Frontal cranioplasty: risk factors and choice of cranial vault reconstructive material

A study of patients with large cranial defects involving the frontal bone, frontal sinus, nose, and orbit does not support the contention that there is a clear superiority of reconstructive material despite a history of previous bone infection. No patient with an isolated cranial reconstruction experienced an infection despite location in the area of the frontal sinus or the use of acrylic material. All patients experiencing infection underwent simultaneous reconstruction of the frontal cranium and nose and three- or four-wall reconstruction of the orbit, where the frontal sinus had previously been eliminated and where a previous bone infection had been present. Risk factors associated with cranioplasty were timing (p = 0.001) and cranial vault reconstruction in communication with previously infected ethmoid sinuses and the nose (p = 0.03). A history of previous bone infection suggests increased risk (p = 0.15). The choice of reconstructive material was not significant, although acrylic cranioplasties did not experience the complications expected from a review of the literature.     

Repeated loss of frontal sinuses in arctoid carnivorans

Many mammal skulls contain air spaces inside the bones surrounding the nasal chamber including the frontal, maxilla, ethmoid, and sphenoid, all of which are called paranasal sinuses. Within the Carnivora, frontal sinuses are usually present, but vary widely in size and shape. The causes of this variation are unclear, although there are some functional associations, such as a correlation between expanded frontal sinuses and a durophagous diet in some species (e.g., hyenas) or between absent sinuses and semiaquatic lifestyle (e.g., pinnipeds). To better understand disparity in frontal sinus morphology within Carnivora, we quantified frontal sinus size in relationship to skull size and shape in 23 species within Arctoidea, a clade that is ecologically diverse including three independent invasions of aquatic habitats, by bears, otters, and pinnipeds, respectively. Our sampled species range in behavior from terrestrial (rarely or never forage in water), to semiterrestrial (forage in water and on land), to semiaquatic (forage only in water). Results show that sinuses are either lost or reduced in both semiterrestrial and semiaquatic species, and that sinus size is related to skull size and shape. Among terrestrial species, frontal sinus size was positively allometric overall, but several terrestrial species completely lacked sinuses, including two fossorial badgers, the kinkajou (a nocturnal, arboreal frugivore), and several species with small body size, indicating that factors other than aquatic habits, such as space limitations due to constraints on skull size and shape, can limit sinus size and presence. J. Morphol. 276:22–32, 2015. © 2014 Wiley Periodicals, Inc.     

Enigmatic Diversity of the Maxillary Sinus in Macaques and Its Possible Role as a Spatial Compromise in Craniofacial Modifications

Understanding the evolutionary significance of morphological diversity is a major goal of evolutionary biology. Paranasal sinuses, which are pneumatized hollow spaces in the face, have attracted attention from researchers as one of the most intriguing traits that show unexpected variations. Macaques are one genus of primates that have accomplished adaptive radiation and therefore present an excellent opportunity to investigate the phenotypic diversification process. Using the large data set of computed tomography images of macaques (172 specimens from 17 species), we applied geometric morphometrics and multivariate analyses to quantitatively evaluate the maxillary sinus (one of the largest paranasal sinuses), the outer craniofacial shape, and nasal cavity. We then applied phylogenetic comparative methods to test their morphological interactions, phylogenetic, and ecogeographical significances. The results showed that the relative maxillary sinus size was significantly associated with the relative nasal cavity size and with the zygomaxillary surface shape. The relative nasal cavity size had ecogeographical correlations and high phylogenetic signal, whereas the zygomaxillary surface shapes were ecogeographically and phylogenetically irrelevant. The significant interactions with multiple surrounding traits that have experienced different evolutionary processes probably enable the maxillary sinus to show enigmatic diversity, which is independent of phylogeny and ecology. The pliable nature of the maxillary sinus, which is positioned between the nasal airways and the outer face, may play a role as a spatial compromise in craniofacial modifications.     

