The most significant sexual differences in the human skull are located in the upper third of the face (the frontal bone), which is a useful research object, mainly in combination with virtual anthropology methods. However, the influence of biological relatedness on sexual dimorphism and frontal bone variability remains unknown. This study was directed at sexual difference description and sex classification using the form and shape of the external surface of the frontal bones from a genealogically documented Central European osteological sample (nineteenth to twentieth centuries). The study sample consisted of 47 cranial CT images of the adult members of several branches of one family group over 4 generations. Three-dimensional virtual models of the frontal bones were analyzed using geometric morphometrics and multidimensional statistics. Almost the entire external frontal surface was significantly different between males and females, especially in form. Significant differences were also found between this related sample and an unrelated one. Sex estimation of the biologically related individuals was performed using the classification models developed on a sample of unrelated individuals from the recent Czech population (Čechová et al. in Int J Legal Med 133: 1285 1294, 2019), with a result of 74.46% and 63.83% in form and shape, respectively. Failure of this classifier was caused by the existence of typical traits found in the biologically related sample different from the usual manifestation of sexual dimorphism. This can be explained as due to the increased degree of similarity and the reduction of variability in biologically related individuals. The results show the importance of testing previously published methods on genealogical data.

• MeSH
• Frontal Bone * diagnostic imaging   anatomy & histology   MeSH
• Adult MeSH
• Humans MeSH
• Tomography, X-Ray Computed MeSH
• Sex Characteristics MeSH
• Forensic Anthropology * methods   MeSH
• Sex Determination by Skeleton * methods   MeSH
• Imaging, Three-Dimensional * MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

S rinogenními zánětlivými nitrolebními komplikacemi se setkáváme poměrně vzácně, jsou však velmi závažné a mohou končit fatálně. Dia gnóza se opírá především o anamnézu, objektivní vyšetření, zobrazovací metody a laboratorní nález. Autoři popisují intrakraniální komplikaci akutní rinosinusitidy u 17letého pacienta. Jednalo se o subperiostální absces se současným subdurálním abscesem ve frontální oblasti a osteomyelitidu frontální kosti. Pacient přišel do otorinolaryngologické ambulance Oblastní nemocnice Jičín pro protrahovanou rinosinusitidu již po primární terapii perorálním aminopenicilinem s dočasným efektem. Při objektivním vyšetření byl zjištěn mírný otok v oblasti kořene nosu a víček, rinoendoskopicky otok sliznic s hlenohnisavým sekretem ve středním nosním průduchu vlevo. Původní podezření na orbitální komplikaci rinosinusitidy bylo výpočetní tomografií (CT) vyloučeno. Pacient byl léčen za hospitalizace intravenózními antibio tiky a kortikoidy, lokálně ošetřována nosní dutina. Postupně klesaly zánětlivé parametry. I přes nastavenou terapii došlo k progresi zduření měkkých tkání frontálně za absence neurologických příznaků. Vzhledem k podezření na intrakraniální komplikaci rinosinusitidy bylo opět provedeno CT vyšetření vedlejších nosních dutin a mozku. Rentgenolog popsal přítomnost subperiostálního a subdurálního abscesu s osteomyelitidou frontální kosti. Domluven akutní překlad na Neurochirurgickou kliniku Fakultní nemocnice Hradec Králové k intravenózní antibio tické terapii a chirurgické intervenci neurochirurgem a otorinolaryngologem. Pooperační hojení bylo příznivé.

Rhinogenic inflammatory intracranial complications are relatively rare, but they are very serious and can be fatal. The diagnosis is mainly based on anamnesis, objective examination, imaging methods and laboratory findings. Our case study is devoted to an intracranial complication of sinusitis of a 17-year-old patient. It was a subperiosteal abscess with simultaneous subdural abscess in the frontal region and osteomyelitis of the frontal bone. The patient came to the otorhinolaryngology clinic at Jičín Regional Hospital with prolonged rhinosinusitis, after already receiving primary therapy of oral aminopenicillin with a temporary effect. An objective examination revealed slight swelling in the area of the root of the nose and eyelids, rhinoendoscopic swelling of the mucous membranes with mucopurulent secretion in the middle nasal passage on the left. The original suspicion of an orbital complication of rhinosinusitis was ruled out by a CT scan. The patient was hospitalized and treated with intravenous antibiotics, corticoids and the nasal cavity was treated locally and the inflammatory parameters decreased gradually. During hospitalization, swelling of soft tissues progressed frontally, without neurological symptoms. Due to the suspicion that there was an intracranial complication of rhinosinusitis, a CT scan of the paranasal sinuses and brain was performed. The radiologist diagnosed subdural empyema and osteomyelitis of the frontal bones. An acute transfer to the neurosurgery clinic of the University Hospital in Hradec Králové for intravenous antibiotic therapy and surgical intervention by a neurosurgeon and otorhinolaryngologist was arranged. Postoperative healing was favourable.

