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Browsing Anatomy by Author "Lazarus, Lelika."
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Item Anatomical classification of Tessier craniofacial clefts number 3 and number 4 in a South African population.(2019) Omodan, Abiola Olugbenga.; Madaree, Anil.; Lazarus, Lelika.; Pillay, Pamela.; Satyapal, Kapil Sewsaran.The craniofacial clefts are rare defects of the face with an incidence of 1.43 to 4.85 per 100,000 live births. In 2016, WHO reported a death rate of 303,000 new-borns before 4 weeks of age due to congenital anomalies of which craniofacial clefts are one. Surviving the defect is associated with long term disabilities which impacts the individual, families, the healthcare system and society. How much we know about these clefts is seriously hampered by the rarity and the variations of these defects, so much so, that its treatment and communication amongst researchers is affected. The understanding of the skeletal defects occurring in the clefts has long been postulated as a key to any successive reconstruction of the face. This study aimed to reveal the extent of our understanding of these clefts, document the anatomical basis for the craniofacial cleft number 3 and number 4 and generating a sub-classification based on this and also document the clinical presentation as well as associated clefts of these craniofacial clefts in our select South African population. The methods used to achieve these included conducting a scoping review of the literature on patients with Tessier cleft number 3 and number 4 using relevant identified studies from 1976 sourced from PubMed, Medline, EBSCOhost, Google Scholar and the Cochrane libraries. The result of the study was reported using the Preferred Reporting Items for Systematic and Meta-analyses (PRISMA). Likewise, CT scans of patients who had been treated for Tessier clefts number 3 and 4 at Inkosi Albert Luthuli Central Hospital in Durban South Africa between 2003 and 2017 were analysed. Measurements of the expected defects in each cleft were taken and compared with the unaffected side as reference points. Emerging patterns of their analysis were then used to generate a sub-classification for these clefts. Lastly the records of 8 patients who had been treated for either Tessier cleft number 3 or number 4 were reviewed and compared with 9 studies sourced from the literature. In addition to the defects recorded, associated clefts and other congenital malformations were also documented, and findings were compared. The scoping review had 33 studies that met the inclusion criteria. The majority were conducted in middle income countries (54.5%) while none were recorded in low income countries. Only 12.1% of the included studies reported on anthropometry. In understanding the skeletal defects, the presence of an alveolar cleft, the emerging patterns of comparison of the measurements of the maxilla and the orbits of the cleft side and the non-cleft side as well as absence of the bone were used to arrive at a sub-classification system using (a), (b). (c), (M+ O+), (M- O-), and (0). Clinical presentation of the patients who had been treated as cases of Tessier cleft number 3 and number 4 were compared to the reviewed literature and the different parameters were documented. In addition, associated clefts were also recorded, and this study found that the association pattern noted for Tessier cleft number 4 did not conform to its traditional counterpart. In conclusion, this study found that the knowledge of Tessier clefts number 3 and number 4 exist albeit not fully documented. Also, the study proposed a sub-classification for Tessier clefts number 3 and number 4 that will allow physicians to anticipate the extent and form of skeletal defect present before even seeing the patient. Lastly, it was concluded that however variable these clefts appear; they have a similar presentation worldwide and also that associated clefts do not conform to the original Tessier classification system.Item An anatomical exploration of the extracranial (V1-V3) and intracranial (V4) components of the vertebral arteries in a select KwaZulu-Natal population.