Hyperostosis frontalis interna as an age-related phenomenon – Differences between males and females and possible use in identification

Cvetković, Danica; Nikolić, Slobodan; Brković, Voin; Živković, Vladimir

doi:10.1016/j.scijus.2018.09.005

Cited by 11 publications

(16 citation statements)

References 17 publications

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“…Seven of the nineteen specimens (37%) that showed a thickened skull with possible HFI were males ranging from 70 to 103 years old (23% of male cadaver sample). The percentage of specimens exhibiting bone abnormalities in our study was much higher than the overall HFI prevalence observed in previous studies [7,10] (Table 1). The average age of cadavers showing the skull abnormalities was 84:53 ± 9:29, which is similar to the average age of the overall female and male cadaver samples.…”

Section: Resultscontrasting

confidence: 71%

“…There are other possible causes for thickening to occur in the frontal bone, such as Paget's disease. In previously conducted studies, the reported rates of HFI are higher in females (20%) than in males (3%) [7]. Another study [10] reported a prevalence of HFI as high as 13% in females compared to 1.3% in males.…”

Section: Discussionmentioning

confidence: 95%

“…Paget's disease is characterized by the destruction of the bone followed by reparative changes [6]. This disease often causes a boney enlargement of the skull and commonly involves the frontal and basal regions [7]. The new bone is laid down in a haphazard fashion and begins at the outer table of the skull; later, the differentiation between the inner and outer portions of the skull is lost and becomes thickened [7].…”

Section: Introductionmentioning

confidence: 99%

“…This disease often causes a boney enlargement of the skull and commonly involves the frontal and basal regions [7]. The new bone is laid down in a haphazard fashion and begins at the outer table of the skull; later, the differentiation between the inner and outer portions of the skull is lost and becomes thickened [7]. Paget's disease is often diagnosed in up to 8% of those over the age of 60 and affects both sexes; however, there is a slight male predominance [8].…”

Section: Introductionmentioning

confidence: 99%

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Skull Abnormalities in Cadavers in the Gross Anatomy Lab

Rose

Laing

Ahmad

2020

BioMed Research International

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Background. The skull encompasses and houses one of the most important organs in the body-the brain-and like all tissues in the body, it is comprised of living cells that are constantly remodeling as this maintains the strength and homeostasis of the bone. In the present study, abnormal bone growth patterns were observed and the possible causes of said findings were investigated in multiple cadaver skulls dissected during head and neck anatomy courses at Detroit Mercy Dental over the past year. There are many factors, both intrinsic and extrinsic, with differences in stimulation to the skull resulting in skull abnormalities. Materials and Methods. For this study, skull abnormalities were examined from 65 formalin-embalmed cadaver heads, obtained from the Gross Anatomy Laboratory at the University of Detroit Mercy School of Dentistry between the years 2016 and 2019. We have recorded the age, sex, and previous chief medical issues of all lab specimens used in the study. Skulls were later evaluated for possible indications of bone disease such as hypertosis frontalis interna (HFI) or Paget's disease. Results. Among the sixty-five specimens provided to the Detroit Mercy Dental cadaver lab, 19 specimens (29%) were found to present with irregular, undulating, thickening of the frontal bone internal surface. The findings located on the skulls closely resembled the gross anatomic appearance of HFI or Paget's disease; however, a conclusive diagnosis of these skull abnormalities cannot be made without a pathologist biopsy and radiological examination. Twelve of the nineteen specimens that displayed possible bone disease, approximating 63% prevalence, were females; their ages ranged from 68 to 95 years old. Thus, seven of the nineteen specimens exhibiting features of skull abnormalities, approximating 36% prevalence, were males with ages ranging from 70 to 103 years old. In addition, five of these nineteen specimens collected (26% prevalence) had been diagnosed with neurological disorders, including Alzheimer's, dementia, depression, and Parkinson's disease. In the current study, the proportion of specimens exhibiting skull abnormalities was higher compared to the overall prevalence observed in previous studies. Conclusion. Possible causes of observed anatomical abnormalities in the skull of cadavers of a gross anatomy laboratory were investigated, and it was determined that hypertosis frontalis interna (HFI) may contribute to such abnormalities. This is a condition that affects bone growth in the frontal skull. Our numbers of skull abnormalities were higher than previous studies and might be due to the fact that HFI was predominately present as an incidental finding during imaging of postmenopausal females or observed postmortem in cadavers. In addition, Paget's disease or hormonal imbalances could also result in similar features, and thus cannot be ruled out as a plausible cause. Paget's disease causes the bone to deposit at a faster rate than normal, which will result in thick and brittle bone. Studies that will involve ...

