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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.
, 1, 2, 1, 1, 1, 1
Affiliations- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.
- Department of Neonatology and Neonatal Intensive Care, the Children’s Memorial Health Institute, Warsaw, Poland
open access
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.
Keywords
chronic sinusitis; concha bullosa; paradoxical middle turbinate; arrested pneumatization; anatomy; radiology
About this articleTitle
Multiple coexisting variations of skull and cervical spine anatomy in a symptomatic patient – uncommon or uncommonly noticed? A CT–based case study.
Journal
Issue
Article type
Case report
Published online
2024-03-06
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121
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80
DOI
Pubmed
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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