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New Method of Age Estimation from Maxillary Sutures Closure in a Thai Population

Sinthubua A, Theera-Umpon N, Auephanwiriyakul S, Ruengdit S, Das S, Mahakkanukrauh P

Clin Ter, 2016 Mar-Apr;167(2):33-7.
PMID: 27212570 DOI: 10.7417/CT.2016.1918

Age estimation is one of the major components of forensic identification. Cranial suture closure has long been used as indicator for age estimation. Maxillary sutures have been less studied for estimation of age at death because they vary in their timing of closure with age. The purpose of this study was to estimate age by examining 190 Thai skulls with age ranging between 15-93 years from Forensic Osteology Research Center, Faculty of Medicine, and Chiang Mai University. Four parts of maxillary suture (incisive, anterior, transverse, and posterior sutures) were investigated the suture obliteration of each suture by computerizing from photograph. The suture were measured by pixel counting.The prediction model which based on the support vector machine (SVM) for regression or support vector regression (SVR) was utilized for data analysis. The results showed high correlation (R2 = 0.9086) between the predicted age and actual age. Plot between actual age group and predicted age in seven groups also revealed high correlation (R2 = 0.9434). These can be implied that we are able to use this SVR model to predict age at death using maxillary suture information.The interesting issue is to further apply this model in more cases to ensure the generalization of the finding. This study is the first attempt to estimate age at death using a new method based on novel analysis which considers a characteristic of relationship between maxillary suture closures with age that are not in linear form. The present study may contribute as a basis knowledge and method for further study of age estimation in archaeological and forensic anthropological contexts, especially when only skull or base of skull are found.

Matched MeSH terms: Skull Base
Fulltext Entrance Surface Dose Measurement and Lifetime Attribute Risk Analysis from Postero-anterior Chest X-ray Imaging via Direct and Indirect Measurement

Kamal, I., Salehhon, N., Hashim, S., Musa, Y., Abdul Karim, M. K.

Physics and Technology in Medicine, 2020;1(2):20-26.
MyJurnal

The aimed of this study is to estimate the entrance surface dose (ESD) of routine chest X-ray (CXR) examination and to compare the direct and indirect measurement. This study also extended to relate with the patients body thickness and established lifetime attributable risk (LAR) of the examinations. A total of 101 CXR examinations in posteroanterior (PA) projections were selected
as subjects and data, such as patient habitus and scanning acquisition parameters were recorded. The mean ESD value obtained from the TLD-100 and the software calculation was 0.31 mGy and 0.17 mGy, respectively. The percentage deviation obtained ranged from 25.5% to 61.3%. In comparison with the national diagnostic reference level (DRL), the mean values of ESD obtained from this study were lower by a factor of 3. Furthermore, it was observed that the mean absorbed dose of the adrenals, kidneys, lungs, oesophagus, and heart walls were lower as compared to the ESD value. The examinations were only associated with very low risk of cancer incidence and mortality. Hence, the results of this study suggested a need for standardisations of the personnel training to perform X-ray examinations according to ALARA principles.

Matched MeSH terms: Skull
Fulltext A Taphonomic Study of Crocodylus porosus (Crocodylidae) and Tomistoma schlegelii (Gavialidae) Remains from Western Sarawak, Malaysian Borneo: Applications for Public Education

Ruhana Hassan, Nur Fatimah Mohd Azizi, Muhammad Amirul Arib Md Adzhar, Mohd Izwan Zulaini Abdul Gani, Rambli Ahmad, Charles Leh Moi Ung

Trends in Undergraduate Research, 2018;1(1):0-0.
MyJurnal

This study documented details of the dentitions, skulls and other skeletal remains of Crocodylus porosus and Tomistoma schlegelii, from western part of Sarawak, Malaysian Borneo. The remains of both reptiles were exhumed, followed by standard cleaning procedures and then detail morphological assessments were carried out accordingly. Both species show similar structure of vertebral columns, but T. schlegelii has the following unique structures: a long and narrower snout, D-shaped eye sockets, long and sharp pointed protruding quadratojugal bones, straight maxillae and dentary, a smooth surfaced skull, elongated triangular suborbital fenestrae, round shaped internal nares and visible supraoccipital from a dorsal view. C. porosus has heterodont dentition with blunt-pointed and irregular size of teeth whereas T. schlegelii has almost homodont dentition with sharp and similar size teeth. This is the first collection of teeth, skulls and other skeletal remains of both species obtained from Sarawak, and the materials have been used regularly to educate the public through science exhibitions, hoping they will spark the interests of young budding scientists to be involved in wildlife taphonomic studies in the future.

