The Radiological Evaluation of the Crista Galli and Its Clinical Implications for Anterior Skull Base Surgery

Abstract

Introduction: Crista galli is extremely important in the endoscopic transcribriform approaches and some extradural approaches. Because of its clinical significance, the morphometric properties of crista galli should be well known. In this study, it was aimed to examine the morphometry and the pneumatization incidence of the crista galli in cone beam computed tomography (CBCT) images. Material and Methods: In this retrospective study, the length and width of the crista galli were measured in CBCT images of 300 healthy individuals. Besides, the presence of crista galli pneumatization was examined. Results: The length and width of the crista galli were determined to be as 14.03 AE 2.93 mm and 3.73 AE 1.48 mm, respectively. Pneumatized crista galli was detected in 53 out of 300 individuals (17.67%). There was no statistical difference between the presence of pneumatization and both length and width values of the crista galli (P ¼ 0.876 and P ¼ 0.478, respectively). In addition, no relationship was determined between age and the presence of pneumatization (P ¼ 0.167). Conclusion:In this study, it is seen that the length (range: 6.00-23.40 mm) and width (range: 1.40-8.00 mm) of crista galli are in a very wide range. Besides, it is seen in the literature that the incidence of crista galli pneumatization is in a very wide range (2.4% to 66.6%). Based on the available data, it will not be possible to determine a specific range of values for crista galli morphometry. Therefore, the authors think that CT imaging is extremely important in preoperative evaluation.

Examination of presence and location of the accessory mental foramen, and its implications on the mental nerve block

“…On the other hand, Katakami et al [20] reported that cone-beam computed tomography scanning is better to detect an accessory mental foramen. Although it is known that the cone-beam computed tomography images clearly show bony structures, [21,22] we think that small structures such as accessory mental foramen is readily seen on bony specimens. However, the most crucial disadvantage of dry bone studies is the lack of information such as gender, age, and ethnicity.…”

The use of crista galli morphology and morphometry in sex determination: a cone-beam computed tomography study

“…In another study, Mladina et al [20] declared that the pneumatized CG height was significantly higher in females than in males on CBCT images of 102 skulls. In another retrospective study with CBCT images of 300 subjects, Uçar et al [32] the average width and length dimensions of the CG were reported to be 14.05 ± 2.98 and 3.69 ± 1.53 mm, respectively, in males, and 14.02 ± 2.90 and 3.77 ± 1.43 mm in females. No significant difference was found between the length and width dimensions of CG and sex.…”

“…In the literature, the incidence of pneumatization of CG was examined in the vast majority of the previous studies [1,3,5,6,8,10,13,16,19,20,24,25,29,[30][31][32].…”

“…In addition, CG is an endoscopic surgical landmark in pituitary surgery and frontal sinus approach [8]. In some individuals it can also be pneumatised, although the CG is usually a compact bony structure [32].…”

Simple and safe resection of the crista galli

“…The foramen cecum comprises two small alae in the frontal bone and crista galli. 10 The first olfactory nerve is the landmark for the posterior limit of Draf III. Therefore, it was already exposed.…”