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Objectives: Endoscopic transnasal transsphenoidal approaches to lesions involving the clivus carry several disadvantages for midline skull base lesions, including higher morbidity and a lesser extent of resection. This study aimed to investigate the anatomical detail of the clivus in order to identify failure criteria and improve success parameters. Methods: Clivus length, width, thickness and area, opisthion–dorsum sellae length, dorsum sellae–basion angle, and foramen magnum length and width were evaluated on 32 adult dry human skulls using ImageJ. The prevalence of clivus shape, border type and surface type was also determined. Results: Mean clivus length was 3.52±0.37 cm in females and 3.25±0.63 cm in males, and clivus width was 1.42±0.50 cm and 1.41±0.57 cm, respectively. Among clivus types, the long-straight type had the greatest length (4.16±0.25 cm) and the short-sloped type the shortest (2.98±0.36 cm). The most common clivus shape was the short-sloped type (56.25%), the most frequent border type was inward-curved (40.6%), and the most common surface type was concave (56.25%). An asymmetric shape was observed in 31.25% of specimens, an irregular surface in 25%, and asymmetric borders in 31.3%. Foramen magnum length was significantly greater in males (p<0.001). Conclusion: The long-straight clivus appears most suitable for transnasal/transclival access and tumour resection, whereas asymmetric types require careful preoperative evaluation. The symmetric border type showed a regular and balanced morphology, providing a consistent bony boundary that may aid intraoperative orientation.

Background: This study aimed to evaluate the educational value of scenario-based anatomy training using patient-specific three-dimensional models of internal carotid artery (ICA) anatomical patterns. Methods: A total of 120 first-year medical students were assigned to either traditional instruction or scenario-based learning supported by interactive 3D simulators. The training included visualization of ICA configurations such as straight, tortuous, kinking, and coiling patterns using computed tomography angiography data. Students were assessed before and after training using structured questionnaires evaluating anatomical understanding, usability, engagement, clinical relevance, and learning outcomes. Results: The scenario-based group demonstrated statistically significant improvements across all domains ( p < 0.01–0.001). Anatomical understanding increased from 3.26 ± 0.92 to 4.50 ± 0.78, while clinical relevance improved from 3.12 ± 0.66 to 4.52 ± 0.64. Engagement scores rose from 3.32 ± 0.88 to 4.45 ± 0.70. The overall experience score was higher in the simulation group (4.62 ± 0.64) compared to the traditional group (3.50 ± 0.68). Conclusion: Scenario-based 3D simulation enhances clinical anatomy learning, supports spatial understanding, and improves diagnostic reasoning skills, offering a more effective alternative to traditional teaching methods.

Background and Objectives: Knee osteoarthritis (OA) is a prevalent musculoskeletal disorder. This study aims to assess the hip-knee-ankle anatomical alignment in patients with OA at different stages. Materials and Methods: Radiological images of 200 OA patients were analyzed to measure parameters such as femoral and tibial lengths (both anatomical and mechanical), abductor length, hip center length, femoral offset, collum femoris length, and shaft angle using ImageJ software (version 1.53k; National Institutes of Health, Bethesda, MD, USA). Results: The female-to-male ratio was 2.17:1. Male participants exhibited greater values for femoral and tibial lengths, abductor length, hip center length, femoral offset, collum femoris length, and collum femoris shaft angle, whereas females showed higher Q angle, hip–knee–ankle angle, mechanical lateral distal femoral angle, mechanical medial proximal tibial angle, and femoral angle measurements. Significant differences in both linear and angular parameters were observed among age groups. Q angle, hip–knee–ankle angle, femoral mechanical axis shaft angle, plateau angle, and ankle tilt angle values were significantly higher in individuals aged 62–75 years. According to Kellgren–Lawrence staging, significant increases were observed in Q angle, hip–knee–ankle angle, femoral mechanical axis shaft angle, plateau angle, and ankle tilt angle in advanced-stage disease (Stage 4) (p < 0.05). Although mechanical lateral distal femoral angle, femoral Q angle, tibial Q angle, condylar plateau angle, and tibiotalar angle showed numerical differences across disease stages, these findings did not reach statistical significance. Conclusions: Comprehensive assessment of lower-extremity alignment may provide complementary information regarding biomechanical changes associated with knee osteoarthritis progression and could support individualized clinical follow-up and treatment planning.

