[Incidence and morphometric analysis of the foramen of Huschke using cone beam CT]

Objective: To investigate the incidence of the foramen of Huschke (FH) in the tympanic plate using cone beam CT (CBCT), to measure its morphological dimensions, and to evaluate potential associations with side (left/right) and gender. Methods: A retrospective review was conducted on CBCT scans from 400 patients (representing 800 tympanic plate sides) examined at the Hospital of Stomatology, Jilin University between January and June 2024. The cohort included 192 males and 208 females, with a median age (interquartile range) of 34 years (19, 52).Two radiologists identified the FH and measured its size on multi-planar reconstructed images. The presence of the FH was compared regarding gender and side. Differences in FH size between left and right sides in the axial, sagittal, and coronal planes, as well as size differences between genders within the same planes, were analyzed. The potential influence of age and gender on FH incidence, along with the relationship between age and FH size in the axial plane, were also assessed. A p-value of less than 0.05 was considered statistically significant. Results: The overall incidence of FH was 19.5% (78/400, 95%CI: 0.156-0.234), comprising a unilateral incidence of 13.0% (52/400, 95%CI: 0.098-0.162) and a bilateral incidence of 6.5% (26/400, 95%CI:0.041-0.089). The incidence rate was 6.8% (54/800, 95%CI: 0.051-0.085) for the left side and 6.3% (50/800, 95%CI: 0.046-0.079) for the right side. No statistically significant difference in FH incidence was observed between males and females (P>0.05), nor was there a significant difference in the side of occurrence between genders (P>0.05). However, binary logistic regression indicated a trend towards significance for gender (OR=0.615, 95%CI: 0.371-1.021, P=0.060). The FH morphology was generally oval. The median FH size was 2.0 (1.54, 2.37) mm in the axial plane, 1.82 (1.53, 2.33) mm in the sagittal plane, and 2.18 (1.69, 2.67) mm in the coronal plane. No significant differences in FH size were found between the left and right sides across these planes (P>0.05), nor were there significant size differences between males and females in any plane (P>0.05). Binary logistic regression and Spearman correlation analysis revealed no significant association between age and FH incidence (OR=0.998, P=0.753), or between age and FH size in the axial plane (left side P=0.915, right side P=0.702). Conclusions: The incidence of the foramen of Huschke, is approximately 19.5%. It typically exhibits an oval shape. The presence and size of the FH appear stable in adulthood, showing no significant correlation with age. CBCT proves to be an effective imaging modality for visualizing the tympanic plate and holds significant value for the clinical diagnosis and preoperative assessment of the foramen of Huschke.