Age-related morphometric and morphological differences in the external aperture of the carotid canal: a retrospective study
In brief
Children's carotid canal openings peak in size at ages 10 to 13
In CT scans from 350 children, carotid canal opening dimensions were largest in the 10 to 13 age group, while distances to nearby skull-base landmarks continued to increase through ages 14 to 18. The oval shape was most common, seen in 56% of openings. These age-specific patterns may aid preoperative imaging orientation, but the study did not test whether they improve surgical outcomes.
- Journal
- Surgical and radiologic anatomy : SRA (Q2)
- Published
- 2 November 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Murat Inci, Hamza Kasar, Mehmet Selcuk, Huseyin Yakar
- PMID
- 42970121
- DOI
- 10.1007/s00276-026-04047-x
Why clinicians should know about it
- Picked for Anatomy (top studies of the week, 8 November 2026): Pediatric skull-base morphometry and CT landmark measurements
Abstract
PURPOSE: This study aimed to evaluate age-stratified morphometric estimates for the external aperture of the carotid canal (EACC) in a paediatric population; it also aimed to assess age-related differences in its morphological and morphometric characteristics and the relationship between its dimensions and transverse skull-base width, measured as the distance between the supramastoid crests (SC-to-SC). METHODS: This retrospective study included 700 EACCs obtained from 350 patients aged between 1 and 18 years, evenly distributed across five age groups. Length, width, estimated area of the EACC, and distances to the midline, supramastoid crest, and mandible were measured on computed tomography images. Morphological types were classified as round, oval, and distinctly transversely elongated according to the width-to-length ratio. Generalized Estimating Equations (GEE) were used to account for bilateral shape dependency. RESULTS: The mean EACC length was 4.11 ± 0.88 mm, the width was 5.39 ± 1.19 mm and the estimated area was 18.03 ± 7.13 mm2. Age group had a very strong effect on all parameters (η2p = 0.389-0.822). Polynomial regression revealed an asynchronous trajectory: aperture dimensions peaked at 10-13 years (quadratic trend), whereas landmark distances increased linearly up to 14-18 years. After Bonferroni correction, EACC width, estimated area and SC-to-SC distance were significantly larger in males. Oval type predominated (56%), and the distinctly transversely elongated type was more common in males (GEE, p = 0.002). CONCLUSION: Growth of EACC parameters occurs asynchronously: canal dimensions reach maximum values in the 10-13-year age group, whereas distances to surrounding landmarks expand into late adolescence (14-18 years). These age-stratified estimates may assist anatomical orientation during preoperative radiological evaluation of the paediatric skull base.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.