-
Journal of Neurosurgery. Pediatrics Apr 2022Variables that can predict outcomes in patients with craniosynostosis, including bone thickness, are important for surgical decision-making, yet are incompletely...
Parietal bone thickness for predicting operative transfusion and blood loss in patients undergoing spring-mediated cranioplasty for nonsyndromic sagittal craniosynostosis.
OBJECTIVE
Variables that can predict outcomes in patients with craniosynostosis, including bone thickness, are important for surgical decision-making, yet are incompletely understood. Recent studies have demonstrated relative risks and benefits of surgical techniques for correcting head shape in patients with nonsyndromic sagittal craniosynostosis. The purpose of this study was to characterize the relationships between parietal bone thickness and perioperative outcomes in patients who underwent spring-mediated cranioplasty (SMC) for nonsyndromic sagittal craniosynostosis.
METHODS
Patients who underwent craniectomy and SMC for nonsyndromic sagittal craniosynostosis at a quaternary pediatric hospital between 2011 and 2021 were included. Parietal bone thickness was determined on patient preoperative CT at 27 suture-related points: at the suture line and at 0.5 cm, 1.0 cm, 1.5 cm, and 2.0 cm from the suture at the anterior parietal, midparietal, and posterior parietal bones. Preoperative skull thickness was compared with intraoperative blood loss, need for intraoperative transfusion, and hospital length of stay (LOS).
RESULTS
Overall, 124 patients with a mean age at surgery ± SD of 3.59 ± 0.87 months and mean parietal bone thickness of 1.83 ± 0.38 mm were included in this study. Estimated blood loss (EBL) and EBL per kilogram were associated with parietal bone thickness 0.5 cm (ρ = 0.376, p < 0.001 and ρ = 0.331, p = 0.004; respectively) and 1.0 cm (ρ = 0.324, p = 0.007 and ρ = 0.245, p = 0.033; respectively) from the suture line. Patients with a thicker parietal bone 0.5 cm (OR 18.08, p = 0.007), 1.0 cm (OR 7.16, p = 0.031), and 1.5 cm (OR 7.24, p = 0.046) from the suture line were significantly more likely to have undergone transfusion when controlling for age, sex, and race. Additionally, parietal bone thickness was associated with hospital LOS (β 0.575, p = 0.019) when controlling for age, sex, and race. Patient age at the time of surgery was not independently associated with these perioperative outcomes.
CONCLUSIONS
Parietal bone thickness, but not age at the time of surgery, may predict perioperative outcomes including transfusion, EBL, and LOS. The need for transfusion and EBL were most significant for parietal bone thickness 0.5 cm to 1.5 cm from the suture line, within the anticipated area of suturectomy. For patients undergoing craniofacial surgery, parietal bone thickness may have important implications for anticipating the need for intraoperative transfusion and hospital LOS.
Topics: Blood Loss, Surgical; Child; Craniosynostoses; Craniotomy; Humans; Infant; Parietal Bone; Postoperative Complications; Retrospective Studies; Skull; Treatment Outcome
PubMed: 35090136
DOI: 10.3171/2021.12.PEDS21541 -
Skeletal Radiology Aug 2021Osteosarcoma is the most common primary bone tumor and usually involves the long bones. Osteosarcoma of the skull, on the other hand, is relatively rare. Here, we...
Osteosarcoma is the most common primary bone tumor and usually involves the long bones. Osteosarcoma of the skull, on the other hand, is relatively rare. Here, we present a 29-year-old man with a growing mass in the skull he first noticed after a fall while skateboarding. The initial clinical diagnosis was hematoma. While undergoing an evacuation surgery for a hematoma, a suspicious mass was detected which was biopsied. Histopathological evaluation showed high-grade osteosarcoma. The patient was referred to our hospital where he underwent definitive resection followed by adjuvant chemotherapy. His course was complicated by wound infection. Even though osteosarcoma of the skull is a rare finding, it should be suspected in a patient with a skull mass, and the history of prior head trauma does not exclude the diagnosis.
Topics: Adult; Bone Neoplasms; Humans; Male; Osteosarcoma; Parietal Bone; Sarcoma; Skull Neoplasms
PubMed: 33604706
DOI: 10.1007/s00256-021-03726-7 -
Child's Nervous System : ChNS :... Mar 2000Intraosseous neurinoma is very uncommon tumor. Its location in the skull is extremely rare. A 4-year-old boy presented with a lump in the right occipital region.... (Review)
Review
Intraosseous neurinoma is very uncommon tumor. Its location in the skull is extremely rare. A 4-year-old boy presented with a lump in the right occipital region. Computed tomography revealed a soft tissue mass with bony erosion in the right occipital bone. The solid, nontender, and immobile mass was totally removed. The pathological examination showed that it was an intraosseous neurinoma. Total resection of intraosseous neurinomas is sufficient treatment and is not followed by recurrence.