Matched MeSH terms: Skull
Skull Base Primary Ewing Sarcoma: A Radiological Experience of a Rare Disease in an Atypical Location

Saifuddin MSAH, Ng CY, Abdullah MS

Am J Case Rep, 2021 Jun 05;22:e930384.
PMID: 34089579 DOI: 10.12659/AJCR.930384

BACKGROUND Ewing sarcoma and primitive neuroectodermal tumor are rare tumors grouped under the spectrum of the Ewing sarcoma family of tumors. These highly malignant tumors involve the bones and commonly occur in children. Ewing sarcoma of the skull bone accounts for only 1% of all Ewing sarcomas, with primary skull base Ewing sarcoma occurring in less than 1% of cases. We present a case of skull base Ewing sarcoma with complete symptom recovery and near-total radiological resolution. CASE REPORT A 4-year-old girl initially presented with a 2-month history of vomiting, poor oral intake, weight loss, and gradual visual deterioration followed by acute symptoms of fever, breathing difficulties, and seizure. Initial computed tomography and magnetic resonance imaging of the brain displayed a large sinonasal mass with extensive regional infiltration and bony destruction and no evidence of distant metastasis. A transnasal biopsy was taken. The histopathology result revealed features of skull base Ewing sarcoma. The child was given a combination of radiotherapy and chemotherapy, to which she responded well, with a minimal residual tumor. CONCLUSIONS Skull base Ewing sarcoma is a rare entity, presenting a challenge to the reporting radiologists. Differential diagnoses of esthesioneuroblastoma, olfactory neuroepithelioma, and, more commonly, sinonasal carcinoma can be misleading since they have similar radiological appearances to skull base Ewing sarcoma, which differs in treatment regimen and prognosis. Therefore, a combination of histopathological appearance, radiographic findings, and clinical correlation is important to determine the correct diagnosis, establish the appropriate treatment regime, and improve the patient's survival.

Matched MeSH terms: Skull Base
Fulltext Pyknodysostosis - complications after dental extraction

Bahadun, J., Nik Hussien, N.N., Yunus, N.N.N.

Ann Dent, 2007;14(1):26-30.
MyJurnal

Pyknodysostosis is a rare sclerosing bone disorder with autosomal recessive mode of inheritance. The condition is characterized by continuous bone deposition without physiological resorption, occurring mainly in the trabecular and not the cortical bone. The skeletal features include short stature, brachycephaly, open cranial sutures and fontanelles, diffuse osteosclerosis and obtuse mandibular angles. Among the oral features observed were grooved or furrowed palate and disturbances in eruption and exfoliation of teeth. Multiple fractures of long bones and osteomyelitis of the jaw are frequent complications. These are attributed to the increased brittleness and reduced vascularity of the bone as a result of continuous endosteal bone deposition. Treatment is usually successful with surgical management and sustained bactericidal antibiotic therapy, although hyperbaric oxygen has been recommended as adjunct treatment in the more refractory form.

Matched MeSH terms: Skull
Fulltext Multiple nail gun penetrating head injury: a case report

Sim, S.K., Theophilus, S.C., Noor Azman, A.R.

International Medical Journal Malaysia, 2013;12(2):75-78.
MyJurnal

Intracranial nail gun injury is a rare subset of penetrating head injury. Here we report a case of intracranial nail gun injury in a Vietnamese patient who attempted suicide with no neurological deficit. Three nails were launched. Because the nail head acted as a brake, the launched nail could make a hole into the skull but could not entirely pass it. A rational management strategy should permit these patients to be discharged with no additional injury. Some medical and surgical management in penetrating head injury are discussed. The use of antibiotics and antiepileptic drugs and the retraction of the nail aided by the performance of a craniotomy surrounding the entry point are recommended.

Matched MeSH terms: Skull
Fulltext A Review of 80 Supernumerary Teeth Removed Under General Anaesthesia

Ngeow, W.C., Anuar, A.M.

Ann Dent, 2004;11(1):-.
MyJurnal

A retrospective study was carried out to review the records of 47 patients who had had in total 80 supernumerary teeth (ST) removed under general anaesthesia between 1975 and 2002. Malays made up 38.30%, Chinese 51.06%, and Indians 10.64% of the patients. The predominant age group was 6-10 year-old. The mean age was 12.96 ± 9.49 years. The male and female ratio was 1.35:1. Most of the patients had either one ST (n=31; 65.96%) or two ST (n=11; 23.40%). Five cases of multiple supernumeraries were recorded. Two patients experienced late formation of subsequent ST after the first surgery, thus requiring a second surgery. The majority of ST were conical in shape (n=35; 43.75%). Most of the ST were located in the premaxilla (n=55; 68.8%). Almost a quarter (23.75%) of ST were inclined towards the oral cavity. Some of the effects on the dentition were diastema, cystic changes, rotation, displacement, and retention of the permanent teeth and these were the indications for removal of ST. The most common surgical approach for maxillary ST was from the labial, buccal or labio-buccal approach.

