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Evaluating the manubrium sterni as a site for bone implantation: a 3D radiological feasibility study
Max Johannes Dullaart1,2, Maarten Jan Antony van Alphen3, Annelieke Boudina Schoen4
1Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands. m.dullaart@nki.nl.
European Radiology Experimental
|December 3, 2025
Summary
The manubrium sterni bone shows potential as an implantation site for hands-free speaking valves after total laryngectomy. Radiological assessment indicates suitability, but individual anatomy must be evaluated before implantation.
Area of Science:
- Anatomy and surgical reconstruction
- Medical imaging and diagnostics
- Head and neck surgery
Background:
- Total laryngectomy necessitates alternative voice restoration methods.
- Hands-free speaking valves require stable fixation.
- The manubrium sterni bone (MSB) is explored as a novel implantation site.
Purpose of the Study:
- To assess the morphometric and densitometric viability of the manubrium sterni bone (MSB) for bone implantation.
- To determine the suitability of the MSB for supporting voice restoration devices.
Main Methods:
- Retrospective cross-sectional study using CT scans of 49 individuals (25 males, 24 females).
- Analysis of MSB morphometry, density, soft tissue thickness (STT), and bone surface slope.
- Creation of heat maps to identify optimal implant locations.
Main Results:
- MSB dimensions (height, thickness, width) were quantified, with males exhibiting significantly larger dimensions.
- Soft tissue thickness (STT) was influenced by Body Mass Index (BMI).
- Cortical and cancellous bone densities were found to be low, comparable to the posterior maxilla.
Conclusions:
- The manubrium sterni bone (MSB) demonstrates theoretical potential for supporting multiple implants for voice restoration devices.
- Radiological assessment suggests the MSB is a viable implantation site.
- Thorough pre-implantation anatomical assessment is crucial for successful outcomes.