Topics: Child, Preschool; Humans; Magnetic Resonance Imaging; Male; Neurilemmoma; Parietal Bone; Skull Neoplasms; Tomography, X-Ray Computed
PubMed: 10804055
DOI: 10.1007/s003810050490 -
World Journal of Surgical Oncology May 2015A benign fibrous histiocytoma with primary site of origin in the parietal bone has not yet been reported in the literature. We report here a case concerning a... (Review)
Review
A benign fibrous histiocytoma with primary site of origin in the parietal bone has not yet been reported in the literature. We report here a case concerning a 12-year-old girl with a 14-month history of an enlarging parietal bone mass. The tumor was excised after removal of the cortical bone and resection of the tumor surrounding the cortical bone erosion using pre-plasticity titanium repair. Both postoperative histopathological examination and immunohistochemical analysis were consistent with a benign fibrous histiocytoma. No clinical or computed tomography (CT) radiological signs of tumor recurrence and/or metastasis were observed at 12 months. Although a primary benign fibrous histiocytoma of the parietal bone is a rare tumor, it should be considered as a potential diagnosis for any cranial tumor. Surgical intervention is the most effective treatment technique for a benign fibrous histiocytoma.
Topics: Child; Female; Histiocytoma, Benign Fibrous; Humans; Parietal Bone; Skull Neoplasms; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 25951848
DOI: 10.1186/s12957-015-0587-5 -
The Pan African Medical Journal 2020Osteoblastoma is an uncommon primary bone tumor. Its occurrence in the cranial vault is extremely rare. We here report our first case of right parietal bone...
Osteoblastoma is an uncommon primary bone tumor. Its occurrence in the cranial vault is extremely rare. We here report our first case of right parietal bone osteoblastoma in a 46-year old woman with a history of benign cranial traumas. She reported progressive painful, non-inflammatory right parietal bone swelling. Craniocerebral CT scan showed hyperdense bone lesion with sparing of the internal table of the right parietal bone. The patient first underwent biopsy, then complete resection of the bone lesion with methyl-methacrylic cement cranioplasty. The postoperative course was uneventful. Anatomopathological examination showed osteoblastoma with no sign of malignancy. This study and literature review highlight the clinical manifestation, the radiological and anatomopathological features as well as the management of osteoblastoma of the parietal bone of the cranial vault.
Topics: Bone Neoplasms; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Multimodal Imaging; Osteoblastoma; Parietal Bone; Radiography; Skull; Skull Neoplasms; Tomography, X-Ray Computed
PubMed: 32874424
DOI: 10.11604/pamj.2020.36.160.16031 -
Anatomical Record (Hoboken, N.J. : 2007) Jul 2016Cranial bone thickness varies among modern humans, and many factors influencing this variability remain unclear. Growth hormones and physical activity are thought to...
Cranial bone thickness varies among modern humans, and many factors influencing this variability remain unclear. Growth hormones and physical activity are thought to influence the vault thickness. Considering that both systemic factors and energy supply influence the vascular system, and taking into account the structural and biomechanical interaction between endocranial vessels and vault bones, in this study we evaluate the correlation between vascular and bone diameters. In particular, we tested the relationship between the thickness of the parietal bone (which is characterized, in modern humans, by a complex vascular network) and the lumen size of the middle meningeal and diploic vessels, in adult modern humans. Our results show no patent correlation between the thickness of parietal bone and the size of the main vascular channels. Values and distributions of the branching patterns, as well as anatomical relationships between vessels and bones, are also described in order to provide information concerning the arrangement of the endocranial vascular morphology. This information is relevant in both evolutionary and medical contexts. Anat Rec, 299:888-896, 2016. © 2016 Wiley Periodicals, Inc.
Topics: Adult; Biological Evolution; Cerebral Arteries; Female; Fossils; Humans; Male; Parietal Bone; Skull
PubMed: 27072555
DOI: 10.1002/ar.23348 -
Clinical Oral Implants Research Apr 2005Particulate parietal bone is used for maxillary sinus floor elevation procedure prior to dental implant placement. However, data on internal structure of the parietal...
Particulate parietal bone is used for maxillary sinus floor elevation procedure prior to dental implant placement. However, data on internal structure of the parietal bone and on graft remodeling and incorporation in the host bone are limited. We determined the structure and remodeling activities of 24 parietal bone specimens sampled at time of sinus grafting (T1 samples), and the amount and turnover of bone formed at the recipient site at time of implant placement (T2 samples, obtained 10 months after T1 samples, on average). In T1 samples, the outer cortex was 1.16+/-0.45 mm thick, had a typical haversian structure, and showed a low level of remodeling. In the cancellous portion of the samples, trabecular bone volume represented 52.8+/-10.3%. Bone remodeling was more active in the cancellous portion than in the cortical portion, but few osteoblasts and osteoclasts were seen. T2 samples consisted solely of trabecular bone, which occupied 49.4+/-18.4% of total sample volume. The boundary between new bone and the recipient bed was not discernible. Remnants of the graft particles were embedded within new bone, and showed signs of intense resorption. Bone remodeling was highly active, as shown by the presence of numerous osteoclasts resorbing new bone, together with thick osteoid seams and large osteoblasts. A loose cotton-like mineralized material was frequently observed in the marrow spaces; this acellular and non-collagenous material was strongly stained by toluidine blue, suggesting a glycoprotein nature. This study offers insights into cortical and trabecular bone structure and shows the low-level remodeling activity of parietal bone. About 10 months after grafting, the grafted chips were incorporated in new bone and almost completely resorbed. This high turnover may be beneficial for implant placement.