Matched MeSH terms: Skull
Fulltext Surgical Management of Large Occipital Encephalocoele: a case report

Sim SK, Theophilus SC, Noor Azman AR

International Medical Journal Malaysia, 2014;13(2):59-62.
MyJurnal

Cranium dysraphism occur less commonly than spinal dysraphism. Overall, occipital encephalocoeles are more frequent than anterior encephalocoes. A large occipital encephalocoele possess difficulty in surgical intervention, not only the sac contains large amount of herniated brain tissue, but the appropriate positioning for successful intubation as well as the higher rate of surgical complications such as cerebrospinal fluid leakage and skin necrosis. In this case report, surgical management of large occipital encephalocoele is discussed. The use of antibiotics in ruptured encephalocoele is recommended.

Matched MeSH terms: Skull
A comparative morphological study on the craniofacial complex of irus monkeys from different habitats by means of roentgenographic cephalometrics

Kobayashi S, Inoue N, Ito G, Komatsu T, Ishibashi K

Bull. Tokyo Med. Dent. Univ., 1965 Mar;12(1):127-41.
PMID: 4953221
Matched MeSH terms: Skull
Fulltext Hydrocephaly Analysis Supported by Computerized Tomography and Nuclear Magnetic Resonance

Zhang T, Zhou Y, Su G, Shi D, Gopinath SCB, Lakshmipriya T, et al.

J Anal Methods Chem, 2019;2019:5872347.
PMID: 31662948 DOI: 10.1155/2019/5872347

Hydrocephalus is widely known as "hydrocephaly" or "water in the brain," a building up of abnormal cerebrospinal fluid in the brain ventricles. Due to this abnormality, the size of the head becomes larger and increases the pressure in the skull. This pressure compresses the brain and causes damage to the brain. Identification by imaging techniques on the hydrocephalus is mandatory to treat the disease. Various methods and equipment have been used to image the hydrocephalus. Among them, computerized tomography (CT) scan and nuclear magnetic resonance (NMR) are the most considered methods and gives accurate result of imaging. Apart from imaging, cerebrospinal fluid-based biomarkers are also used to identify the condition of hydrocephalus. This review is discussed on "hydrocephalus" and its imaging captured by CT scan and NMR to support the biomarker analysis.

Matched MeSH terms: Skull
Effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery: a randomised, controlled study

Ng BHK, Tang IP, Narayanan P, Raman R, Carrau RL

J Laryngol Otol, 2019 Dec;133(12):1059-1063.
PMID: 31774052 DOI: 10.1017/S0022215119002329

BACKGROUND: Nasal lavage with mupirocin has the potential to reduce sinonasal morbidity in endoscopic endonasal approaches for skull base surgery.
OBJECTIVE: To evaluate the effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery.
METHODS: A pilot randomised, controlled trial was conducted on 20 adult patients who had undergone endoscopic endonasal approaches for skull base lesions. These patients were randomly assigned to cohorts using nasal lavages with mupirocin or without mupirocin. Patients were assessed in the out-patient clinic, one week and one month after surgery, using the 22-item Sino-Nasal Outcome Test questionnaire and nasal endoscopy.
RESULTS: Patients in the mupirocin nasal lavage group had lower nasal endoscopy scores post-operatively, and a statistically significant larger difference in nasal endoscopy scores at one month compared to one week. The mupirocin nasal lavage group also showed better Sino-Nasal Outcome Test scores at one month compared to the group without mupirocin.
CONCLUSION: Nasal lavage with mupirocin seems to yield better outcomes regarding patients' symptoms and endoscopic findings.

