Avaliação imaginológica da relação topográfica do canal retromolar, com o terceiro molar inferior, de acordo com a Classificação de Winter,por meio da tomografia computadorizada de feixe cônico / Cone beam computed tomography assessment of the topographic relationship between the retromolar canal and the third lower molar, according to the Classifications of Winter

O canal retromolar (CR) é uma das possíveis variações morfológicas do canal da mandíbula (CM), consideradas dentro dos padrões de normalidade na literatura científica, sendo que ramificações acessórias deste nervo retromolar se distribuem em direção ao músculo temporal, músculo bucinador, a porção mais posterior do processo alveolar da mandíbula, ao terceiro molar inferior, a mucosa bucal e a mucosa gengival de região dos elementos dentais posteriores inferiores. Este canal acessório da mandíbula possui um padrão imaginológico, caracterizado, pelo diâmetro, expressiva corticalização, sinuosidade do seu trajeto intraósseo, e consequente emergência no forame de mesmo nome; tornando-se necessário para o profissional da Odontologia o conhecimento desta variação anatômica, a fim de se evitarem intercorrências durante os procedimentos clínicos realizados na região de trígono retromolar. A tomografia computadorizada de feixe cônico (TCFC) é considerada um recurso imaginológico de grande valia, para a exploração do CM, uma vez que favorece a individualização deste acidente anatômico, nos diferentes cortes, em imagens de alta resolução, sendo designado como o recurso imaginológico mais sensível, considerado ¨padrão ouro¨ para esta exploração imaginológica. O objetivo deste estudo foi avaliar imaginologicamente, segundo as Classificações de Naitoh et al., (2009) e de Patil et al., (2013) a relação topográfica do CR, com o elemento dental terceiro molar inferior, seja irrompido ou não, com rizogênese completa ou incompleta, possivelmente impactado no elemento dental vizinho, utilizando-se da Classificação de Winter, por meio da TCFC. Foram avaliadas 244 (duzentas e quarenta e quatro) TCFC, nas quais se observaram a região de terceiros molares inferiores e a região de trígono retromolar da mandíbula, de indivíduos, selecionados aleatoriamente em relação ao sexo e em indivíduos entre 16 e 75 anos de idade cronológica. Todos os exames tomográficos utilizados neste estudo foram adquiridos por meio do equipamento; Ortophos XG 3D, da Sirona Dental Systems GmbH, nos quais por meio dos diferentes cortes, foi avaliada imaginologicamente a relação topográfica do canal retromolar, com o terceiro molar inferior, de acordo com a Classificação de Winter, por meio da tomografia computadorizada de feixe cônico. Nos resultados observamos que ambos os Observadores, nomeados 01 e 02 apresentaram porcentagens na identificação de canais retromolares a citar 19,3% e 34,0% respectivamente do total da amostra, quando da presença do canal retromolar, com respeito ao sexo, o Observador 01 identificou uma frequência de ocorrência maior em mulheres 21% do que em homens 15%, não sendo observada associação significativa, tendo-se como base valor de (P>0,05), P = 0,277; entretanto observando o lado de ocorrência desta variação anatômica, constatou-se que em mulheres do lado direito apresentaram uma frequência 70% das ocorrências, com uma associação significativa com valor de P=0,023; quando da associação da posição do terceiro molar inferior usando-se da Classificação de Winter associado a Classificação de Patil et al., constatou-se pelo Observador 01 que 74,4% das ocorrências de canais retromolares estavam nas posições mesioangular e vertical, sendo observado que o Subtipo A2 apresentou a maior frequência de ocorrência 45,0% na posição mesioangular e 30% na posição vertical; para o Observador 02 constatou-se 78,3% das ocorrências de canais retromolares estavam nas posições mesioangular e vertical, correspondendo ao subtipo A2 a maior frequência de ocorrência 65,1% na posição mesioangular e 68,2% na posição vertical; quando da associação da posição do terceiro molar inferior usando-se da Classificação de Winter associado a Classificação de Naitoh et al., constatou-se pelo Observador 01 que 74,4% das ocorrências de canais retromolares estavam nas posições mesioangular e vertical, sendo o subtipo F que apresentou a maior frequência de ocorrência 85,5% na posição mesioangulado e 93,3% na posição vertical, para o Observador 02 constatou-se que 78,3% das ocorrências de canais retromolares estavam nas posições mesioangular e vertical, sendo o Subtipo F quem apresentou a maior frequência de ocorrência 90,7% na posição mesioangular e 81,% na posição vertical. Nas conclusões, esta pesquisa permitiu diante da metodologia empregada concluir que, não existe associação significativa entre a ocorrência do canal retromolar com o sexo e faixa etária, houve associação significativa, quando da ocorrência do canal retromolar, situado no lado direito da mandíbula, para as mulheres pertencentes a amostra, em relação as maiores incidências de posição topográfica do terceiro molar inferior, estas ocorreram nas denominadas posições mesioangular e vertical, que relacionadas com a Classificação de Patil et al. (2013), encontrou-se como sendo a posição A2 do canal retromolar e correspondente a posição F da Classificação de Naitoh et al. (2009).