Background Epidural procedures have a steep learning curve and may raise patient-safety concerns during early anesthesiology training. We evaluated whether a low-cost, three-dimensional (3D) simulation model improves early procedural success and efficiency in novice trainees. Methods In this prospective randomized controlled study, 36 anesthesia residents were randomized into two groups. Group A received hands-on training on a 3D simulation model plus audiovisual teaching, whereas Group B received audiovisual teaching only. Performance was assessed at baseline (0 h), 3 h, and 6 h using procedural success, a checklist score, and a global rating scale; procedure time was recorded. Results Baseline success was comparable between groups. At 3 h and 6 h, Group A demonstrated a marked improvement, reaching a success rate of 94.4% at 6 h compared with 50.0% in Group B. Checklist scores did not differ at baseline (p = 0.888) but were significantly higher in Group A at 3 h and 6 h (both p < 0.001). Procedure time decreased significantly in Group A (from 149 ± 24 s to 107 ± 26 s, p < 0.001) versus a limited reduction in Group B (from 148 ± 26 s to 142 ± 22 s, p = 0.001). The model was inexpensive and feasible to produce (~ 6 h printing time; total cost ~$11.50/model). Conclusion Low-cost 3D model–assisted training improved short-term simulator-based epidural performance, checklist scores, GRS scores, and procedural efficiency among novice anesthesiology residents. These findings support the use of 3D printed models as an accessible hands-on adjunct to conventional audiovisual epidural anesthesia training. Further studies are needed to determine whether these improvements translate into long-term retention, clinical performance and patient outcomes.

The piriform aperture (PA) is a critical anatomical structure that forms the bony framework of the nasal inlet and influences nasal airway patency and support of the nasal base. This study aimed to present detailed morphometric and morphological data on the PA to contribute to the surgical anatomy of PA enlargement. Seventy adult crania (female, n = 34; male, n = 36) were included. Using standardized digital images, PA length, PA width, related craniometric distances, and planimetric area were measured with ImageJ software. PA morphology was classified into six types. PA length was 4.71 ± 0.67 cm in females and 5.54 ± 0.50 cm in males; PA width was 3.52 ± 0.39 cm in females and 3.80 ± 0.35 cm in males. PA area was 12.61 ± 2.77 cm² in females and 15.99 ± 2.82 cm² in males. PA length, width, width at the level of the infraorbital foramen, the nasion-anterior nasal spine distance, inter-infraorbital distance, rhinion-right/left infraorbital foramen distances, and PA area were significantly higher in males. Regarding morphological type distribution, the pear type was most frequent (42.86%), followed by inverted heart (21.43%), round (12.86%), teardrop (10%), and oval (8.6%). PA length in the round type was lower than in the pear/oval/teardrop types, whereas PA area in the oval type was higher than in the round type. PA morphometry demonstrates marked sexual dimorphism. In males, PA length was approximately 18% greater and PA area approximately 27% greater, reflecting the combined effect of increased length and width.

