Faisal Siddiqui Humza, Cardona Juan J, Chaiyamoon Arada, Gilkes Aishwarya, Rajaram-Gilkes Mathangi, Keshavarzi Sassan, Iwanaga Joe, Dumont Aaron S, Tubbs R Shane
Department of Neurosurgery, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Department of Neurosurgery, Tulane University School of Medicine, New Orleans, USA.
Cureus. 2022 Dec 8;14(12):e32326. doi: 10.7759/cureus.32326. eCollection 2022 Dec.
Background A detailed understanding of the relationship between the occipital condyle (OC) and the deeper-lying hypoglossal canal (HC) is necessary for surgeons who place screws into the OC or drill through or around the HC. Therefore, this anatomical study was performed. Methodology A total of 30 skulls (60 sides) underwent an analysis of the angle formed between the long axis of the OC and the HC, i.e., the OC/HC angle. Additionally, the lengths and widths of the OCs and foramen magnum (FM) of each skull were measured using a micrometer. Statistical analyses were performed between the left and right sides, and a Pearson's correlation coefficient was calculated between OC/HC angles and the sizes of the OCs and FM of the skulls. Results The OC/HC angle for the left and right sides ranged from 30 to 56 degrees (mean 46 degrees). The width of the OCs ranged from 9 to 18 mm (mean 13 mm). The length of the OCs was 18 to 31 mm (mean 24 mm). The mean length and width of the FM were 36 mm and 30 mm, respectively. There was no statistically significant difference between the OC/HC angle comparing left and right sides or male or female specimens. Additionally, no statistically significant differences were found between septated and non-septated HC. Pearson's correlation coefficient for left and right OC/HC angles and left and right OC lengths was r = 0.4056 and r = 0.2378, respectively. Pearson's correlation coefficient for left and right OC/HC angles and left and right OC width was r = 0.3035 and r = 0.3530, respectively. Pearson's correlation coefficient for left and right OC/HC angles and the width of the FM was r = 0.2178 and r = 0.2048, respectively. Pearson's correlation coefficient for left and right OC/HC angles and the length of the FM was r = 0.3319 and r = 0.2683, respectively. Conclusions The OC/HC angle as measured here was relatively consistent with no statistically significant differences between sides. We did not find a strong correlation between the width or length of the OC or the width or length of the FM and the OC/HC angles. Therefore, based on our study, surgeons can expect that this angle will range between 30 and 56 degrees (mean 46 degrees). Such knowledge might decrease patient morbidity following invasive procedures involving the OC.
背景 对于将螺钉植入枕髁（OC）或在舌下神经管（HC）内或其周围进行钻孔的外科医生而言，详细了解枕髁与更深层的舌下神经管之间的关系是必要的。因此，开展了这项解剖学研究。
方法 总共30个颅骨（60侧）接受了枕髁长轴与舌下神经管之间形成的角度分析，即枕髁/舌下神经管角度。此外，使用测微计测量每个颅骨的枕髁和枕大孔（FM）的长度和宽度。在左右两侧之间进行统计分析，并计算枕髁/舌下神经管角度与颅骨的枕髁和枕大孔尺寸之间的Pearson相关系数。
结果 左右两侧的枕髁/舌下神经管角度范围为30至56度（平均46度）。枕髁的宽度范围为9至18毫米（平均13毫米）。枕髁的长度为18至31毫米（平均24毫米）。枕大孔的平均长度和宽度分别为36毫米和30毫米。在比较左右两侧或男性与女性标本的枕髁/舌下神经管角度之间没有统计学上的显著差异。此外，在有分隔和无分隔的舌下神经管之间未发现统计学上的显著差异。左右枕髁/舌下神经管角度与左右枕髁长度的Pearson相关系数分别为r = 0.4056和r = 0.2378。左右枕髁/舌下神经管角度与左右枕髁宽度的Pearson相关系数分别为r = 0.3035和r = 0.3530。左右枕髁/舌下神经管角度与枕大孔宽度的Pearson相关系数分别为r = 0.2178和r = 0.2048。左右枕髁/舌下神经管角度与枕大孔长度的Pearson相关系数分别为r = 0.3319和r = 0.2683。
结论 此处测量的枕髁/舌下神经管角度相对一致，两侧之间无统计学上的显著差异。我们未发现枕髁的宽度或长度、枕大孔的宽度或长度与枕髁/舌下神经管角度之间存在强相关性。因此，基于我们的研究，外科医生可以预期这个角度将在30至56度之间（平均46度）。这些知识可能会降低涉及枕髁的侵入性手术患者的发病率。