Relationships between the frontal sinus and climatic conditions: a skeletal approach to cold adaptation

Previous studies in physical anthropology, using superficial facial features, show that the relationship between human facial morphology and climate is not clear. An alternate approach to the problem is the investigation of the deeper facio-anatomical structures (i.e., cranial sinuses and/or foramina) in relation to climatic variables. The present investigation statistically analyses the relationship between climatic conditions (wind chill equivalent temperatures and absolute humidities) and the occurrence and size of frontal sinuses in 153 Eskimo crania. Conditional results from tests of significance of differences and correlation suggest a relationship between low wind chill equivalent temperatures and small frontal sinus surface areas. These results are interpreted in light of cranial sinus function and environmental physiology.     

Morphology and postnatal ontogeny of the cranial endocast and paranasal sinuses of capybara (Hydrochoerus hydrochaeris), the largest living rodent

Recent studies have analyzed and described the endocranial cavities of caviomorph rodents. However, no study has documented the changes in the morphology and relative size of such cavities during ontogeny. Expecting to contribute to the discussion of the endocranial spaces of extinct caviomorphs, we aimed to characterize the cranial endocast morphology and paranasal sinuses of the largest living rodent, Hydrochoerus hydrochaeris, by focusing on its ontogenetic growth patterns. We analyzed 12 specimens of different ontogenetic stages and provided a comparison with other cavioids. Our study demonstrates that the adult cranial endocast of H. hydrochaeris is characterized by olfactory bulbs with an irregular shape, showing an elongated olfactory tract without a clear circular fissure, a marked temporal region that makes the endocast with rhombus outline, and gyrencephaly. Some of these traits change as the brain grows. The cranial pneumatization is present in the frontal and lacrimal bones. We identified two recesses (frontal and lacrimal) and one sinus (frontal). These pneumatic cavities increase their volume as the cranium grows, covering the cranial region of the cranial endocast. The encephalization quotient was calculated for each specimen, demonstrating that it decreases as the individual grows, being much higher in younger specimens than in adults. Our results show that the ontogenetic stage can be a confounding factor when it comes to the general patterns of encephalization of extinct rodents, reinforcing the need for paleobiologists to take the age of the specimens into account in future studies on this subject to avoid age-related biases.     

Extensive enlargement of the maxillary sinus in Alouatta caraya (mammalia, primates, cebidae): an allometric approach to skull pneumatization in Atelinae

In contrast to the paranasal sinuses of Old World monkeys and hominoids, little information is available about the paranasal sinuses of New World monkeys. Because this information is crucial in order to draw further conclusions about the evolution and biological role of skull pneumatization, this study investigates the morphology of the paranasal sinuses in adult black-and-gold howler monkeys (Alouatta caraya). Volumes of the paranasal sinuses were calculated using computer software (SURFdriver or Allegro) from serial coronal CT scans of 20 skulls of both sexes. Skull pneumatization in A. caraya is more complex than in other higher primates. In both sexes, the maxillary sinus (MS) is the only pneumatic cavity and enlarges regularly into neighboring bones such as the frontal bone and the basisphenoid. The resulting pansinus is often partitioned by several vertical septa. As in most external cranial dimensions, mean MS volume of A. caraya (male 4.08 cm(3); female 2.00 cm(3)) shows significant sexual dimorphism. Reduced major axis regression analysis between MS volume and different cranial dimensions for A. caraya (and for available data from other platyrrhines) suggests a distinct association for this group, with Alouatta having one of the largest pneumatic cavities. The combination of this unusual expansion of the MS of Alouatta and the occurrence of distinct septa within the sinus may be a consequence of the distinct skull architecture of Alouatta.     

