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A group of intrinsic ligaments of the sphenoid bone which connect the anterior, middle & posterior clinoid processes occasionally get ossified and give rise to various types of ossified interclinoid bars. In present study the incidence of various types of ossified interclinoid bars were observed in 200 dry human skulls of unknown age & sex belonging to department of Anatomy of various Medical Colleges of Gujarat region. The interclinoid bars are classified on the basis of two classifications, proposed by Rani Archana et al and Keyers. Rani Archana et al, classified interclinoid bars into four types : Type I (caroticoclinoid foramen) bridge present between anterior and middle clinoid process, Type II bridge between anterior, middle and posterior clinoid process, Type III bridge between anterior and posterior clinoid process and Type IV bridge between the middle and posterior clinoid process. Each interclinoid bar was classified into contact, incomplete, complete types based on the classification of Keyers. In present study total incidence of interclinoid bars was 18%. Type I were present in 10.5%, out of which 8% were complete and 2.5% were incomplete. Types II in 3.5%, amongst them 2% were complete and 1.5% was mixed. Type III in 4%, out of which 2% were complete and 2% were incomplete. Total incidence of caroticoclinoid foramens was 14.5%, out of which 11.5% were complete and 3% were incomplete. Total incidence of sellar bridge was 7.5%, out of which 4.5% were complete and 3% were incomplete. Presence of osseous interclinoid bars may cause compression of surrounding structures like the cavernous sinus and its content, sphenoid sinus and pituitary gland. Therefore, detailed anatomical knowledge of various types of interclinoid bars can increase the success of diagnostic evaluation and surgical approaches to the region.

Abstract:

The morphology of the suprascapular notch (SSN) has been associated with suprascapular entrapment neuropathy, and injury to the suprascapular nerve in arthroscopic shoulder procedures. This study aimed to describe the morphology and morphometry of the suprascapular notch in dry scapulae. The present study was done in 314 dry scapulae obtained from B. J. Medical College, Ahmedabad. In the present study the suprascapular notch is classified on the basis of two classifications. According to one classification, SSN was classified into five types, type I without a discrete notch; type II a notch that was longest in transverse diameter; type III a notch that was longest in vertical diameter; type IV a bony foramen; type V a notch and a bony foramen. Based on gross appearance, SSN was classified as ‘U’ shaped, ‘V’ shaped, ‘J’ shaped, absent notch and indentation instead of a notch. The complete and partial ossification of the superior transverse scapular ligament was also noted. According to first classification following observations were made in the present study: type I-29%; type II-52%; type III-16%; type IV-2%; type V-1%. According to another classification, following observations were made: ‘U’ shaped notch 38%, ‘V’ shaped notch 7%, ‘J’ shaped notch 22%, absent notch 18%, and indentation instead of a notch 12%. The complete ossification was seen in 3% and partial ossification of the superior transverse scapular ligament in 2% of cases. This anatomic information is important in the management of entrapment neuropathy or interventional procedure of the SSN.

Keywords: morphology, morphometry, suprascapular notch

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Background and Aim The superior border of scapula is marked by suprascapular notch which is bridged by suprascapular ligament. Beneath this ligament, passes the suprascapular nerve. Narrow notch and completely ossified superior transverse scapular ligament is one of the risk factors for suprascapular nerve entrapment. This study is done to study morphological variation of suprascapular notch. Knowledge of various types of suprascapular notch will help the clinician in early diagnosis and surgical treatment. Materials and Methods A total of 525 human scapulae of unknown age and sex were studied for morphology of suprascapular notch at the Department of Anatomy, GMERS medical college, Vadnagar and at B. J. Medical College, Ahmedabad. Photographs of various types of suprascapular notch were taken using digital camera and classified as per the Rengachary classification. Result In the present study, as per Rengachary classification, out of 525 scapulae, the most common is Type III (47.1%), least common is Type V (1.9%), and completely ossified superior transverse scapular ligament is Type VI (8.9%). Conclusion Knowledge of various types of suprascapular notch will help the physician in screening high-risk patients as well as diagnosis and treatment of suprascapular nerve entrapment disorder.