• MeSH
• Frontal Bone diagnostic imaging   microbiology   pathology   MeSH
• Respiratory Tract Infections classification   complications   MeSH
• Humans MeSH
• Adolescent MeSH
• Osteomyelitis etiology   MeSH
• Paranasal Sinuses diagnostic imaging   microbiology   pathology   MeSH
• Pott Puffy Tumor surgery   etiology   MeSH
• Rhinosinusitis * diagnosis   complications   MeSH
• Empyema, Subdural * surgery   etiology   MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Publication type
• Case Reports MeSH
• Research Support, Non-U.S. Gov't MeSH

Přestože je hlavní modalitou léčby mnohočetného myelomu systémová terapie, v některých případech mohou mít své opodstatnění i chirurgické postupy. Jedná se zejména o chirurgické řešení kostních komplikací (deformity, stabilita), ale i dalších symptomatických lézí k zajištění lepší kvality života. Důležitosti nabývá zejména v případě absence stanovené diagnózy. V případě výskytu ložiska kalvy se suspekcí na kostní infiltraci musí být kladen důraz na podrobné vyšetření zobrazovacími metodami - zejména pomocí magnetické rezonance a provedení laboratorních vyšetření a odeslání pacienta k dalšímu postupu na příslušné specializované pracoviště.

Although the main modality for the treatment of multiple myeloma is systemic therapy, in some cases surgical procedures may be justified. Surgical solution may be indicated in case of bone complications (deformities, stability), but also other symptomatic lesions to ensure a better quality of life. It becomes important especially in the absence of diagnosis. When bone infiltration is suspected in any lesion of the skull, emphasis must be placed on detailed examination by imaging methods - especially by means of magnetic resonance imaging and laboratory examinations and referral of the patient to the appropriate specialized clinic.

• MeSH
• Frontal Bone * surgery   diagnostic imaging   MeSH
• Bone Substitutes MeSH
• Middle Aged MeSH
• Humans MeSH
• Multiple Myeloma * surgery   diagnosis   therapy   MeSH
• Skull Neoplasms surgery   diagnosis   therapy   MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

The skull, along with the pelvic bone, serves an important source of clues as to the sex of human skeletal remains. The frontal bone is one of the most significant sexually dimorphic structures employed in anthropological research, especially when studied by methods of virtual anthropology. For this reason, many new methods have been developed, but their utility for other populations remains to be verified. In the present study, we tested one such approach-the landmark-free method of Bulut et al. (2016) for quantifying sexually dimorphic differences in the shape of the frontal bone, developed using a sample of the Turkish population. Our study builds upon this methodology and tests its utility for the Czech population. We evaluated the shape of the male and female frontal bone using 3D morphometrics, comparing virtual models of frontal bones and corresponding software-generated spheres. To do so, we calculated the relative size of the frontal bone area deviating from the fitted sphere by less than 1 mm and used these data to estimate the sex of individuals. Using our sample of the Czech population, the method estimated the sex correctly in 72.8% of individuals. This success rate is about 5% lower than that achieved with the Turkish sample. This method is therefore not very suitable for estimating the sex of Czech individuals, especially considering the significantly greater success rates of other approaches.

• MeSH
• Frontal Bone anatomy & histology   diagnostic imaging   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Tomography, X-Ray Computed MeSH
• Computer Simulation * MeSH
• Image Processing, Computer-Assisted MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Forensic Anthropology MeSH
• Support Vector Machine MeSH
• Sex Determination by Skeleton methods   MeSH
• Imaging, Three-Dimensional * MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

Sex estimation is a task of utmost importance in forensic anthropology and bioarcheology. Along with the pelvic bone, the skull is the most important source of sexual dimorphism. On the human skull, the upper third of the face (i.e., the frontal bone) is one of the most significant sexually dimorphic structures useful in anthropological research, especially when studied by methods of virtual anthropology. This study was focused on sex estimation using the form and shape of the external surface of the frontal bone with or without the inclusion of its sinuses. The study sample consisted of 103 cranial CT images from a contemporary Czech population. Three-dimensional virtual models of the frontal bones and sinuses were analyzed using geometric morphometrics and multidimensional statistics: coherent point drift-dense correspondence analysis (CPD-DCA), principal component analysis (PCA), and support vector machine (SVM). The whole external frontal surface was significantly different between males and females both in form and shape. The greatest total success rate of sex estimation based on form was 93.2%, which decreased to 86.41% after crossvalidation, and this model identified females and males with the same accuracy. The best estimation based on shape reached a success rate of 91.26%, with slightly greater accuracy for females. After crossvalidation, however, the success rate decreased to 83.49%. The differences between sexes were significant also in the volume and surface of the frontal sinuses, but the sex estimation had only 64.07% accuracy after crossvalidation. Simultaneous use of the shape of the frontal surface and the frontal sinuses improved the total success rate to 98.05%, which decreased to 84.46% after crossvalidation.

• MeSH
• Frontal Bone anatomy & histology   diagnostic imaging   MeSH
• Skull anatomy & histology   diagnostic imaging   MeSH
• Humans MeSH
• Sex Characteristics MeSH
• Forensic Anthropology methods   MeSH
• Sex Determination by Skeleton methods   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH