The Frequency of Occipital Spurs in Relation to the Cephalic Index: An Anatomorphometric Cone Beam CT Study

Abstract

Background: The occipital spur (OS) can be described as an abnormal elongation of the external occipital protuberance (EOP). The cephalic index (CI) refers to the ratio of width to length in any skull. Aim: The aim of the present study was to evaluate the frequency and types of OS. It also aimed to determine the mean CI and the distribution of skull types using cone beam computed tomography (CBCT). And to determine if there was a relationship between the cephalic index and the presence and types of OS. Methods: CBCT scans from 523 patients were included in the study. OSs were classified as type 1 (flat), type 2 (crest), and type 3 (spine). Skull length and width were measured on axial sections and the CI was calculated. Based on the cephalic index (CI), skull types were classified as dolichocephalic (CI < 75), mesocephalic (75 < CI < 80), brachycephalic (80 < CI < 85), and hyperbrachycephalic (CI > 85). Results: The most common cranial types in the study group were brachycephalic (44.7%), mesocephalic (28.3%), hyperbrachycephalic (21.2%), and dolichocephalic (5.7%). Regarding the presence of OS, 54.3% of the participants had no OS, 23.1% had flat type, 15.3% had crest type, and 7.2% had spin type OS. There was a statistically significant difference (P < 0.05) in the frequency of OS according to skull type. Conclusion: This study, the first to evaluate CI and OS using CBCT, concludes that brachycephaly is the most common cranial type. OS is more common in mesocephalic and dolichocephalic skulls, at older ages, and in males.