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Case report
Submitted: 2023-12-19
Accepted: 2024-01-29
Published online: 2024-03-06
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Multiple coexisting variations of skull and cervical spine anatomy in a symptomatic patient – uncommon or uncommonly noticed? A CT–based case study.

Izabela Zamojska1, Joanna Jaworek-Troć1, Bartosz Kołodziejczyk1, Michał Zarzecki2, Przemysław Pękala1, Jerzy Andrzej Walocha1, Jarosław Zawiliński1, Marcin Lipski1
·
Pubmed: 38445513
Affiliations
  1. Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.
  2. Department of Neonatology and Neonatal Intensive Care, the Children’s Memorial Health Institute, Warsaw, Poland

open access

Ahead of Print
CASE REPORTS
Submitted: 2023-12-19
Accepted: 2024-01-29
Published online: 2024-03-06

Abstract

Introduction: Among many anatomical variations of the skull and cervical spine, some may be an underlying cause of a disease, while others remain clinically silent. The estimated individual prevalences of them differ, but given the available data it is impossible to clarify how frequently they coexist with each other. The following study presents an example of seven anomalies, amongst which at least few have manifested clinically in the examined patient. Case report: A 35 y.o. Polish woman who suffered from chronic sinusitis was subjected to a computed tomography scan. Mild thickening of the anterior ethmoidal cells’ mucosa, bilateral concha bullosa, paradoxical right middle turbinate, bilateral uncinate process pneumatization and arrested pneumatization of sphenoid sinus were found and addressed in context of the reported symptoms. Simultaneously other, clinically silent anatomical anomalies, were found – namely ossification of the anterior petroclinoid ligament, incomplete medial basal canal and bilateral arcuate foramen. Conclusion: To the best knowledge of the authors, this case report is the first to present such a coexistence of this many various anatomical anomalies, among which some played a crucial part in the chronic sinusitis experienced by the patient. Concurrence of multiple variations in the same anatomical area or functional unit may exacerbate clinical presentation of a patient. Identifying a single anomaly ought to warrant a thorough investigation into any other potentially existing variants.

Abstract

Introduction: Among many anatomical variations of the skull and cervical spine, some may be an underlying cause of a disease, while others remain clinically silent. The estimated individual prevalences of them differ, but given the available data it is impossible to clarify how frequently they coexist with each other. The following study presents an example of seven anomalies, amongst which at least few have manifested clinically in the examined patient. Case report: A 35 y.o. Polish woman who suffered from chronic sinusitis was subjected to a computed tomography scan. Mild thickening of the anterior ethmoidal cells’ mucosa, bilateral concha bullosa, paradoxical right middle turbinate, bilateral uncinate process pneumatization and arrested pneumatization of sphenoid sinus were found and addressed in context of the reported symptoms. Simultaneously other, clinically silent anatomical anomalies, were found – namely ossification of the anterior petroclinoid ligament, incomplete medial basal canal and bilateral arcuate foramen. Conclusion: To the best knowledge of the authors, this case report is the first to present such a coexistence of this many various anatomical anomalies, among which some played a crucial part in the chronic sinusitis experienced by the patient. Concurrence of multiple variations in the same anatomical area or functional unit may exacerbate clinical presentation of a patient. Identifying a single anomaly ought to warrant a thorough investigation into any other potentially existing variants.

Get Citation

Keywords

chronic sinusitis; concha bullosa; paradoxical middle turbinate; arrested pneumatization; anatomy; radiology

About this article
Title

Multiple coexisting variations of skull and cervical spine anatomy in a symptomatic patient – uncommon or uncommonly noticed? A CT–based case study.

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Case report

Published online

2024-03-06

Page views

108

Article views/downloads

70

DOI

10.5603/fm.98606

Pubmed

38445513

Keywords

chronic sinusitis
concha bullosa
paradoxical middle turbinate
arrested pneumatization
anatomy
radiology

Authors

Izabela Zamojska
Joanna Jaworek-Troć
Bartosz Kołodziejczyk
Michał Zarzecki
Przemysław Pękala
Jerzy Andrzej Walocha
Jarosław Zawiliński
Marcin Lipski

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