The safe zone for blinded sternal interventions based on CT evaluation of midline congenital sternal foramina

Abstract

Sternal interventions should be avoided at the level of fourth to sixth CCJ, which is considered the danger zone. An intervention at the fourth to sixth CCJ may lead to disastrous consequences in patients who have SF.

Morphological approach of the sternal foramen: an anatomic study and a short review of the literature

“…Reported incidence ranges from 0.06% to 18.3%. Prevalence of SF is reported from 0.06% up to 11.6% in radiological studies [4,5,8,18,20,24,26,30], 6.7% to 16.6% in cadaveric studies [3,9,19], and 13.8% and 18.3% in the 2 published anatomic studies, conducted in dry specimens [12,21]. SFs were observed in 5 of 35 sterna (14.6% of dried specimens) in the present study.…”

“…SF may be even only in males encountered [18]. Most recent data indicate a male:female ratio 2.5:1 among the subjects featuring a SF [8]. In our study this ratio was measured 4:1.…”

“…Prevalence of SF features an important correlation with the sex, being reported mainly in male subjects among the studies [8,18,25]. SF may be even only in males encountered [18].…”

“…SF is basically observed in midline, in the lower third of sternum. Xiphoidal foramen constitutes the most common type of sternal foramen and, concerning SF in body, it is fundamentally observed in 5 th intercostal segment [8,11,13,21,30]. However, prevalence of SF in body is reported to be higher than this in xiphoid process in specific studies [5,12].…”

“…The incidence of the SF varies remarkably among different studies in the literature, being reported from 0.06% up to 18.3% [3-5, 8, 9, 12, 18-21, 24, 26, 30]. Its anatomic localisation is observed in the inferior portion of the sternum and basically in the xiphoid process [8,13,21,30]. Pseudoforamen constitutes a rare morphological type of the SF, being described in only 2 studies [11,30].…”