and the latter is more comfortable for patients and more economical, irradiation with single 7 Gy fraction should be prefered.     

Effect of Reducing Abdominal Compression during Prone CT Colonography on Ascending Colonic Rotation during Supine-to-Prone Positional Change

Objective

To determine the effect of reduced abdominal compression in prone position on ascending colonic movement during supine-to-prone positional change during CT colonography (CTC).

Materials and Methods

Eighteen consecutive patients who had undergone prone CTC scanning with cushion blocks placed under the chest and hip/thigh to reduce abdominal compression and had confirmed sessile polyps ≥ 6 mm in the well-distended, straight, mid-ascending colon, were included. Radial location along the ascending colonic luminal circumference (°) was measured for 24 polyps and 54 colonic teniae on supine and prone CTC images. The supine-to-prone change ranging between -180° and +180° (- and + for internal and external colonic rotations, respectively), was determined. In addition, possible causes of any ascending colonic rotations were explored.

Results

Abdominal compression during prone CTC scanning completely disappeared with the use of cushion blocks in 17 of 18 patients. However, some degrees of ascending colonic rotation were still observed, with the radial location changes of -22° to 61° (median, 13.9°) for the polyps and similar degrees for teniae. Fifty-four percent and 56% of polyps and teniae, respectively, showed changes > 10°. The radial location change of the polyps was significantly associated with the degree of anterior shift of the small bowel and mesentery (r = 0.722, p < 0.001) and the degree of posterior displacement of the ascending colon (r = 0.566, p = 0.004) during supine-to-prone positional change.

Conclusion

Ascending colonic rotation upon supine-to-prone positional change during CTC, mostly in the form of external rotation, is not eliminated by removing abdominal compression in prone position.     

Intravenous, contrast-enhanced MR colonography using air as endoluminal contrast agent: impact on colorectal polyp detection

Purpose

To compare diagnostic accuracy and patient tolerance of MR colonography with intravenous contrast and luminal air (MRC) to conventional colonoscopy (CC).

Materials and methods

IRB approval and written informed consent were obtained. Forty-six patients, both screening and symptomatic, underwent MRC followed by CC. The MRC technique employed 3D T1W spoiled gradient echo sequences performed after the administration of gadopenetate dimeglumine, with parallel imaging. The diagnostic accuracy and tolerance of patients for MRC was compared to CC.

Results

Twenty-four polyps were detected in eighteen patients with CC (5 polyps ≥10 mm, 4 polyps 6–9 mm, 15 polyps ≤5 mm). MRC was 66.7% (12/18) sensitive and 96.4% (27/28) specific for polyp detection on a per-patient basis. When analyzed by polyp size, sensitivity and specificity of MRC was 100% (5/5) and 100% (19/19), respectively, for lesions greater than 10 mm, 100% (4/4) and 100% (20/20) for lesions 6–9 mm, and sensitivity of 20% (3/15) lesions less than 5 mm. The sensitivity and specificity of MRC for detecting significant lesions (>6 mm) was 100% (9/9) and 100% (15/15), respectively. Regarding tolerance of the exams, there were no significant differences between MRC and CC. Thirty-five percent (n = 16) of patients preferred MRC as a future screening test compared to 33% (n = 15) for CC.

Conclusion

MRC using air as an intraluminal contrast agent is a feasible and well-tolerated technique for detecting colonic polyps ≥6 mm in size. Further studies are warranted.     

Accuracy of CT-guided joint aspiration in patients with suspected infection status post-total hip arthroplasty

Objective

To determine the accuracy of guided computed tomography aspiration in the detection of septic hip prosthesis before surgery.

Materials and Methods

Sixty-three patients (35 women and 28 men; age range, 29?C86?years; mean age, 71?years) with clinically suspected septic hip prosthesis were prospectively studied with independent review board (IRB) approval. Volume and microbiological cultures of aspirated fluid and several computed tomography imaging findings such as periprosthetic fluid collections, prosthetic acetabular malposition, and heterotopic ossification were analyzed. All patients underwent revision surgery and infection was finally diagnosed in 33 patients.

Results

Statistical comparative analysis was performed comparing computed tomography aspiration and surgical findings (95% CI; level of significance at P?=?0.05 two-sided) with 70% sensitivity, 100% specificity, 84% accuracy, 100% positive predictive value, and 75% negative predictive value. Using Fisher??s exact test, the presence of periprosthetic fluid collections (P?=?0.001), prosthetic acetabular malposition (P?=?0.025) and aspirated fluid volume (P?=?0.009) were significantly higher in infected than in non-infected prostheses, whereas heterotopic ossification was not (P?=?0.429).

Conclusion

Computed tomography aspiration is accurate to preoperatively diagnose septic hip prosthesis on the basis of volume and bacterial cultures of aspirated joint fluid. Furthermore, imaging findings such as periprosthetic fluid collections and prosthetic acetabular malposition strongly suggest infected prosthesis.     

Embolisation of bone metastases from renal cancer

Purpose

This study was done to evaluate embolisation for palliative and/or adjuvant treatment of bone metastases from renal cell carcinoma and discuss the clinical and imaging results.