Matched MeSH terms: Skull Base/surgery; Skull Base Neoplasms/surgery*
Fulltext Description of cranial elements and ontogenetic change within Tropidolaemus wagleri (Serpentes: Crotalinae)

Hill N

PLoS One, 2019;14(2):e0206023.
PMID: 30785876 DOI: 10.1371/journal.pone.0206023

Tropidolaemus wagleri is a species of Asian pitviper with a geographic range including Thailand, Vietnam, Malaysia, Singapore, Bruniei, parts of Indonesia, and the Philippines. Tropidolaemus is a member of the Crotalinae subfamily, within Viperidae. The genus Tropidolaemus includes five species, and was once included within the genus Trimeresurus. While some osteologic characteristics have been noted a comprehensive description of cranial elements has not been produced for T. wagleri. An in-depth description of the cranial skeleton of Tropidolaemus wagleri lays the foundation for future projects to compare and contrast other taxa within Crotalinae and Viperidae. The chosen reference specimen was compared to the presumed younger specimens to note any variation in ontogeny. The study here provides a comprehensive description of isolated cranial elements as well as a description of ontogenetic change within the specimens observed. This study contributes to the knowledge of osteological characters in T. wagleri and provides a foundation for a long term project to identify isolated elements in the fossil record.

Matched MeSH terms: Skull
Fulltext Posterior reversible encephalopathy in undiagnosed systemic lupus erythematous: a case report

Sulaiman W, Husin NM, Baba MS

Oman Med J, 2011 Nov;26(6):e026.
PMID: 28861180 DOI: 10.5001/omj.2011.119

A 33-year old Malay woman with undiagnosed systemic lupus erythematosus (SLE) and other comorbids presented with acute glomerularnephritis, hypertensive emergency and later acute confusional state. Cranial MRI revealed features consistent with posterior reversible encephalopathy syndrome (PRES).

Matched MeSH terms: Skull
Fulltext A new method for sex estimation from maxillary suture length in a Thai population

Sinthubua A, Ruengdit S, Das S, Mahakkanukrauh P

Anat Cell Biol, 2017 Dec;50(4):261-264.
PMID: 29354297 DOI: 10.5115/acb.2017.50.4.261

Sex estimation is one of the crucial procedures in the biological profile identification of human skeletal remains. Knowing sex of unknown case can lead to accurate and appropriate methods for predicting age, stature, ancestry, or even personal identification. Skull is one of the most reliable one among other skeletons and it is usually retained for both archaeological and forensic contexts. Although many morphological features and metric measurements of skull have been studied for sexing, but to the best of our knowledge is no study on maxillary suture length for sex estimation. Therefore, this study aims to develop a new sex estimation method for a Thai population by determining three maxillary suture lengths: anterior, transverse, and posterior maxillary suture, by computerizing amount of pixel obtained from photographs of these sutures. The present study was conducted on 190 Thai bone samples of which 96 were males and 94 were females. Independent t test revealed statistically significant difference (P<0.01) between males and females in all maxillary suture measurements. Equations derived from prediction model, which required three maxillary suture lengths gave 76.8421% accuracy from the leave-one-out cross validation in estimating sex percentage accuracies in predicting sex from these equations, which were relatively moderate. This study provides a novel and objective sex estimation method for Thais. It suggests that maxillary suture length can be applied for sex estimation. The new computerized technique will contribute basis knowledge and method for sex estimation, especially when only base of skull is available in forensic circumstance.

Matched MeSH terms: Skull Base
Metabolic Superscan on 18 F-FDG PET/CT in a Patient With Secondary Hyperparathyroidism

Mohd Rohani MF, Bujang NL, Rosdi AH, Amir Hassan SZ

Clin Nucl Med, 2024 Jan 01;49(1):e19-e21.
PMID: 37883221 DOI: 10.1097/RLU.0000000000004941

Superscan on PET/CT has been reported in the literature and mainly involved metastatic diseases. We report an uncommon case of a metabolic superscan on 18 F-FDG PET/CT in a 56-year-old man with end-stage renal disease on hemodialysis who presented with secondary hyperparathyroidism. Parathyroid scintigraphy showed 2 lesions posteroinferior to both thyroid lobes, suggestive of parathyroid adenoma/hyperplasia. FDG PET/CT performed to assess for pulmonary nodules revealed diffuse FDG hypermetabolism involving the visualized skull, mandible, spine, sternum, ribs, and appendicular skeleton without corresponding CT lesion with no urinary radiotracer excretion, consistent with metabolic superscan secondary to renal osteodystrophy.

Matched MeSH terms: Skull
Fulltext Extended applications of endoscopic sinus surgery and its reference to cranial base and pituitary fossa

Gendeh BS

Indian J Otolaryngol Head Neck Surg, 2010 Sep;62(3):264-76.
PMID: 23120724 DOI: 10.1007/s12070-010-0077-6

Sinus surgery has the potential of allowing ENT surgeons to encroach the boundaries of our colleagues in ophthalmology and neurosurgery. The advent of nasal endoscope and lately powered instrumentation and computer-assisted navigational systems has avoided the use of the conventional and more radical approaches by the ENT surgeon for the treatment of inflammatory pathology or tumors of the orbit and skull base. As rhinologists have gained more experience in endoscopic surgery, more areas related to the orbit and the anterior skull base are accessible and surgery is safer.