The frontal sinus in ancient and modern Greenlandic Inuit

The purpose of this study was to compare the frontal sinus size of ancient Greenlandic Inuit with ancient Inuit of Alaska and Canada, and to compare sinus size between ancient and modern Greenlandic Inuit. Also, it was analyzed whether cranial size was a determinant of frontal sinus size. Frontal sinus size was evaluated in terms of absence frequency and planimetrically. Absence was defined as a frontal sinus not exceeding a line drawn between the supraorbital rims. A significant increase in absence frequency was noted from Alaska over Canada to Greenland (males: p<0.03; females p<0.0001). This is in accordance with earlier studies, indicating that although these Inuit populations once have been commonly related to the Old Bering Sea population, the Greenland Inuit represent an endpoint in an eastward migration. There was a significant increase (p<0.0001) in frontal sinus size from ancient to modern Greenlandic Inuit, probably indicative of a high degree of admixture with non-Inuit after modern colonization. The results regarding craniofacial size parameters and frontal sinus side were inconclusive. No single craniofacial variable showed significant effect on frontal sinus size, but the area displayed sexual dimorphism, females having smaller frontal sinuses.     

Assessing the variation in individual frontal sinus outlines

It is often suggested that the frontal sinus morphology of no two individuals is alike, and that the configuration of the frontal sinus is as unique to an individual as his or her fingerprints. However, no empirical, quantitative testing of the uniqueness of frontal sinus outlines has ever been performed. Such testing is necessary for frontal sinus identifications to be admissible in many courts. This study investigated frontal sinus outline variability using elliptic Fourier analysis (EFA), a geometric morphometric approach that fits a closed curve to an ordered set of data points, generating a set of coefficients that can be used to reproduce the outline. Two-dimensional representations of 808 frontal sinuses (as seen in posterior-anterior cranial radiographs) were digitized, and differences in their shapes were assessed quantitatively by comparing the Euclidean distances between EFA-generated outlines. Results show that Euclidean distances between outlines of different individuals are significantly larger than those between replicates of the same individual, and typicalities show that the probability of finding two different individuals with Euclidean distances less that that between a particular case's replicate is very small. Thus, there is a quantifiable and significant difference between the shapes of individuals' frontal sinus outlines.     

Facial correlates of frontal bone pneumatisation in strepsirrhine primates

Despite a substantial amount of research, a consensus has yet to emerge regarding the function of the paranasal sinuses found in some but not all species of mammals. In this paper, we suggest a new statistical approach for the analysis of paranasal sinus function in a comparative framework. We model the data using a censored linear regression and three different phylogenetic correlation structures (independence, Brownian motion, and the Ornstein–Uhlenbeck model of evolution). The method specifically addresses the difficulty involved in modelling a character that is fundamentally quantitative but also completely absent in many taxa. We use this approach to test hypotheses of correlation between aspects of facial morphology and the development of frontal bone pneumatisation in strepsirrhine primates, based on pneumatisation volume estimates derived from planar radiographs. Our preliminary survey illustrates that frontal pneumatisations are frequent among strepsirrhines, but that they are also completely absent from several groups. Our analyses suggest that the relationship between frontal pneumatisation and other variables is complex. Bridging between the orbital and neural components of the frontal bone in response to varying degrees of spatial separation between those components emerges as one likely determinant of the development of frontal pneumatisation. Scaling properties, however, imply that additional factors are involved in determining the development of frontal bone pneumatisation in strepsirrhines.     

An allometric study of the frontal sinus in Gorilla, Pan and Pongo

There is considerable speculation about the role and significance of the paranasal sinuses in the Hominoidea, and this study aims to present new data about an old problem from cephalograms of dried crania. Measurements of frontal sinus volumes were determined for Gorilla gorilla gorilla; G. gorilla beringei and Pan troglodytes. By adopting an allometric approach it was determined that the frontal sinus volume of Gorilla is relatively smaller than that of Pan, and that the frontal sinus of G. g. gorilla is relatively smaller than that of G. g. beringei. Frontal sinus volume scales in a positive allometric fashion relative to skull length. Since the slope is steeper for Pan, frontal sinus volume is increasing at a faster rate than in Gorilla. Sexual dimorphism in frontal sinus volume is present. Thirty crania of Pongo were investigated for evidence of pneumatization of the frontal bone. In no case was secondary invasion of the frontal bone by the maxillary antrum observed. In Gorilla, the nasal cavity volume scales isometrically with skull length. The scaling relationships discussed do not support any 'functional' role of the frontal sinus associated with nasal function but suggest a 'structural' role associated with craniofacial architecture.     

