Crista Galli Morphology in Patients With Trisomy 21: A Computed Tomography-Based Analysis

This study aimed to investigate differences in the morphology of the crista galli (CG) between individuals with trisomy 21 (T21) and healthy controls.

Computed tomography scans from 41 patients with T21 (mean age: 11.46±4.06 y) and 47 healthy controls (mean age: 12.04±4.03 y) were analyzed. The CG was measured for length (CG-L), width (CG-W), and height (CG-H). In addition, CG shape and pneumatization patterns were evaluated.

CG-H (P=0.325) and CG-W (P=0.518) in patients with T21 were comparable with those in the control group, whereas CG-L was significantly shorter in the T21 group (P=0.001). Three CG shape types were identified in the T21 group: ossified (39%), tubular (34.2%), and teardrop (26.8%). In the control group, the distribution was ossified (12.8%), tubular (38.3%), and teardrop (48.9%). CG shape distribution differed significantly between groups (P=0.012), with the ossified type being more prevalent in patients with T21 and the teardrop type more common in controls. Pneumatization of the CG was observed in 4.9% of patients with T21 (n=2) and 12.8% of controls (n=6), with no significant association with T21 (P=0.276). A bifid CG was identified in a 6-year-old male with T21.

Trisomy 21 is associated with differences in CG length and shape. Evaluation of skull base structures such as the CG in individuals with T21 may improve understanding of cranial base development and help identify characteristic anatomic features relevant to clinical practice.