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Purpose: Sternal foramen is a perforation of the sternum that can be a source of misdiagnosis during radiographic imaging or life-threatening perforations during bone marrow sampling. The aim of this study was to conduct a meta-analysis on the prevalence, morphometrics, and location of foramen in the sternal body and xiphoid process, describe morphometric features of this phenomenon, and thus verify its clinical importance. Moreover, our secondary outcome was to compare effectiveness of various imaging methods in diagnosis of the sternal or xiphoid foramen.

Methods: A comprehensive search was conducted on major scientific databases to identify studies containing relevant information. Data on foramen's prevalence, location, morphometrics, and accompanying findings were extracted and pooled into a meta-analysis using MetaXL 5.0.

Results: Thirty-five studies (n = 16,666 subjects) were included. The overall pooled prevalence of a foramen in the sternal body and/or a xiphoid process was 8.9% (95% CI 6.5-11.7) and it equaled 6.5% (95% CI 5.6-7.6) for sternal body alone and 2.9% (95% CI 0.5-6.9) for the xiphoid process. The foramen was more prevalent in males than in females (12.2% vs. 6.8%). The prevalence of sternal foramen was higher in South American [13.9% (95% CI 11.2-16.9)] and African [13.6% (95% CI 9.7-18.0)] studies compared to North American [6.2% (95% CI 5.0-7.5)] and European populations [8.6% (95% CI 3.1-16.3)]. Mean transverse and vertical diameter of foramen equaled 4.7 mm (95% CI 3.8-5.5), and 5.6 mm (95% CI 4.2-6.9), respectively.

Conclusion: Our analysis proves that the sternal foramina are structures of significant prevalence and size. Any physician should keep them in mind when performing punctures in this area.

Titel:	Prevalence and morphometry of sternal and xiphoid foramen: a meta-analysis on 16,666 subjects.
Autor/in / Beteiligte Person:	Pasieka, P ; Pasieka, PM ; Komosa, A ; Barnowska, A ; Pękala, J ; Malinowski, K ; Tomaszewski, K
Link:	Zum Volltext
Zeitschrift:	Surgical and radiologic anatomy : SRA, Jg. 45 (2023-05-01), Heft 5, S. 623-635
Veröffentlichung:	Berlin ; New York : Springer International, c1986-, 2023
Medientyp:	academicJournal
ISSN:	1279-8517 (electronic)
DOI:	10.1007/s00276-023-03116-9
Schlagwort:	Female Humans Male Prevalence Tomography, X-Ray Computed Sternum anatomy & histology Sternum diagnostic imaging Xiphoid Bone anatomy & histology Xiphoid Bone diagnostic imaging
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Meta-Analysis; Journal Article Language: English [Surg Radiol Anat] 2023 May; Vol. 45 (5), pp. 623-635. <i>Date of Electronic Publication: </i>2023 Mar 15. MeSH Terms: Sternum* / anatomy & histology ; Sternum* / diagnostic imaging ; Xiphoid Bone* / anatomy & histology ; Xiphoid Bone* / diagnostic imaging ; Female ; Humans ; Male ; Prevalence ; Tomography, X-Ray Computed References: Akin K, Kosehan D, Topcu A et al (2011) Anatomic evaluation of the xiphoid process with 64-row multidetector computed tomography. Skeletal Radiol 40:447–452. https://doi.org/10.1007/s00256-010-1022-1. (PMID: 10.1007/s00256-010-1022-120721551) ; Aktan ZA (1998) Anatomic and HRCT demonstration of midline sternal foramina. Tr J Med Sci 28:511–514. https://journals.tubitak.gov.tr/medical/vol28/iss5/9/. ; Anderson BW, Holme MR, Burns B (2020) Anatomy, thorax, xiphoid process (Updated 2020 May 22). In: StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL). https://www.ncbi.nlm.nih.gov/books/NBK526082/. ; Ashley GT (1956) The relationship between the pattern of ossification and the definitive shape of the mesosternum in man. J Anat 90(1):87–107. (PMID: 132951541244824) ; Ateşoğlu S, Deniz M, Uslu Aİ (2018) Evaluation of the morphological characteristic and sex differences of sternum by multi-detector computed tomography. Folia Morphol 77(3):489–497. https://doi.org/10.5603/FM.a2018.0002. (PMID: 10.5603/FM.a2018.0002) ; Babinski MA, de Lemos L, Babinski MS et al (2015) Frequency of sternal foramen evaluated by MDCT: a minor variation of great relevance. Surg Radiol Anat 37:287–291. https://doi.org/10.1007/s00276-014-1339-x. (PMID: 10.1007/s00276-014-1339-x25023390) ; Babinski MA, Rafael FA, Steil AD et al (2012) High prevalence of sternal foramen: quantitative, anatomical analysis and its clinical implications in acupuncture practice. Int J Morphol 30(3):1042–1049. https://doi.org/10.4067/S0717-95022012000300045. (PMID: 10.4067/S0717-95022012000300045) ; Bayaroğulları H, Yengil E, Davran R, Ağlagül E, Karazincir S, Balcı A (2014) Evaluation of the postnatal development of the sternum and sternal variations using multidetector CT. Diagn Interv Radiol 20:82–89. https://doi.org/10.5152/dir.2013.13121. (PMID: 10.5152/dir.2013.1312124100061) ; Boruah DK, Prakash A, Yadav RR et al (2016) The safe zone for blinded sternal interventions based on CT evaluation of midline congenital sternal foramina. Skeletal Radiol 45:1619–1628. https://doi.org/10.1007/s00256-016-2473-9. (PMID: 10.1007/s00256-016-2473-927629288) ; Chaudhari SH, Kumar N, Thakre G et al (2016) A study on medico-legal and clinical aspects of congenital sternal foramina. Indian J Forensic Commun Med 3(3):194–197. (PMID: 10.5958/2394-6776.2016.00043.6) ; Choi PJ, Iwanaga J, Tubbs RS (2017) A comprehensive review of the sternal foramina and its clinical significance. Cureus 9(12):e1929. https://doi.org/10.7759/cureus.1929. (PMID: 10.7759/cureus.1929294569055805319) ; Cooper PD, Stewart JH, McCormick WF (1998) Development and morphology of the sternal foramen. Am J Forensic Med Pathol 9(4):342–347. https://doi.org/10.1097/00000433-198812000-00016. (PMID: 10.1097/00000433-198812000-00016) ; Deadman P, Al-Khafaji M, Baker K (2016) A manual of acupuncture. Chinese Medicine Publications, East Sussex. ; Del Sol M, Vásquez B, Cantín M (2014) Características morfológicas métricas y no métricas del esternón del individuo Mapuche. Int J Morphol 32(1):351–356. https://doi.org/10.4067/S0717-95022014000100055. (PMID: 10.4067/S0717-95022014000100055) ; Duraikannu C, Noronha O, Sundarrajan P (2016) MDCT evaluation of sternal variations: pictorial essay. Indian J Radiol Imaging 26:185–194. https://doi.org/10.4103/0971-3026.184407. (PMID: 10.4103/0971-3026.184407274132634931775) ; El-Busaid H, Kaisha W, Hassanali J et al (2012) Sternal foramina and variant xiphoid morphology in a Kenyan population. Folia Morphol 71(1):19–22. ; Fujita H, Nishimura S, Oyama K (2009) Retrospective study on CT findings on the sternal bone after bone marrow aspiration procedure in hematological patients. Rinsho Ketsueki 50(12):1687–1691. (PMID: 20068275) ; Gans BD, Neunuebel AD, Umbarger LJ et al (2021) High prevalence of sternal foramina in indigenous Bolivians compared to Midwest Americans and indigenous North Americans (sternal foramina in indigenous Bolivians). Anat Sci Int 96(4):517–523. https://doi.org/10.1007/s12565-021-00618-7. (PMID: 10.1007/s12565-021-00618-7340530018445587) ; Gkantsinikoudis N, Chaniotakis C, Gkasdaris G, Georgiou N, Kapetanakis S (2017) Morphological approach of the sternal foramen: an anatomic study and a short review of the literature. Folia Morphol 76(3):484–490. https://doi.org/10.5603/FM.a2017.0006. (PMID: 10.5603/FM.a2017.0006) ; Gossner J (2013) Relationship of sternal foramina to vital structures of the chest: a computed tomographic study. Anat Res Int. https://doi.org/10.1155/2013/780193. (PMID: 10.1155/2013/780193242240923810316) ; Halvorsen TB, Anda SS, Naess AB et al (1995) Fatal cardiac tamponade after acupuncture through congenital sternal foramen. Lancet 345(8958):1175. https://doi.org/10.1016/s0140-6736(95)91004-2. (PMID: 10.1016/s0140-6736(95)91004-27723561) ; Ishii S, Shishido F, Miyajima M et al (2011) Causes of photopenic defects in the lower sternum on bone scintigraphy and correlation with multidetector CT. Clin Nucl Med 36(5):355–358. https://doi.org/10.1097/RLU.0b013e31820aa41b. (PMID: 10.1097/RLU.0b013e31820aa41b21467851) ; Kirum GG, Munabi IG, Kukiriza J et al (2017) Anatomical variations of the sternal angle and anomalies of adult human sterna from the Galloway osteological collection at Makerere University Anatomy Department. Folia Morphol 76(4):689–694. https://doi.org/10.5603/FM.a2017.0026. (PMID: 10.5603/FM.a2017.0026) ; Kuzucuoglu M, Albayrak I (2020) Topographic evaluation of sternal foramen patients with thoracic computed tomography. Surg Radiol Anat 42:405–409. https://doi.org/10.1007/s00276-019-02416-3. (PMID: 10.1007/s00276-019-02416-331907578) ; Larsen WJ (1997) Human embryology, 2nd edn. Churchill Livingstone, New York. ; Macaluso PJ, Lucena J (2014) Morphological variations of the anterior thoracic skeleton and their forensic significance: Radiographic findings in a Spanish autopsy sample. Forensic Sci Int 241:220.e1–7. https://doi.org/10.1016/j.forsciint.2014.05.009. (PMID: 10.1016/j.forsciint.2014.05.00924933632) ; McCormick WF (1981) Sternal foramena in man. Am J Forensic Med Pathol 2(3):249–252. https://doi.org/10.1097/00000433-198109000-00011. (PMID: 10.1097/00000433-198109000-000117325136) ; Moore KL (2011) Moore clinically oriented anatomy, 7th edn. LWW, Philadelphia. ; Nayak G, Mohanty BB, Pradhan S (2018) Study of sternal foramina in Eastern Indian dry Sterna. IOSR J Dent Med Sci 17(7):87–90. https://doi.org/10.9790/0853-1707028790. (PMID: 10.9790/0853-1707028790) ; Papadimitriou P, Chalkias A, Mastrokostopoulos A, Kapniari I, Xanthos T (2013) Anatomical structures underneath the sternum in healthy adults and implications for chest compressions. Am J Emerg Med 31:549–555. https://doi.org/10.1016/j.ajem.2012.10.023. (PMID: 10.1016/j.ajem.2012.10.02323380086) ; Paraskevas G, Tzika M, Anastasopoulos N, Kitsoulis P, Sofidis G, Natsis K (2015) Sternal foramina: incidence in Greek population, anatomy and clinical considerations. Surg Radiol Anat 37(7):845–851. https://doi.org/10.1007/s00276-014-1412-5. (PMID: 10.1007/s00276-014-1412-525552238) ; Pevenage P, De Maeseneer M, Muylle K et al (2002) Sternal foramen simulating osteolytic lesion on scintigraphy and SPET imaging. Ann Nucl Med Sci 15(4):227–230. ; Schratter M, Bijaki M, Nissel H, Gruber I, Schratter-Sehn AU (1997) Foramen sternale: Kleine Anomalie—große Relevanz. Fortschr Röntgenstr 166(1):69–71. (PMID: 10.1055/s-2007-1015380) ; Shivakumar GL, Deepa