Frontal bone periosteal osteomas

Osteomas are the most common tumors of the cranial vault and facial skeleton. Osteomas are usually benign in nature, commonly presenting with symptoms of facial deformity, facial pain, and headaches. Although the frontal sinus is the most frequent location of cranial osteomas, they are also occasionally seen involving only the frontal bone periosteum. This study is a retrospective series investigating the characteristics, management, and outcomes of five patients with frontal bone periosteal osteomas surgically treated with superficial osteotomies with primary closure. Medical charts were reviewed focusing on symptoms, size, radiographic findings, and disease of the periosteal osteomas. The chief complaint primarily involved a palpable deformity, which led to surgical evaluation. Radiographic studies were obtained to evaluate size and location of the frontal osteomas. Microanalysis of the specimens confirmed the presence of mature cancellous and/or cortical bone. Postoperative follow-up revealed no evidence of recurrence or complications. The superficial ostectomy technique with primary closure offers a simple, effective method for removal of frontal bone periosteal osteomas with minimal side effects.     

An ontogenetic perspective on the study of sexual dimorphism, phylogenetic variability, and allometry of the skull of European ground squirrel, Spermophilus citellus (Linnaeus, 1766)

Most studies of morphological variability in or among species are performed on adult specimens. However, it has been proven that knowledge of the patterns of size and shape changes and their covariation during ontogeny is of great value for the understanding of the processes that produce morphological variation. In this study, we investigated the patterns of sexual dimorphism, phylogenetic variability, and ontogenetic allometry in the Spermophilus citellus with geometric morphometrics applied to cross-sectional ontogenetic data of 189 skulls from three populations (originating from Burgenland, Banat, and Dojran) belonging to two phylogenetic lineages (the Northern and Southern). Our results indicate that sexual dimorphism in the ventral cranium of S. citellus is expressed only in skull size and becomes apparent just before or after the first hibernation because of accelerated growth in juvenile males. Sexes had the same pattern of ontogenetic allometry. Populations from Banat and Dojran, belonging to different phylogroups, were the most different in size but had the most similar adult skull shape. Phylogenetic relations among populations, therefore, did not reflect skull morphology, which is probably under a significant influence of ecological factors. Populations had parallel allometric trajectories, indicating that alterations in development probably occur prenatally. The species’ allometric relations during cranial growth showed characteristic nonlinear trajectories in the two northern populations, with accelerated shape changes in juveniles and continued but almost isometric growth in adults. The adult cranial shape was reached before sexual maturity of both sexes and adult size after sexual maturity. The majority of shape changes during growth are probably correlated with the shift from a liquid to a solid diet and to a lesser degree due to allometric scaling, which explained only 20 % of total shape variation. As expected, viscerocranial components grew with positive and neurocranial with negative allometry.     