(2021) Omotoso, Bukola Rukayat.; Lazarus, Lelika.; Satyapal, Kapil Sewsaran.; Harrichandparsad, Rohen.The risk of injury to the vertebral artery is a significant complication of surgery. The presence of anatomical variation in the course of the vertebral artery increases the likelihood of injury. Due to inadequate understanding of the presence and location of anatomical variations in the morphology and morphometry, the vertebral artery can be injured during surgical intervention. Apart from the vascular injury that can occur during surgical intervention, anatomical variations have implications for some pathologies in the posterior circulation territory. These include aneurysm formation, cerebrovascular disorders, posterior circulatory stroke, and some neurovascular problems. In this retrospective observational study, we investigated the anatomical features of the extracranial (V1-V3) and intracranial (V4) components of the vertebral arteries in a South African population. The study is an observational, retrospective chart review of 554 consecutive South African patients (Black, Indian, and White) who had undergone computed tomography angiography (CTA) at Lenmed Ethekwini Hospital and Heart Centre, Durban, South Africa, from January 2009 to September 2019. The vertebral artery exhibited various morphological variations in its course. We report the incidence of variant origin of the left vertebral artery (6.9%). The level of entry into the transverse foramen ranged between C7-C3. We report the incidence of vertebral artery tortuosity at V1, V2: 76.6%, and 32.1%, respectively. We observed fenestration at V3 (0.18%) and V4 (0.4%) segments. We registered the incidence of the persistent first intersegmental artery (1.1%), extradural PICA origin (2.8%), atresia (6.7%), and hypoplastic terminal vertebral artery (13.2%). Average length and diameter at each vertebral artery segment were registered; we also report on hypoplasia of the vertebral artery. Anatomical variations of the vertebral artery are common in the South African population studied in the present study. Imaging of the complete segments of the vertebral artery from the origin to the point of convergence to form the basilar artery may be necessary to decide a treatment strategy for interventions in the vicinity of the vertebral artery. Understanding the patterns of anatomical variations of the vertebral arteries will contribute significantly to the diagnosis of various diseases in the posterior circulatory territory. The average diameter was significantly larger on the left in all the racial groups, but there were no significant gender differences. We registered a left dominance pattern in all the segments (V1-V4). Iqoqa Ingozi yokulimala emithanjeni yomgogodla iyinkinga enzima kakhulu yokuhlinzwa. Ukuba khona kokwehlukahlukana kokwakheka komzimba ekuhambeni komthambo womgogodla kwandisa amathuba okulimala. Ngenxa yokuqonda okunganele kokukhona kanye nendawo yokwehlukahlukana kwesakhikwo somzimba ekwakhekeni nokulinganisa umumo, umthambo womgogodla ungalimala ngesikhathi sokuhlinzwa. Ngaphandle kokulimala kwemithambo yegazi okungenzeka ngesikhathi sokuhlinzwa, ukuhlukahlukana kwemithamdo yomgogodla kunomthelela ngezinye izimbangela ngokuthola umsuka wesifo ngokuhamba kwegazi emigudwini. Lokhu kubandakanya ukwakheka kokuvuvukala komthambo, ukuphazamiseka kokuhamba kwegazi engqondweni, ukushaywa yisifo sohlangothi, nezinye izinkinga ngezinzwa nemithambo. Kulolu cwaningo lokubheka ngokuqhathanisa abanesifo nabangenaso, sibheke ukwakheka komzimba kwamathambo ekhanda ngaphandle (V1-V3) kanye nokwakheka kwawo ngaphakathi (V4) nezingxenye zemithambo yomgogodla emphakathini waseNingizimu Afrikha. Ucwaningo lungukuzibonela ngqo, ukuqhathanisa ngokubuyekeza amashadi eziguli zaseNingizimu Afrikha angama-554 ngokulandelana (abaNsundu, amaNdiya, nabaMhlophe) abafakwe emshinini bahlolwa wonke umzimba ngekhompuyutha ukubona okusemithanjeni (isibonathambomzimba) (CTA) esibhedlela i-Lenmed Ethekwini neSikhungo seNhliziyo, eThekwini, eNingizimu Afrikha, kusukela kuMasingana wowezi-2009 kuya kuMandulo wowezi-2019. Umthambo womgogodla ukhombisa ukwehlukahluka kwesakhiwo ekuthubelezeni kwawo. Sibika isehlakalo semvelaphi esehlukile somthambo womgogodla kwesokunxele (6.9%). Izinga lokungena esikhaleni esiphakathi komthambo womgogodla laliphakathi kwe-C7 ne-C3. Sibika isehlakalo esihambisana nokuguga komthambo womgogodla nomfutho wegazi okulinganiselwa phakathi kuka-V1, V2: 76.6% no-32.1%, ngokulandelana. Sibone ukuhlinzwa kwesakhiwo sendlebe ngaphakathi kwezingxenye ezingu-V3 (0.18%) nezingu-V4 (0.4%). Sabhalisa izehlakalo zomthambo wokuqala ngezingxenye ezilokhu zikhona ngo-1.1%, imvelaphi ye-PICA yamathambo ekhanda (2.8%), isicubu esingenayo embotsheni ngokwemvelo (6.7%), nokungakhuli kwesitho ngokuphelele (13.2%). Isilinganiso sobude nobubanzi engxenyeni ngayinye yomthambo womgogodla yabhaliswa; siphinde sibike ngokungasebenzi ngokwejwayelekile komthambo womgogoda. Ukwehlukahlukana kokwakheka komthambo womgogodla kuvamile kubantu baseNingizimu Afrikha ocwaningweni lwamanje. Ukufanekisa kwezingxenye eziphelele zomthambo womgogodla lapho zihlangana khona ukwenza umthambo ophakathi nendawo ekhanda kungadingakala ukunquma ngamasu okwelapha ngokungenelela endaweni eseduze nomthambo womgogodla. Ukuqonda ukuphiceka kwesakhiwo esahlukahlukene semithambo yomgogodla kuzodlala indima ebalulekile ekuhlonzeni izifo ezahlukahlukene ekuhlinzekweni kokuhamba kwegazi. Isilinganiso sobubanzi besisikhulu kakhulu kwesokunxele kuwo wonke amaqembu ezinhlanga, kodwa kwakungekho mehluko obalulekile phakathi kobulili. Sibhalise indlelakwenza ebihamba phambili kuzo zonke izingxenye ebe ngu-V1-V4.Item An anatomical investigation of intracranial meningiomas.(2021) Anirudh, Ezra Earl.; Lazarus, Lelika.; Harrichandparsad, Rohen.Meningiomas are generally benign, highly vascularised, slow-growing tumours arising from the arachnoid cap cells of the arachnoid villi. The clinical presentation of these tumours is usually location dependant due to the vast expanse covered by the meninges. Resection of a meningioma is generally performed after preoperative embolisation. A feeder vessel is selected and embolised in an attempt to reduce excessive blood loss and postoperative complications. However, embolisation requires a sound knowledge of the vasculature of the meninges since these vessels supply portions of the cranial nerves. Literature consulted have investigated anatomical features of meningioma’s; however, there is a scarcity of studies investigating patients specifically referred for preoperative embolisation. Therefore, this study aimed to investigate the anatomical features, namely the location, histology, volume and vascularity of intracranial meningiomas referred for preoperative embolisation. This entailed using Magnetic resonance imaging (MRI), Digital subtraction angiography (DSA), and the histological reports obtained from the data bank at the central regional hospital in Durban, South Africa. A retrospective chart review yielded 103 patients that met the inclusion criteria, of which 98 patients (subset 1) presented with a single meningioma and 5 patients (subset 2) presented with multiple meningiomas. The average age of patients (at the time of diagnosis) was reported within the 40–49-year group and primarily within the female population (subset 1: 67.3%; subset 2: 80%). The benign grade of meningiomas was reported as the most common (70.4%), of which the meningothelial subtype (48%) was predominant. Meningiomas were mostly observed within the supratentorial region (subset 1: 57.2%; subset 2: 91.7%) with almost equal incidences in subset 1 and a majority on the right side in subset 2. Regarding tumour volume, subset 1 revealed the largest meningiomas within the supratentorial region (90.9 cm3), and subset 2 revealed an average tumour volume of 43.9 cm3. In terms of meningioma vascularity, within the supratentorial region, the external carotid arteries were noted to be a common primary feeder vessel, for the skull base region the primary arterial supply is the internal carotid artery. This study provides insight into the anatomical basis of intracranial meningiomas within a select South African population as it has introduced a novel methodology of meningioma vascularity. This may assist endovascular surgeons in assessing the feeder vessel contributions of meningiomas and understand the prevalence of these anatomical parameters in this population.Item An anatomical investigation of the sympathetic and parasympathetic contributions to the cardiac plexus.