G, Kadlimatti HS (2013) Variations in the human sterna. J Evol Med Dent Sci 2(2):99–104. https://doi.org/10.14260/jemds/226. (PMID: 10.14260/jemds/226) ; Singh J, Pathak RK (2013) Sex and age related non-metric variation of the human sternum in a Northwest Indian postmortem sample: a pilot study. Forensic Sci Int 228:181.e1-181.e12. https://doi.org/10.1016/j.forsciint.2013.02.002. (PMID: 10.1016/j.forsciint.2013.02.00223453187) ; Spałek M, Zychowska M, Wolak P et al (2016) Sternal foramen as extracardiac findings in cardiac computed tomography. Med Stud/Studia Medyczne 32(4):274–278. https://doi.org/10.5114/ms.2016.64700. (PMID: 10.5114/ms.2016.64700) ; Stark P (1985) Midline sternal foramen: CT demonstration. J Comput Assist Tomogr 9(3):489–490. https://doi.org/10.1097/00004728-198505000-00013. (PMID: 10.1097/00004728-198505000-000133989043) ; Turkay R, Inci E, Ors S et al (2017) Frequency of sternal variations in living individuals. Surg Radiol Anat 39:1273–1278. https://doi.org/10.1007/s00276-017-1854-7. (PMID: 10.1007/s00276-017-1854-728396982) ; Vatzia K, Fanariotis M, Makridis KG et al (2021) Frequency of sternal variations and anomalies in living individuals evaluated by MDCT. Eur J Radiol 142:109828. https://doi.org/10.1016/j.ejrad.2021.109828. (PMID: 10.1016/j.ejrad.2021.10982834280594) ; Verna E, Piercecchi-Marti M, Chaumoitre K et al (2015) Relevance of discrete traits in forensic anthropology: from the first cervical vertebra to the pelvic girdle. Forensic Sci Int 253:134.e1-134.e7. https://doi.org/10.1016/j.forsciint.2015.05.005. (PMID: 10.1016/j.forsciint.2015.05.00526048863) ; Vulović M et al (2019) Multidetector computed tomography (MDCT) estimation of prevalence and anatomic characteristics of the sternal body foramen in the population of central Serbia. Vojnosanit Pregl 76(2):186–191. https://doi.org/10.2298/VSP170321084V. (PMID: 10.2298/VSP170321084V) ; Xie Y, Wang B, Yun JS et al (2013) Morphology of the human xiphoid process: dissection and radiography of cadavers and MDCT of patients. Surg Radiol Anat 36(3):209–217. https://doi.org/10.1007/s00276-013-1163-8. (PMID: 10.1007/s00276-013-1163-823839070) ; Yang M, Jiang H, Yu X et al (2017) Sternal development and variations and anomalies in patients with microtia: evaluation using 3-dimensional computed tomography. J Comput Assist Tomogr 41(5):784–791. https://doi.org/10.1097/RCT.0000000000000590. (PMID: 10.1097/RCT.000000000000059028296686) ; Yekeler E, Tunaci M, Tunaci A et al (2006) Frequency of Sternal Variations and Anomalies Evaluated by MDCT. AJR Am J Roentgenol 186(4):956–960. https://doi.org/10.2214/AJR.04.1779. (PMID: 10.2214/AJR.04.177916554563) ; Yurasakpong L, Asuvapongpatana S, Weerachatyanukul W, Meemon K, Jongkamonwiwat N, Kruepunga N, Chaiyamoon A, Sudsang T, Iwanaga J, Tubbs RS, Suwannakhan A (2022) Anatomical variants identified on chest computed tomography of 1000+ COVID-19 patients from an open-access dataset. Clin Anat 35(6):723–731. https://doi.org/10.1002/ca.23873. (PMID: 10.1002/ca.23873353851539083245) Contributed Indexing: Keywords: Perforated sternum; Sternal biopsy; Sternal body; Thoracic anatomy; Xiphoid process Entry Date(s): Date Created: 20230315 Date Completed: 20230517 Latest Revision: 20230517 Update Code: 20240513 PubMed Central ID: PMC10129975

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Prevalence and morphometry of sternal and xiphoid foramen: a meta-analysis on 16,666 subjects.