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A new golden ratio for foramen magnum in pre- and post-adolescent children
Ramazan Dulkadir1, Tufan Ulcay2, Özkan Görgülü3
1Faculty of Medicine, Department of Pediatrics, Kirsehir Ahi Evran University, Bağbaşı Campus, Kırşehir, Turkey. drrdulkadir40@hotmail.com.
Insights
This study found a consistent skull-to-foramen magnum ratio in children, suggesting anatomical balance. Different foramen magnum shapes were identified, with implications for understanding the golden ratio in pediatric skulls.
Area of Science:
- Anatomy
- Anthropology
- Radiology
Background:
- The foramen magnum (FM) is a critical skull-spine junction, largely developed by age four.
- Adult studies suggest a golden ratio alignment between skull and FM diameters.
- The presence of this ratio in children and its relation to FM shape remain uninvestigated.
Purpose of the Study:
- To determine if the golden ratio-like skull-to-FM diameter ratio exists in children.
- To analyze the influence of foramen magnum shape variations on this ratio.
- To identify and classify foramen magnum shapes in a pediatric population.
Main Methods:
- Computed Tomography (CT) images of 201 Turkish children (aged 6-17) were analyzed.
- Measurements included maximum cranial length (MCL), width (MCW), foramen magnum length (FML), and width (FMW).
- Statistical analyses included Independent t-test, ANOVA, Pearson correlation, and Chi-Square tests.
Main Results:
- Consistent ratios of MCW/FMW and MCL/FML (approximately 4.90) were observed in children, indicating skull-FM anatomical balance.
- Twelve distinct foramen magnum shapes were identified, with the "two semicircle" shape being most common (32.8%).
- Pentagonal and triangular FM shapes were the rarest (0.5% each).
Conclusions:
- A distinct anatomical balance exists between the skull and foramen magnum in children.
- The identified ratios in children differ slightly from the adult golden ratio.
- Further research correlating these ratios with specific FM shapes may clarify the golden ratio's validity in pediatric anatomy.
Abstract:
The foramen magnum (FM) is a crucial transition zone between the skull and spine, with its growth mostly completed by the end of the age of four. A study on adults reported that the ratio of the anteroposterior to transverse diameter of the FM and skull aligns with the golden ratio (4.62), suggesting a harmonious relationship. Our study aims to investigate whether this ratio is present in children by analyzing Computed Tomography (CT) images, and whether FM shape variations affect this ratio. We analyzed CT images of 201 Turkish children (male: 117, female: 84), measuring maximum cranial length (MCL), width (MCW), foramen magnum length (FML), and width (FMW). Group comparisons were made using the Independent t-test and ANOVA. Relationships between continuous variables were examined using Pearson correlation analysis. Ratios of MCW to FMW and MCL to FML were consistent in children aged 6-17. The ratio of 4.90 obtained from these parameters observed between the skull and FM reveals the presence of a unique anatomical balance in the skull. FM shapes were classified morphologically, with their frequency and incidence recorded. For categorical variables, associations were analyzed using the Chi-Square test. A total of 12 distinct FM shapes were identified, with the two semicircle shape being the most prevalent, appearing in 32.8% of cases. In contrast, the pentagonal and triangular shapes were the rarest, each representing only 0.5% of the cases. Recalculating these ratios across different FM shapes may provide a clearer understanding of the validity of the golden ratio.