(2011) De Gama, Brenda Zola.; Satyapal, Kapil Sewsaran.; Partab, Pravesh.; Lazarus, Lelika.The cardiac plexus is “formed by mixed autonomic nerves” that are “described in terms of superficial and deep components, with the superficial located below the aortic arch and anterior to the right pulmonary artery, and the deep located anterior to the tracheal bifurcation (above the division of the pulmonary trunk) and posterior to the aortic arch” (Standring et al., 2008). This investigation aims to review and update the medial cardiac contributions of the cervical and thoracic sympathetic chains to the cardiac plexus and also the contributions from the vagus nerve and its counterpart, the recurrent laryngeal nerve. This study involved the macro and micro-dissection of 100 cadaveric sides of adult and fetal material. The number of ganglia in a cervical sympathetic chain varied from 2 to 5 in this study. This study confirms previous reports on the location of the two components of the cardiac plexus. The origin of the sympathetic contributions to the cardiac plexus in this study were either ganglionic, interganglionic or from both the ganglion and interganglionic chain of the respective ganglia. The superior cervical cardiac nerve had an incidence of 92% while the middle cervical cardiac nerve had an incidence of 65% in the specimens studied. This study also records a vertebral cardiac nerve that arose from the vertebral ganglion in 39% of the cases. The inferior cervical and cervicothoracic cardiac nerves had incidences of 21%, respectively. This investigation records the thoracic caudal limit of the sympathetic contributions to the cardiac plexus as the T₅ ganglion. The findings in this study indicate the importance of understanding the medial sympathetic contributions and their variations to the cardiac plexus as this may assist surgeons during minimal surgical procedures, sympathectomies, pericardiectomies and in the management of diseases like Reynaud’s Phenomenon and angina pectoris (Kalsey et al., 2000; Zhang et al., 2009).Item Anterior synostotic plagiocephaly: a quantitative analysis of craniofacial features using computed tomography.(2021) Mohan, Nivana.; Lazarus, Lelika.; Madaree, Anil.; Harrichandparsad, Rohen.Anterior synostotic plagiocephaly (ASP) is caused by the premature fusion of one coronal suture, which results in severe craniofacial asymmetry that can be challenging to correct. The various methods of the surgical procedures, as well as the distinctive facial characteristics of ASP, have been well documented. However, there is a paucity of literature pertaining to the quantitative analysis of the craniofacial features that are affected in ASP. This study used preoperative computed tomography (CT) scans to document and compare the morphometry of the anterior cranial fossa (ACF), orbit, and ear on the ipsilateral (synostotic) and contralateral (non-synostotic) sides in a select South African population of patients diagnosed with ASP. The dimensions of the ACF, orbit and the position of the ear on the ipsilateral and contralateral sides were measured using a set of anatomical landmarks on two-dimensional (2D) CT scans of 18 consecutive patients diagnosed with non-syndromic ASP. The differences between the ipsilateral and contralateral sides were computed and expressed as a percentage of the contralateral side. The findings of this study revealed that there was side-to-side asymmetry in the ACF, orbit, and ear. All ACF parameters decreased significantly (t-test; p<0.001) on the ipsilateral side when compared to the contralateral side, resulting in the volume of the ACF being the most affected (-27.7%). In terms of the orbit, on the ipsilateral side, the length-infraorbital rim (IOR), height, and surface area parameters increased significantly (t-test; p<0.001), with the height being the most affected (24.6%). The remaining orbital