Background and Objectives: The association between spinal and pelvic alignment significantly impacts sagittal balance in adults. This study, that is retrospective, aims to investigate sagittal alignment anatomy of the pelvis and spine in juvenile idiopathic scoliosis (JIS) and adolescent idiopathic scoliosis (AIS) patients. Materials and Methods: We evaluated nine sagittal parameters from lateral radiographs of 100 JIS and AIS patients, including thoracic kyphosis (TKA), lumbar lordosis (LLA), pelvic tilt (PTA), pelvic incidence (PIA), spinosacral (SSA), sacral slope (SSLA), C7 tilt angles (C7-TA), sagittal vertical axis length (SVAL), and odontoid process hip axis angle (OPHAA) using the ImageJ program. Participants were classified based on their coronal curve group. Analysis of variance compared parameters between curve groups, and Pearson coefficients assessed the relationship between all parameters (p < 0.05). Results: Female participants had an average age of 13.4, and male participants had an average age of 13.0. Female participants had an average scoliosis degree of 19.3, while male participants had 15.2. PIA, PTA, SSLA, and SSA values were significantly higher in women participants than in men participants (p < 0.05). Additionally, PIA, PTA, SSLA, SSA, and OPHAA values were significantly lower in participants with a lower scoliosis degree (p < 0.05). We observed a moderately positive association between LLA and TKA, PIA, SSA, and C7-TA. There was also a moderate positive association between spinopelvic alignment parameters and the degree of scoliosis in participants. Conclusions: Easily measured values such as PIA, PTA, SSLA, SSA, and OPHAA may be related to severity of vertebral column deformities in patients, making them valuable for monitoring scoliosis patients.

Purpose: This study aimed to evaluate multiple anatomical and morphological factors influencing the localization of the sphenoid sinus ostium (SSO) to improve surgical safety in endoscopic sinus surgery. Methods: Computed tomography (CT) images of 302 subjects were examined. The vertical and horizontal positions of the SSO were assessed using standardized reference lines on sagittal and axial sections. Pneumatization patterns were classified on sagittal and coronal planes. Rostrum pneumatization and the presence of Onodi cells were also evaluated. Morphometric measurements and potential influencing factors were analyzed using logistic and linear regression models. Results: The SSO was most frequently located in the superior (72.8%) and medial (55.6%) thirds. The female gender increased the likelihood of medial ostium localization by 2.715-fold. Compared to the sellar type, conchal pneumatization increased the probability of medial positioning by 9.82-fold, while the postsellar type reduced it (OR: 0.208). The postrotundum type was strongly associated with superior and medial localizations (OR: 3.289 and OR: 2.978, respectively). A wider sphenoid rostrum reduced the probability of medial localization, whereas rostrum pneumatization promoted superior displacement of the SSO. Onodi cells and increased sinus height shifted the SSO inferiorly by 1.929 and 0.341 units, respectively. Conclusions: The localization of the SSO was found to be significantly influenced by gender, sphenoid sinus pneumatization patterns, rostrum morphology, and the presence of Onodi cells. Careful preoperative evaluation of CT images for these factors may provide valuable insights for surgeons and help minimize the risk of serious complications during endoscopic sinus surgery.

Managing adult degenerative/de novo scoliosis patients presents challenges due to the unique characteristics of each deformity, the complexity of classification. The rotation or translation of vertebrae can lead to the displacement of surrounding vital structures, narrowing the safe zones for pedicle screw insertion. This study evaluates the effectiveness of 3-dimensional (3D) scoliotic models in orthopedic training, specifically for teaching pedicle screw placement in scoliosis surgery. The goal is to validate the efficacy of a 3D model-navigated training system. Twenty life-sized 3D models of de novo scoliotic lumbar deformity were utilized by 20 residency trainees, categorized based on their years of experience: those with <3 years and those with 3 years or more. Each trainee practiced pedicle screw placement across 5 lumbar levels. Their performance was assessed through postinstrumentation CT scans for accuracy and detection of screw malpositions. Instances of screw malposition and breaches of the pedicle’s medial and lateral walls were recorded. The distribution of total cortical and critical penetrations was analyzed based on years of experience and lumbar levels. The training significantly enhanced the speed and accuracy of pedicle screw placement, reducing the incidence of errors. Trainees with less than 3 years of experience were 6 times more likely to misplace screws, particularly at higher levels of lumbar deformity. The average time to complete the simulation was approximately 34 minutes, with a 77.5% accuracy rate for screw placement. Odds ratios indicated that less experience increased the risk of critical cortex penetration 6-fold, and screw placement at the level of deformity increased the risk of poor placement by 4.7 times. The use of 3D models in surgical training enables residents to safely gain practical experience, highlighting potential for broader application in complex orthopedic procedures. This training system supports increasing task complexity and enhancing performance in actual surgical settings.