A model of developmental canalization,applied to human cranial form

Developmental mechanisms that canalize or compensate perturbations of organismal development (targeted or compensatory growth) are widely considered a prerequisite of individual health and the evolution of complex life, but little is known about the nature of these mechanisms. It is even unclear if and how a “target trajectory” of individual development is encoded in the organism’s genetic-developmental system or, instead, emerges as an epiphenomenon. Here we develop a statistical model of developmental canalization based on an extended autoregressive model. We show that under certain assumptions the strength of canalization and the amount of canalized variance in a population can be estimated, or at least approximated, from longitudinal phenotypic measurements, even if the target trajectories are unobserved. We extend this model to multivariate measures and discuss reifications of the ensuing parameter matrix. We apply these approaches to longitudinal geometric morphometric data on human postnatal craniofacial size and shape as well as to the size of the frontal sinuses. Craniofacial size showed strong developmental canalization during the first 5 years of life, leading to a 50% reduction of cross-sectional size variance, followed by a continual increase in variance during puberty. Frontal sinus size, by contrast, did not show any signs of canalization. Total variance of craniofacial shape decreased slightly until about 5 years of age and increased thereafter. However, different features of craniofacial shape showed very different developmental dynamics. Whereas the relative dimensions of the nasopharynx showed strong canalization and a reduction of variance throughout postnatal development, facial orientation continually increased in variance. Some of the signals of canalization may owe to independent variation in developmental timing of cranial components, but our results indicate evolved, partly mechanically induced mechanisms of canalization that ensure properly sized upper airways and facial dimensions.     

Ancestral loss of the maxillary sinus in Old World monkeys and independent acquisition in Macaca

Cercopithecoid monkeys are unique among primates in that all species (except macaques) lack a maxillary sinus, an unusual condition among eutherian mammals. Although this uncommon distribution of cranial pneumatization was noted previously, the phylogenetic ramifications have not been investigated fully. Recently, character state optimization analysis of computed tomography (CT) data from extant Old World monkeys suggested that the loss of the sinus may have occurred at the origin of the group, unlike previous hypotheses positing only a reduction in size of the structure. To critically evaluate the "early loss" hypothesis, a recently recovered complete cranium of Victoriapithecus macinnesi from Maboko Island, Kenya, was examined by CT to determine the extent of its cranial pneumatization. This taxon is crucial for evaluating character state evolution in Old World monkeys, due to its phylogenetic position, preceding the cercopithecine/colobine split. CT analysis reveals only cancellous bone lateral of the nasal cavity, indicating that Victoriapithecus does not possess a maxillary sinus. Phylogenetic evaluation of the fossil with extant catarrhine taxa strongly supports the early loss of the sinus in cercopithecoids. The results suggest that the maxillary sinus found in the genus Macaca is not homologous with that of other eutherians, which may provide insights into the origin and function (if any) of the paranasal pneumatizations.     

The bony labyrinth of Neanderthals

This paper presents a comprehensive comparative analysis of the Neanderthal bony labyrinth, a structure located inside the petrous temporal bone. Fifteen Neanderthal specimens are compared with a Holocene human sample, as well as with a small number of European Middle Pleistocene hominins, and early anatomically modern and European Upper Palaeolithic humans. Compared with Holocene humans the bony labyrinth of Neanderthals can be characterized by an anterior semicircular canal arc which is smaller in absolute and relative size, is relatively narrow, and shows more torsion. The posterior semicircular canal arc is smaller in absolute and relative size as well, it is more circular in shape, and is positioned more inferiorly relative to the lateral canal plane. The lateral semicircular canal arc is absolutely and relatively larger. Finally, the Neanderthal ampullar line is more vertically inclined relative to the planar orientation of the lateral canal. The European Upper Palaeolithic and early modern humans are most similar, although not fully identical to Holocene humans in labyrinthine morphology. The European Middle Pleistocene hominins show the typical semicircular canal morphology of Neanderthals, with the exception of the arc shape and inferiorly position of the posterior canal and the strongly inclined ampullar line. The marked difference between the labyrinths of Neanderthals and modern humans can be used to assess the phylogenetic affinities of fragmentary temporal bone fossils. However, this application is limited by a degree of overlap between the morphologies. The typical shape of the Neanderthal labyrinth appears to mirror aspects of the surrounding petrous pyramid, and both may follow from the phylogenetic impact of Neanderthal brain morphology moulding the shape of the posterior cranial fossa. The functionally important arc sizes of the Neanderthal semicircular canals may reflect a pattern of head movements different from that of modern humans, possibly related to aspects of locomotor behaviour and the kinematic properties of their head and neck.     