parameters (length-supraorbital rim (SOR), breadth and volume) decreased significantly (t-test; p<0.001), with the length-SOR parameter being the most affected (-10.8%). Furthermore, the ipsilateral SOR was noted to be displaced more cranially by an average of 3.89mm from the contralateral SOR. With regards to the position of the ipsilateral ear, it was found to be displaced anteriorly (9.33mm) and caudally (5.87mm) from the contralateral ear. This study augments the existing literature by providing actual values to corroborate the hallmark characteristics of ASP. These measures may help surgeons plan the technique and extent of surgical correction of the affected craniofacial structures during corrective surgery as it will provide them with an indication of the extent of the deformity on the ipsilateral side as compared to the contralateral side. The results of this study have the potential to propose a grading system in ASP patients according to severity of the condition if the sample size is increased.Item An anthropometric evaluation of the glenohumeral joint in a South African population.(2018) Khan, Raeesa.; Satyapal, Kapil Sewsaran.; Lazarus, Lelika.; Naidoo, N.The glenohumeral joint (GHJ), the most mobile yet unstable joint in the body, is comprised of a large humeral head which fits into the relatively smaller socket formed by the glenoid fossa. While this articulation allows for a wide range of motion, it predisposes the shoulder to injury. There is a paucity of literature on the biomechanics of the GHJ in the South African population. The aim of the study was to evaluate the anthropometric parameters of the GHJ, with emphasis on the coracoid process, glenoid fossa, bicipital groove (BG), long head of the biceps brachii tendon (LHBBT) and the transverse humeral ligament (THL). This study comprised of two subsets (n = 404), viz. (i) anthropometric evaluation of the scapula and proximal humerus [n=324: Scapula – Right (R): 80, Left (L): 84; Male (M): 68, Female (F): 96; Humerii – (R): 80, (L): 80; (M): 68, (F): 96] and (ii) cadaveric dissection of the LHBBT and THL [n=80: (R): 40, (L): 40; (M): 44, (F): 36], both of which focused on morphological and morphometric parameters. Results (i) (a) Shape of glenoid fossa = Type 1 (inverted comma): (R): 16.47%, (L): 10.98%; (M): 20.12%, (F): 7.32%; Type 2 (pear): (R): 14.02%, (L): 15.24%; (M): 18.29%, (F): 10.98%; Type 3 (oval) : (R): 18.29%, (L): 25.00%; (M): 27.44%, (F): 15.85%. (b) Notch type of glenoid fossa: Type 1 (without a notch): (R): 1.83%, (L): 7.32%; (M): 6.71%, (F): 2.44%; Type 2 (with one notch): (R): 46.95%, (L): 43.90%; (M): 59.15%, (F): 31.70%. (c) Mean parameters of coracoid process (mm): Length (CL): (R): 41.74±4.74, (L): 41.50±4.87; (M): 42.07±4.73, (F): 40.74±4.84; Width (CW): (R): 13.27±1.89, (L): 14.18±11.90; (M): 13.05±1.90, (F): 15.07±14.49. (d) Mean parameters of glenoid fossa (mm): Horizontal diameter 1 (HD1): (R): 18.40±3.27, (L): 17.51±2.87; (M): 18.23±3.29, (F): 17.38±2.60; Horizontal diameter 2 (HD2): (R): 24.45±2.88, (L): 23.64±2.63; (M): 24.22±2.74, (F): 23.68±2.83; Vertical diameter (VD): (R): 35.23±3.10, (L): 34.88±3.03; (M): 35.26±3.18, (F): 34.64±2.79. (e) Mean coracoglenoid distance (CGD) (mm): (R): 27.40±8.34, (L): 28.15±3.53; (M): 28.19±7.41, (F): 27.00±3.38 .(f) Mean dimensions of BG (mm): Length: (R): 66.64±9.06, (L): 68.31±11.52; (M): 67.44±9.12, (F): 67.53±12.25; Width: (R): 8.98±1.49, (L): 9.27±1.30; (M): 9.18±1.45, (F): 9.05±1.31; Depth: (R): 7.73±1.31, (L): 7.20±1.18; (M): 7.43±1.29, (F): 7.53±1.24. (ii) (a) Mean parameters of the LHBBT (mm): Length: (R): 81.99±21.28, (L): 79.73±17.27; (M): 79.82±19.66, (F): 82.14±19.03; Width: (R): 4.28±1.31, (L): 4.67±1.43; (M): 4.35±1.17, (F): 4.63±1.60. (b) Mean parameters of the THL (mm): Length: (R): 20.91±5.24, (L): 21.19±6.36; (M): 21.52±5.71, (F): 20.48±5.92; Width: (R): 16.65±6.92, (L): 16.63±7.49; (M): 16.83±6.65, (F): 16.40±7.84. In this study, Type 3 (oval) was observed to be most prevalent shape of the glenoid fossa, which corroborated the findings of previous studies. Type 2 (with one notch) was found to be the predominant notch type, differing from the literature