Topics: Adult; Aged; Bone Remodeling; Bone Transplantation; Female; Humans; Male; Maxillary Sinus; Middle Aged; Parietal Bone
PubMed: 15777335
DOI: 10.1111/j.1600-0501.2004.01102.x -
The Journal of Craniofacial Surgery Jan 2011Supernumerary cranial sutures represent a rare cause of plagiocephaly. In the case of an extra suture dividing the parietal bone, the presenting features are often...
Supernumerary cranial sutures represent a rare cause of plagiocephaly. In the case of an extra suture dividing the parietal bone, the presenting features are often inconsistent with the typical presentation of deformational or synostotic plagiocephaly. Disagreement exists as to how the presence of this suture affects the shape of the skull. We present a case of a supernumerary suture in the parietal bone leading to plagiocephaly and discuss the role this suture plays in cranial growth.
Topics: Female; Humans; Infant; Parietal Bone; Plagiocephaly, Nonsynostotic; Tomography, X-Ray Computed
PubMed: 21239935
DOI: 10.1097/SCS.0b013e3181f7e151 -
PloS One 2015Bone formation and skeletal repair are dynamic processes involving a fine-tuned balance between osteoblast proliferation and differentiation orchestrated by multiple...
Enhanced Activation of Canonical Wnt Signaling Confers Mesoderm-Derived Parietal Bone with Similar Osteogenic and Skeletal Healing Capacity to Neural Crest-Derived Frontal Bone.
Bone formation and skeletal repair are dynamic processes involving a fine-tuned balance between osteoblast proliferation and differentiation orchestrated by multiple signaling pathways. Canonical Wnt (cWnt) signaling is known to playing a key role in these processes. In the current study, using a transgenic mouse model with targeted disruption of axin2, a negative regulator of cWnt signaling, we investigated the impact of enhanced activation of cWnt signaling on the osteogenic capacity and skeletal repair. Specifically, we looked at two calvarial bones of different embryonic tissue origin: the neural crest-derived frontal bone and the mesoderm-derived parietal bone, and we investigated the proliferation and apoptotic activity of frontal and parietal bones and derived osteoblasts. We found dramatic differences in cell proliferation and apoptotic activity between Axin2-/- and wild type calvarial bones, with Axin2-/- showing increased proliferative activity and reduced levels of apoptosis. Furthermore, we compared osteoblast differentiation and bone regeneration in Axin2-/- and wild type neural crest-derived frontal and mesoderm-derived parietal bones, respectively. Our results demonstrate a significant increase either in osteoblast differentiation or bone regeneration in Axin2-/- mice as compared to wild type, with Axin2-/- parietal bone and derived osteoblasts displaying a "neural crest-derived frontal bone-like" profile, which is typically characterized by higher osteogenic capacity and skeletal repair than parietal bone. Taken together, our results strongly suggest that enhanced activation of cWnt signaling increases the skeletal potential of a calvarial bone of mesoderm origin, such as the parietial bone to a degree similar to that of a neural crest origin bone, like the frontal bone. Thus, providing further evidence for the central role played by the cWnt signaling in osteogenesis and skeletal-bone regeneration.
Topics: Animals; Axin Protein; Bone Regeneration; Fracture Healing; Frontal Bone; Mesoderm; Mice; Mice, Knockout; Neural Crest; Osteogenesis; Parietal Bone; Signal Transduction; Wnt Proteins
PubMed: 26431534
DOI: 10.1371/journal.pone.0138059 -
Child's Nervous System : ChNS :... Apr 2013Enlarged parietal foramina are variable ossification defects in the parietal bones that present as symmetric radiolucencies on skull radiographs. In contrast to the... (Review)
Review
INTRODUCTION
Enlarged parietal foramina are variable ossification defects in the parietal bones that present as symmetric radiolucencies on skull radiographs. In contrast to the normal small parietal foramina, enlarged parietal foramina are a hereditary condition and genes associated with it have been identified.
METHODS
A literature review was performed to discuss the many known findings related to enlarged parietal foramina.
CONCLUSIONS
Even though they remain asymptomatic in the majority of cases, they may be associated with other pathologies and occasionally become symptomatic. This article provides a comprehensive review of the current knowledge of enlarged parietal foramina.
Topics: Encephalocele; Humans; Parietal Bone; Prognosis; Radiography
PubMed: 23207976
DOI: 10.1007/s00381-012-1982-7