Revisiting morphology of xiphoid process of the sternum in human: a comprehensive anatomical study
Issued Date
2024-01-01
Resource Type
ISSN
09301038
eISSN
12798517
Scopus ID
2-s2.0-85201812090
Journal Title
Surgical and Radiologic Anatomy
Rights Holder(s)
SCOPUS
Bibliographic Citation
Surgical and Radiologic Anatomy (2024)
Suggested Citation
Iwanaga J., Samrid R., Shelvin K.B., Cardona J.J., Kikuchi K., Chaiyamoon A., Suwannakhan A., Tubbs R.S. Revisiting morphology of xiphoid process of the sternum in human: a comprehensive anatomical study. Surgical and Radiologic Anatomy (2024). doi:10.1007/s00276-024-03463-1 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/100695
Title
Revisiting morphology of xiphoid process of the sternum in human: a comprehensive anatomical study
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: The xiphoid process (XP) in animals such as sheep and rats are well known to have cartilage called xiphoidal cartilage (XC). In humans, the cartilage in the xiphoid process is considered an anatomical variant and is not well understood. The aim of this study was to investigate the morphology of the XP. Methods: A total of twenty embalmed European descendant cadaveric sterna (aged 52 to 98 years) were used. Transilluminated XPs and midsagittal sections of XPs were used to examine the bone and cartilage. Subsequently, a sagittally-sectioned XP was harvested for histology and stained with Masson’s trichrome. The results of the transillumination and histological examinations were compared qualitatively. Results: The dark area visible in transilluminated XPs was consistent with the bony part in the midsagittal XP sections, which contained bone marrow; the bright area was consistent with the cartilage part in the midsagittal XP sections. This was all demonstrated histologically. Most of the XPs (85%) had some portion of cartilage. The XP was classified into four types based on its proportions of bone and cartilage: Type I, no ossification (< 1/3 ossification) 45%; Type II, minor ossification (1/3 − 1/2 ossification) 20%; Type III, major ossification (1/2–2/3 ossification) 20%; Type IV, complete ossification (> 2/3 ossification) 15%. Most of the XPs (85%) had bone and cartilage, which could have been overlooked in studies using skeletons or CT. Conclusion: Previous studies probably underestimated or overestimated the size of the XP. The XC needs to be considered as normal anatomy.