reviewed. The mean VD, HD1, HD2, CL and CGD were larger in male individuals, while female individuals presented with larger means of CW. Both BG length and depth were increased on the right side; with the latter yielding a statistically significant difference thus suggesting that an increased depth is a common finding in the right side of individuals. Although the BG length and depth were noted to be greater in female individuals, male individuals presented with larger widths. The mean length and width of the THL were markedly smaller than those reported in previous studies. Any variation from the normal musculoskeletal composition of the GHJ is fundamental to understand rotator cuff disease, tendinitis and shoulder dislocation. This study may provide clinicians and biomechanical engineers with reliable anthropometric reference parameters of the GHJ for the design of prosthesis and may also act as diagnostic tools of degenerative pathology.Item Developmental changes of the facial skeleton from birth to 18 years within a South African cohort: a computed tomography study.(2021) Niemann, Kristen.; Rennie, Carmen Olivia.; Lazarus, Lelika.Introduction: The facial skeleton or viscerocranium has been recently noted as a method for age estimation as its development is influenced not only by the developing paranasal air sinuses and tooth eruption, but also the individual’s ancestry particularly population specific normative data. This study aimed to investigate the developmental changes of the facial skeleton in males and females from birth to 18 years within the South African population with African ancestry to estimate age. The facial skeleton was assessed according to five regions viz: - orbital, nasal, midfacial, maxillary and mandibular. Methods and materials: A retrospective study which consisted of 239 computed tomography (CT) scans of subadult individuals (0–18 years of age) of African ancestry (128 males; 111 females) was conducted. The scans were obtained from an online server utilised by a private medical facility in the eThekwini Muncipality. The DICOM images were viewed from an online Picture Archiving and Communication Systems server using Infinitt software (version 5.0.1.1) which is the standard software used by the practitioners. Linear parameters in the horizontal, sagittal, and vertical planes assessed the development of the viscerocranial regions. Results: a) Development: Most of the viscerocranial regions experienced a rapid increase in growth between 0–5 years of age viz: orbital (orbital height and width: 0–5 years; lateral orbital wall distance: 0–3.75 years), midfacial (zygomatic arch distance: 0–3.75 years), nasal (aperture height and width: 0–5 years); maxilla (length: 0–3.75 years), mandibular (mandible width: 0–5 years). Thereafter growth continued to increase at a slower rate in the orbital width (0.61–0.8 mm/year in females; 0.56–0.76 mm/year in males), lateral orbital wall distance (1.1 mm/year in females; 1 mm/year in males), zygomatic arch distance (1.6 mm/year in females; 1.8 mm/year in males), nasal aperture width (0.45 mm/year in females; 0.4 mm/year in males) and height (0.63 mm/year in females; 0.77 mm/year in males), maxillary length (0.7 mm/year in females; 0.81 mm/year in males), mandible width (1.1 mm/year in females; 1.5 mm/year in males) and mandible head widths (right: 0.42 mm/year in females, 0.49 mm/year in males; left: 0.52 mm/year in females, 0.68 mm/year in males). Additionally, in the orbital region, the orbital width underwent two periods of rapid growth i.e., 0–5 and 10–18 years of age, whilst the anterior interorbital distance noted no significant increase after 7.5 years of age. xiv b) Sexual dimorphism: Males displayed overall larger measurements than females in all the parameters, except for the anterior interorbital distance and the zygomatic arch lengths (ZAL) on the right and left, as females displayed larger measurements. Although these differences were not statistically significant (p>0.05). The only measurements which displayed statistically significant differences between males and females were the left orbital height (p = 0.048), nasal aperture height (p = 