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Pneumatized Crista Galli: A Histopathologic Study
Marcel Marjanovic Kavanagh1, Tomislav Tokic1, Antonia Jakovcevic2
1Department of ENT-Head and Neck Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
Insights
This histopathologic study found a low incidence of pneumatized crista galli (4.59%). All identified cases showed chronic inflammation, suggesting clinical importance.
Area of Science:
- Anatomy
- Pathology
- Histopathology
Background:
- The pneumatized crista galli is a rare anatomical variation.
- Previous studies on its incidence primarily used radiologic methods.
Purpose of the Study:
- To determine the incidence of pneumatized crista galli using histopathologic analysis.
- To investigate the association between pneumatized crista galli and chronic inflammation.
Main Methods:
- Prospective histopathologic study of 109 postmortem crista galli specimens.
- Specimens were analyzed using light microscopy after standard histological processing.
- Pneumatization was defined by the presence of mucosa within the crista galli cavity.
Main Results:
- Pneumatized crista galli was identified in 4.59% (5/109) of the specimens.
- Chronic inflammation was present in 100% (5/5) of the pneumatized crista galli cases.
- The observed incidence is lower than reported in most previous radiologic studies.
Conclusions:
- The histopathologic incidence of pneumatized crista galli is lower than previously suggested by radiologic studies.
- A high association between pneumatized crista galli and chronic inflammation was observed.
- Further research with larger sample sizes is recommended to generalize findings.
Objective:
This is the first histopathologic study that investigates the incidence of the pneumatized crista galli.
Study Design:
A prospective histopathologic study.
Setting:
Tertiary academic medical center.
Subjects And Methods:
A total of 109 specimens of crista galli were obtained postmortem during 2018 from randomly chosen patients who died at the University Hospital Centre Zagreb and had an autopsy at our Department of Pathology and Cytology. Specimens were surgically resected during the autopsy and then fixed, decalcinated, dehydrated, and embedded in paraffin. All slides were cut into 5-µm-thin sections and stained with a standard method (hematoxylin and eosin) for light microscope analysis. Specimens were histopathologically analyzed for the existence of pneumatization inside crista galli. The criterion to declare a specimen pneumatized was the presence of mucosa inside the cavity.
Results:
Pneumatized crista galli was found in 5 of 109 specimens (4.59%). In 5 of 5 cases (100%) of pneumatized crista galli, there was evidence of chronic inflammation.
Conclusion:
We found that the incidence of pneumatized crista galli is significantly lower in our histopathologic study in comparison with the majority of previous radiologic studies. Our study also found that all 5 specimens with pneumatized crista galli had chronic inflammation in the mucosa, which is a considerably higher incidence than in the previous studies (7.7%-44%). Due to the emerging evidence of pneumatized crista galli being of clinical importance, we suggest that a larger study be conducted before the results are generalized to the general population.
