Morphometric Assessment of the Clivus using Computed Tomography in Adult Nigerians Visiting a Private Health Care Facility in Delta State
TL;DR
The observed sexual dimorphism in clival dimensions suggests that clival morphometry may serve as a useful adjunct skeletal marker for forensic sex estimation and contribute to the development of clival implants and fixation devices tailored to the population of Delta State, Nigeria.
Abstract
Background: The management of clival pathologies requires accurate morphometric assessment of the clivus to facilitate preoperative planning and inform the design of population-specific implants. The clival index provides valuable insight into clival morphology, an important parameter in skull base surgery. Clival morphometry is also useful in the forensic identification of unknown skeletal remains. This study aimed to evaluate the dimensions of the clivus and determine their variations according to age and sex in a Nigerian population. Methods: This retrospective cross-sectional study evaluated clival dimensions using 230 cranial computed tomography (CT) images from 115 males and 115 females aged 20–80 years, retrieved from the radiological database of a private hospital in Delta State, Nigeria. Access to the database was granted following approval by a University's Ethics Committee. Data were analyzed using the Statistical Package for the Social Sciences (IBM SPSS Statistics), version 27. The independent-samples t-test and one-way analysis of variance (ANOVA) were used to compare mean values between sex and age groups, respectively. Pearson's correlation analysis was performed to assess the relationships between variables. Statistical significance was set at p < 0.05. Results: Clival length and width exhibited significant sexual dimorphism, with males demonstrating larger dimensions than females (p < 0.05). In contrast, age was not significantly correlated with either clival length or width. A strong positive correlation was observed between clival length and width (p < 0.05). Conclusion: This study provides population-specific baseline morphometric data that may support preoperative planning for craniovertebral junction (CVJ) procedures and contribute to the development of clival implants and fixation devices tailored to the population of Delta State, Nigeria. The observed sexual dimorphism also suggests that clival morphometry may serve as a useful adjunct skeletal marker for forensic sex estimation.