0.048) and the mandible width (p = 0.05), in which males displayed larger measurements than females. c) Age estimation: The measurements which displayed the strongest correlation to age were the ZAD (r = 0.8842, p<0.001), ZAL (right: r = 0.8929, p<0.001; left: r = 0.8656, p<0.001) and the mandible width (r = 0.8444, p<0.001). Formulas were derived for the measurements which could be used to estimate age. Discussion and conclusion: The findings from this study have outlined the development of the viscerocranium in subadult individuals with African ancestry. This study discussed the correlation between the development patterns of each viscerocranial region with age. The data from this study can be a useful addition to the existing data on the skeletal developments of subadult South African individuals. Forensically the development of formulas for subadult individuals could be utilised in the age estimation of skeletal remains.Item Scaphocephaly in a select South African population: a morphometric analysis of the cranial fossae and ventricular access points.(2021) Bisetty, Vensuya.; Lazarus, Lelika.; Madaree, Anil.; Harrichandparsad, Rohen.Scaphocephaly is a cranial deformity that results from premature fusion of the sagittal suture and is characterized by an elongated and narrowed skull. Patients with this condition present with varying clinical features including frontal bossing and occipital protrusion. This study comprised two subsets, analysing different aspects related to this cranial deformity. Most morphological and morphometrical studies in patients with scaphocephaly focus on the cranial vault. Literature on the morphometry of the cranial base and its fossae in these patients is sparse. Therefore, the first subset aimed to analyse and compare the morphometry of the cranial fossae in patients with scaphocephaly. Due to varying cranial morphology among patients with these deformities, ventricular access using conventional techniques is often a challenge. Although ventricular access may not be frequently required in paediatric scaphocephalic patients, it is vital that an ideal location of the access points be established for safe ventricular catheterization. Accordingly, the second subset aimed to document the morphometry of Kocher’s and Frazier’s points in scaphocephalic patients using known craniometric and surface anatomical landmarks. Dimensions of the anterior, middle and posterior cranial fossae (ACF, MCF and PCF) were measured using select anatomical landmarks on computed tomography (CT) scans of 24 consecutive patients diagnosed with scaphocephaly between 2014 and 2020, and 14 non-affected/ normal paediatric patients selected as controls. Parameters of Kocher’s and Frazier’s points were measured in relation to known cranial surface anatomical landmarks on scans of the scaphocephalic patients utilized in subset 1. The study found that ACF and PCF are most affected in scaphocephalic patients, with elongation along the anteroposterior (AP) plane (lengths) (ACF, p=0.041 and PCF, p=0.018). Minimal changes were observed in the transverse plane (widths) in scaphocephaly versus non-affected/normal controls. Regarding subset 2, Kocher’s point was located between 91.6mm and 140mm posterior to the nasion, and between 20.5mm and 34.6mm lateral to the midline in patients with scaphocephaly. Frazier’s point was located between 60.9mm and 82.8mm superior to the inion, and 25.9mm and 41.4mm lateral to the midline. Parameters measured in the AP plane were found to be more affected than those measured lateral from the midline. This study contributes to the literature by providing novel morphometric data based on a select South African population. Data obtained could aid craniofacial surgeons in understanding which cranial fossa is most affected in scaphocephaly and to what extent, to decide on the most appropriate method of treatment. Additionally, the study concluded that the traditional landmarks used for ventricular access are relatively unreliable in scaphocephalic patients. This study provides data for neurosurgical consideration regarding ventricular catheterization procedures in patients with scaphocephaly.