Purpose Understanding gender-based foot morphological differences is critical for ergonomic footwear design. This study investigated these variations in young adults using photogrammetric and plantar pressure analysis. Methods We analyzed 200 healthy participants (100 males, 100 females; aged 19–21 years) through digital photogrammetry and RSscan Footscan pressure mapping. Key parameters included foot length (FL), ball width (BWF), hallux valgus angle (HVd), lateral foot angle (LdF), and Clarke’s Index for arch classification. Plantar pressure distribution was assessed across 10 anatomical zones. Results We revealed significant gender disparities: males had longer (26.6 vs. 25.2 cm) and wider feet (10.2 vs. 9.1 cm), while 75% of participants exhibited HVd (5.1°–6.3°), with no gender difference. Dynamic Clarke’s Index showed 80% had high arches, correlating with lower BMI (p < 0.001). Pressure analysis highlighted higher midfoot loading (37.8–41.2 cm²) and medial forefoot pressure in HVd cases. Females predominantly wore smaller shoes (sizes 36–38), whereas 89% of males wore sizes 42–44. BMI influenced midfoot pressure (r = 0.3) and arch height, with flat arches linked to higher BMI. Foot asymmetry (38%) and HVd prevalence underscored the need for gender-specific shoe designs. Conclusion It emphasize prioritizing ergonomic footwear to mitigate pressure imbalances, HVd progression, and asymmetry, particularly in high-BMI individuals. This dual-method approach provides actionable insights for biomechanical applications and footwear customization.

Background Anatomical variations of the aorta-celiac trunk are highly relevant in abdominal surgery and interventional radiology. Traditional CT-A images may fall short in conveying these complex structures. This study investigates whether patient-specific 3D models can enhance resident-level understanding of aorta–celiac trunk anatomy and support surgical education. Methods In this study, CT-A images of 1,000 adults aged between 18 and 60 were evaluated. Celiac trunk patterns were classified into eight types, and 3D solid models were created for each. In this study, seven residents were presented with eight stations, each showcasing an aorta-celiac trunk pattern in both CT-A and 1:1 scale solid model formats. The participants were asked to assess each format individually, identifying the variations, describing structural characteristics, and evaluating their educational value. Results The vascular origin measurement values, when compared to the actual anatomical values of the corresponding cases, showed that the models were 1:1 identical replicas. According to the survey results, although 85.71% of the residents were aware of 3D printing and anatomical models, they lacked knowledge about the computer programs used to create these models. All residents agreed that the aorta-celiac trunk models enhanced their understanding of the vascular source and improved pattern recognition when compared to conventional cross-sectional CT-A imaging. Eight carousel-based stations provided qualitative assessments, with results showing the usefulness of celiac trunk models when used as anatomical tools for detecting pattern type (p = 0.018), determining the number of branches of the celiac trunk (p = 0.026), visualizing celiac trunk variations more clearly (p = 0.017), clearly observing the diameters of branches arising from the celiac trunk (p = 0.043), understanding the presence of variations in the celiac trunk (p = 0.018), and effectively explaining celiac trunk variations to residents (p = 0.018). Across all cases, participants’ scores for understanding anatomical variations were significantly higher when using the 3D model; moreover, residents judged the 3D models to be substantially more useful than conventional twodimensional CTangiography slices for studying the celiac trunk. Conclusion 3D aorta-celiac trunk models can improve anatomy education by offering tangible, high-fidelity representations that enhance visuospatial understanding. These models provide clear, demonstrative feedback, allowing learners to accurately grasp complex anatomical relationships. Specifically, the plastic-like material used to replicate celiac trunk vascular structures enables precise visualization of the origin, branching patterns, shapes, and angles—facilitating a well-structured and spatially coherent learning experience.