Matched MeSH terms: Skull Base
Fulltext Atypical Clival Chordoma in an Adolescent without Imaging Evidence of Bone Involvement

Hashim H, Rosman AK, Abdul Aziz A, Roqiah AK, Bakar NS

Malays J Med Sci, 2014 Sep-Oct;21(5):78-82.
PMID: 25977639

Clival chordoma is a rare primary bone tumour that arises from the remnant of the notochord and typically occurs in older adults. Upon imaging, the tumour can be seen arising from the clivus and causes clival destruction. This usually provides insight for a diagnosis. Here we present a case of a non-enhancing, pre-pontine mass that was hypointense on T1W and hyperintense on T2W in an adolescent. No clival bone erosion was observed. Based on the age group, imaging findings, and lack of clival erosion, a provisional diagnosis of epidermoid cyst was made and the tumour was resected. This patient was eventually diagnosed with a clival chordoma based on histopathological examination.

Matched MeSH terms: Skull Base Neoplasms
A haemostatic agent delivery system for endoscopic neurosurgical procedures

Waran V, Sek K, Bahuri NF, Narayanan P, Chandran H

Minim Invasive Neurosurg, 2011 Oct;54(5-6):279-81.
PMID: 22278798 DOI: 10.1055/s-0031-1297997

In endoscopic neurosurgery problems with haemostasis due to poor access exist. We have developed a system which allows the delivery of a variety of haemostatic agents in a more efficacious manner. The system has been used successfully in endoscopic skull base surgery and endoscopic surgery within the parenchyma of the brain using tube systems.

Matched MeSH terms: Skull Base/surgery
Study on the performance of different craniofacial superimposition approaches (II): Best practices proposal

Damas S, Wilkinson C, Kahana T, Veselovskaya E, Abramov A, Jankauskas R, et al.

Forensic Sci Int, 2015 Dec;257:504-508.
PMID: 26482539 DOI: 10.1016/j.forsciint.2015.07.045

Craniofacial superimposition, although existing for one century, is still a controversial technique within the scientific community. Objective and unbiased validation studies over a significant number of cases are required to establish a more solid picture on the reliability. However, there is lack of protocols and standards in the application of the technique leading to contradictory information concerning reliability. Instead of following a uniform methodology, every expert tends to apply his own approach to the problem, based on the available technology and deep knowledge on human craniofacial anatomy, soft tissues, and their relationships. The aim of this study was to assess the reliability of different craniofacial superimposition methodologies and the corresponding technical approaches to this type of identification. With all the data generated, some of the most representative experts in craniofacial identification joined in a discussion intended to identify and agree on the most important issues that have to be considered to properly employ the craniofacial superimposition technique. As a consequence, the consortium has produced the current manuscript, which can be considered the first standard in the field; including good and bad practices, sources of error and uncertainties, technological requirements and desirable features, and finally a common scale for the craniofacial matching evaluation. Such a document is intended to be part of a more complete framework for craniofacial superimposition, to be developed during the FP7-founded project MEPROCS, which will favour and standardize its proper application.

Matched MeSH terms: Skull/anatomy & histology*
Fulltext Surface Reconstruction from Parallel Curves with Application to Parietal Bone Fracture Reconstruction

Majeed A, Mt Piah AR, Ridzuan Yahya Z

PLoS One, 2016;11(3):e0149921.
PMID: 26967643 DOI: 10.1371/journal.pone.0149921

Maxillofacial trauma are common, secondary to road traffic accident, sports injury, falls and require sophisticated radiological imaging to precisely diagnose. A direct surgical reconstruction is complex and require clinical expertise. Bio-modelling helps in reconstructing surface model from 2D contours. In this manuscript we have constructed the 3D surface using 2D Computerized Tomography (CT) scan contours. The fracture part of the cranial vault are reconstructed using GC1 rational cubic Ball curve with three free parameters, later the 2D contours are flipped into 3D with equidistant z component. The constructed surface is represented by contours blending interpolant. At the end of this manuscript a case report of parietal bone fracture is also illustrated by employing this method with a Graphical User Interface (GUI) illustration.

Matched MeSH terms: Skull Fractures/surgery

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