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Anatomical study and meta-analysis of the episternal ossicles

  • Anatomic Variations
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Abstract

Episternal ossicles (EO) are accessory bones located superior and posterior to the manubrium, representing an anatomical variation in the thoracic region. This study aimed to investigate the prevalence and developmental aspects of EO in global populations. The prevalence of EO in pediatric populations was assessed using the “Pediatric-CT-SEG” open-access data set obtained from The Cancer Imaging Archive, revealing a single incidence of EO among 233 subjects, occurring in a 14-year-old patient. A meta-analysis was conducted using data from 16 studies (from 14 publications) through three electronic databases (Google Scholar, PubMed, and Journal Storage) encompassing 7997 subjects. An overall EO prevalence was 2.1% (95% CI 1.1–3.0%, I2 = 93.75%). Subgroup analyses by continent and diagnostic methods were carried out. Asia exhibited the highest prevalence of EO at 3.8% (95% CI 0.3–7.5%, I2 = 96.83%), and X-ray yielded the highest prevalence of 0.7% (95% CI 0.5–8.9%, I2 = 0.00%) compared with other modalities. The small-study effect was indicated by asymmetric funnel plots (Egger’s z = 4.78, p < 0.01; Begg’s z = 2.30, p = 0.02). Understanding the prevalence and developmental aspects of EO is crucial for clinical practitioners' awareness of this anatomical variation.

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Data availability

The anonymised computed tomography data set can be retrieved from the Cancer Imaging Archive: https://doi.org/https://doi.org/10.7937/TCIA.X0H0-1706. Raw data for meta-analysis is available in the Supplementary Information.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Mahidol University International College, Mahidol University, Nakhon Pathom, Thailand

    Weerapoom Pongruengkiat & Warisa Pitaksinagorn

  2. Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand

    Laphatrada Yurasakpong, Napawan Taradolpisut & Athikhun Suwannakhan

  3. In Silico and Clinical Anatomy Research Group (iSCAN), Bangkok, Thailand

    Laphatrada Yurasakpong, Napawan Taradolpisut, Nutmethee Kruepunga & Athikhun Suwannakhan

  4. Department of Anatomy, Faculty of Medicine, Kasetsart University, Bangkok, Thailand

    Nutmethee Kruepunga

  5. Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

    Arada Chaiyamoon

Authors
  1. Weerapoom Pongruengkiat
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  2. Warisa Pitaksinagorn
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  3. Laphatrada Yurasakpong
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  4. Napawan Taradolpisut
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  5. Nutmethee Kruepunga
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  6. Arada Chaiyamoon
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  7. Athikhun Suwannakhan
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Contributions

WPo and AS conceptualized the study. WPo and AS performed the anatomical study. WPo, LY and AS conducted the systematic review and meta-analysis. WPo and AS wrote the main text and prepared all the figures. WPi, NK, NT critically revised the manuscript. All authors approved the manuscript prior to submission.

Corresponding author

Correspondence to Athikhun Suwannakhan.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval

This study was exempted by Mahidol University Central Institutional Review Board (MU-CIRB) (approval number: 2023/139.3108).

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Pongruengkiat, W., Pitaksinagorn, W., Yurasakpong, L. et al. Anatomical study and meta-analysis of the episternal ossicles. Surg Radiol Anat 46, 195–202 (2024). https://doi.org/10.1007/s00276-023-03280-y

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  • DOI: https://doi.org/10.1007/s00276-023-03280-y

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