Nasal cavities and paranasal sinuses in newborns and children]

The paranasal or accessory nasal sinuses begin their development as evaginations of the mucosa during the 3rd and 4th fetal months, but undergo their major expansion after birth according to the development of the facial cranium and the teeth. While in the newborn the sphenoidal and frontal sinuses are still only predispositioned, the ethmoidal labyrinth and particularly the maxillary sinus are of appreciable size. In the 4-year-old the frontal and sphenoidal sinuses are already developed and in the 12-year-old the paranasal sinuses reach their final form and a size equivalent to the adult.     

A comparison of the craniofacial morphology in 2-month-old unoperated infants with unilateral complete cleft lip and palate, and unilateral incomplete cleft lip.

This paper reports a cephalometric analysis of the craniofacial morphology in infants with unoperated unilateral complete cleft lip and palate (UCCLP) and unoperated unilateral incomplete cleft lip (UICL). The purpose of the study was to determine the nature and extent of the craniofacial deviations in UCCLP as compared to the morphology in UICL, which has previously been shown to be close to normal. The samples comprised 82 infants with UCCLP (58 males and 24 females) and 75 with UICL (48 males and 27 females). The mean age was about 2 months in both groups. The cephalometric analysis of craniofacial morphology included the lateral, frontal, and axial projections. The data were presented as mean plots of the craniofacial region including the calvaria, cranial base, orbits, nasal bone, maxilla, mandible, cervical column, pharynx, and soft-tissue profile. The most pronounced deviations in the UCCLP group were observed in the maxillary complex and the mandible. The most striking findings were: markedly increased width of the maxilla, a short mandible, and bimaxillary retrognathia except for the premaxillary area, which was relatively protruding and asymmetric. The study did not support the hypothesis previously suggested in the literature that cleft lip and palate is a craniofacial anomaly as size and shape of the calvaria and cranial base were found to be normal. The etiology of cleft lip and palate is still incompletely understood. Based on the present study, we suggest that facial type may be a liability factor that could represent a developmental threshold increasing the probability of cleft lip and palate.     

现代各主要人群额骨3D几何形态的对比

额骨是连接面颅和脑颅的重要头骨组成部分,关于现代各个人种的额骨形态是否存在明显的差别,这些人种额骨的基本形态如何,变异范围以及与其他人群的相似与差异等问题都尚未完全厘清。而额骨的很多特征由于技术手段的限制很难进行测量和准确的描述比较。鉴于这些问题,本文将采用基于三维表面半标志点的几何形态测量方法,研究东亚现代人额骨的表面形态及其变异范围,并与欧洲,东南亚,美洲,非洲以及澳洲的现代人群的额骨形态进行对比,为对比不同人群的形态研究建立基础数据。结果显示,额骨形态的变异主要表现在:1)额骨鳞部的额结节和正中矢状脊共同向前隆起或回缩以及相对额骨宽度;2)眉弓的粗壮程度,额结节的侧向发育程度和正中矢状脊的发育情况。为了进一步揭示中国现代人与其他人群在额骨形态上的关系,本文还探讨了额骨大小在不同人群中的差异。结果显示,东亚现代人和欧洲现代人额骨中心大小值的中位数最大,澳洲现代人的最小。东亚现代人的额骨形态与澳洲,欧洲和非洲均有非常显著的差异。为了检验额骨的形态是否与遗传距离一致,作者还对额骨形态距离和遗传距离做了相关性分析。结果显示,不同人群的额骨形态与其遗传距离呈显著的相关性,说明本研究结果中不同人群额骨形态上的差异大小可以在一定程度上反映其遗传距离,并可能进一步反映人群历史。东亚现代人的额骨平均形态在与各个人群比较过程中表现出一致性特征,可能在一定程度上反映了东亚现代人群的进化过程是相对独立的。未来额骨的三维几何形态测量可通过扩大标本数量进一步探讨不同性别和不同演化阶段之间的差异。