Materials and methods

We retrospectively studied 107 patients with bone metastases from renal cell carcinoma treated from December 2002 to January 2011 with 163 embolisations using N-2-butyl cyanoacrylate (NBCA). Mean tumour diameter before embolisation was 8.8 cm and mean follow-up 4 years. Clinical and imaging effects of treatment were evaluated at follow-up examinations with a pain score scale, analgesic use, hypoattenuating areas, tumour size and ossification.

Results

A clinical response was achieved in 157 (96%) and no response in six embolisations of sacroiliac metastases. Mean duration of clinical response was 10 (range 1–12) months. Hypoattenuating areas resembling tumour necrosis were observed in all patients. Variable ossification appeared in 41 patients. Mean maximal tumour diameter after embolisation was 4.0 cm. One patient had intraprocedural tear of the left L3 artery and iliopsoas haemorrhage and was treated with occlusion of the bleeding vessel with NBCA. All patients had variable ischaemic pain that recovered completely within 2–4 days. Postembolisation syndrome was diagnosed after 15 embolisations (9.2%). Transient paraesthesias in the lower extremities were observed after 25 embolisations (25%) of pelvis and sacrum metastatic lesions.

Conclusions

Embolisation with NBCA is recommended as primary or palliative treatment of bone metastases from renal cell carcinoma. Strict adherence to the principles of transcatheter embolisation is important to avoid complications.     

Electronic cleansing for CT colonography: does it help CAD software performance in a high-risk population for colorectal cancer?

Objective

To compare the performance of computer-aided detection (CAD) for CT colonography (CTC) with and without electronic cleansing (EC) in a high-risk population tagged with a faecal tagging (FT) protocol.

Methods

Thirty-two patients underwent CTC followed by same-day colonoscopy. All patients underwent bowel preparation and FT with barium and gastrografin. Each CTC dataset was processed with colon CAD with and without EC. Per-polyp sensitivity was calculated. The average number of false-positive (FP) results and their causes were also analysed and compared.

Results

Eighty-six polyps were detected in 29 patients. Per-polyp sensitivities of CAD with EC (93.8% and 100%) were higher than those without EC (84.4% and 87.5%) for polyps ≥6 mm and ≥10 mm, respectively. However, the differences were not significant. The average number (6.3) of FPs of CAD with EC was significantly larger than that (3.1) without EC. The distribution of FPs in both CAD settings was also significantly different. The most common cause of FPs was the ileocaecal valve in both datasets. However, untagged faeces was a significantly less common cause of FPs with EC, EC-related artefacts being more common.

Conclusion

Electronic cleansing has the potential to improve per-polyp sensitivity of CTC CAD, although the significantly larger number of FPs with EC remains to be improved.     

Polyp measurement based on CT colonography and colonoscopy: variability and systematic differences

Objective

To assess the variability and systematic differences in polyp measurements on optical colonoscopy and CT colonography.

Materials

Gastroenterologists measured 51 polyps by visual estimation, forceps comparison and linear probe. CT colonography observers randomly assessed polyp size two-dimensionally (abdominal and intermediate window) and three-dimensionally (manually and semi-automatically). Linear mixed models were used to assess the variability and systematic differences between CT colonography and optical colonoscopy techniques.

Results

The variability of forceps and linear probe measurements was comparable and both showed less variability than measurement by visual assessment. Measurements by linear probe were 0.7 mm smaller than measurements by visual assessment or by forceps. The variability of all CT colonography techniques was lower than for measurements by forceps or visual assessment and sometimes lower (only 2D intermediate window and manual 3D) compared with measurements by linear probe. All CT colonography measurements judged polyps to be larger than optical colonoscopy, with differences ranging from 0.7 to 2.3 mm.

Conclusion

A linear probe does not reduce the measurement variability of endoscopists compared with the forceps. Measurement differences between observers on CT colonography were usually smaller than at optical colonoscopy. Polyps appeared larger when using various CT colonography techniques than when measured during optical colonoscopy.     

CT evaluation of the bony nasal pyramid dimensions in Anatolian people

Objectives

The aim of this study was to evaluate the nasal bone and bony nasal pyramid in adult Anatolian people.

Method

A total of 80 patients (48 males, 32 females, mean age of 40.03 years) were all evaluated using CT. Upper, intermediate and inferior thickness of the nasal bone on each side and on the lateral and medial osteotomy line were measured. In addition, nasal bone length and pyriform aperture width were determined.

Results

The bone thickness was 2.23 mm ± 0.15 mm in males and 2.19 mm ± 0.14 mm in females at the level of upper border of the nasal bone; 1.82 mm ± 0.32 mm in males and 1.81 mm ± 0.25 mm in females at the intermediate level; and 1.73 mm ± 0.30 mm in males and 1.86 mm ± 0.69 mm in females at the lower border of the nasal bone. The mean thickness on the lateral osteotomy line was 1.85 mm ± 0.32 mm in males and 1.91 mm ± 0.46 mm in females. The mean thickness of the medial osteotomy line was 2.08 ± 0.17 mm in males and 2.04 mm ± 0.17 mm in females. The mean length of the nasal bone was 30.61 mm ± 1.26 mm in males and 29.01 mm ± 1.12 mm in females. The mean width of the pyriform aperture was 18.83 mm ± 2.17 mm in males and 18.19 mm ± 1.85 in females.

Conclusion

The dimensions of the nasal pyramid are known to be important in the selection of appropriate osteotome. Our results can be used for pre-operative evaluation of Anatolian people undergoing nasal surgery.