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Section: Resultscontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Skull Abnormalities in Cadavers in the Gross Anatomy Lab

Rose

Laing

Ahmad

2020

BioMed Research International

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“…In some other cases, HFI could also be used by forensic pathologists as criteria for sexing and aging a skeleton . Indeed, we have seen that HFI is a sex and age‐dependent phenomena, with females manifesting a significantly higher prevalence than men.…”

Section: Discussionmentioning

confidence: 97%

Finding of Hyperostosis Frontalis Interna During the Autopsy Procedure: Forensic Issues

Bascou

Savall

Vergnault

et al. 2019

Journal of Forensic Sciences

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Hyperostosis frontalis interna is a common phenomenon, which may have been overrated in its significance in the past, and may, currently be underrated in its significance. We present three cases of hyperostosis frontalis interna found during medicolegal autopsies and discuss their forensic considerations. The patients were all middle‐aged women with metabolic and endocrine manifestations and psychiatric ailments; thickening of the inner table of the frontal bone of the skull was found during each autopsy. We describe the relationship between hyperostosis frontalis interna, metabolic manifestations, and neuropsychiatric symptoms as part of Morgagni‐Stewart‐Morel syndrome. There is still considerable disagreement in the scientific community as to whether this syndrome is a clinical entity. Nonetheless, awareness of Morgagni‐Stewart‐Morel syndrome can be of help in understanding the circumstances surrounding death. In some other cases, hyperostosis frontalis interna could be used by forensic pathologists as criteria for sexing and aging a skeleton.

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Hyperostosis frontalis interna: A new perspective in burned individuals' analysis for determining age and sex from archeo‐anthropological and medicolegal contexts

Tour

Couture

Paraf

et al. 2022

Intl J of Osteoarchaeology

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Hyperostosis frontalis interna (HFI) is a benign bone lesion, which is asymptomatic for the most part and is manifested by the accretion of bone on the endocranial surface of the frontal bone. This type of lesion has been discussed in a multitude of publications since the 19th century. Although a consensus has yet to be reached as to its etiology, it would seem generally accepted that hormones play a role, which would explain the high frequency of this disorder among older and postmenopausal women. The objective of this study is to demonstrate the benefit of HFI diagnosis for identifying individuals (estimating their age and determining their sex) in the archeo‐anthropological analysis of ancient cremation burial sites and in medicolegal investigations on burned human remains. Our sample consisted of 82 cremated individuals from the Roman Porta Nocera necropolis in Pompeii (1st century BC–1st century AD). After excluding juveniles under 15 years of age, as HFI primarily affects adult individuals, our sample was reduced to 71 individuals, and the prevalence of HFI was 15.5% (n = 11). A statistically significant difference is observed between women and men, and no individuals previously identified as male displayed HFI. Furthermore, 90.9% of the individuals displayed degenerative conditions in conjunction with HFI, showing a highly significant correlation of this lesion with signs of aging (chi‐square 9.365; p = 0.01). Finally, this disorder boosted diagnostic performance in respect of determining sex, increasing the number of biologically sexed individuals from 46.5% to 53.5%. Therefore, we propose that the HFI diagnosis offers genuine added value in the identification of burned human remains.

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Hyperostosis frontalis interna as an age-related phenomenon – Differences between males and females and possible use in identification

Cited by 11 publications

References 17 publications

Skull Abnormalities in Cadavers in the Gross Anatomy Lab

Skull Abnormalities in Cadavers in the Gross Anatomy Lab

Finding of Hyperostosis Frontalis Interna During the Autopsy Procedure: Forensic Issues

Hyperostosis frontalis interna: A new perspective in burned individuals' analysis for determining age and sex from archeo‐anthropological and medicolegal contexts

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