Clinical and Anatomical Variation During Assessment of Maximum Glottic Angle.

INTRODUCTION: Quantitative measurement and analysis of glottic abduction is used to assess laryngeal function and success of interventions; however, the consistency of measurement over time has not been established. This study assesses the consistency of glottic abduction measurements across visits in healthy patients and anatomic factors impacting these measurements. METHODS: Review of patients with two sequential flexible stroboscopic exams over seven months from 2019-2022. Images of maximal glottic abduction were captured and uploaded into and measured with ImageJ. Cadaver heads were used to assess the impact of visualization angles on glottic measurements with a monofilament inserted into the supraglottis of each cadaver as a point of reference. Comparisons were done with a paired T-test, T-test, or Mann-Whitney U test as appropriate. RESULTS: Fifty-nine patients and twenty-six cadaveric exams were included. Absolute change in maximum glottic abduction angle (MGAA) was 6.90° (95% CI [5.36°, 8.42°]; p < 0.05). There were no significant differences in change in MGAA by gender or age. Twenty percent of patients had a change of at least 25% in their MGAA between visits. Absolute differences in glottic angle between nasal side for cadaveric measurements was 4.77 ± 4.59° (p < 0.005)-2.22° less than the change in MGAA seen over time (p = 0.185). CONCLUSION: Maximal glottic abduction angles varied significantly between visits. Factors considered to be contributing to the differences include different viewing windows between examinations due to the position and angulation of the laryngoscope and changes in patient positioning, intra- and inter-rater variations in measurement, and patient effort. LEVEL OF EVIDENCE: N/a Laryngoscope, 134:2793-2798, 2024.

Assessment of Accessory Canals and Foramina in the Mandibular Arch Using Cone-Beam Computed Tomography and a New Classification for Mandibular Accessory Canals.

OBJECTIVES: The objectives of the study include the following: (i) to assess the presence of accessory canals and foramina in the body of the mandible using cone-beam computed tomography (CBCT), (ii) to evaluate the location, number, diameter, and length of accessory canals in the body of the mandible, and (iii) to propose a new classification for mandibular accessory canals based on the location. METHODS: A total of 50 (25 males and 25 females) CBCT scans were analyzed in three anatomical planes and three-dimensional (3D) reconstructions for the exact number, location, diameter, and accessory length canals and accessory foramina in the body of the mandible. The statistical analysis used was an independent t-test. RESULTS: Out of 50 CBCT scans, a total of 243 accessory canals and 245 accessory foramina were found. About 53% of accessory canals and foramina were found in males, while 47% were observed in females; 89% were evident in the anterior region, and only 11% were in the posterior region. The majority (64%) of the medial lingual canals had a diameter greater than or equal to 1 mm, while only 32% of accessory canals had a diameter of less than 1 mm (p < 0.05). The mean length of median lingual canals in females was 1.2910 ± 0.2582 mm and 2.6438 ± 0.5288 mm in male subjects. Mandibular accessory canals are classified broadly into anterior and posterior accessory canals, which have further subdivisions. CONCLUSION: CBCT plays a dynamic role in determining the mandible location of various neurovascular structures, including accessory canals and foramina. Female subjects were observed with more accessory canals and foramina and more common in the anterior region than in the posterior region.

Variations in the venous supply of the floor of the oral cavity: Assessment of relative hemorrhage risk during surgery.

There is little anatomical evidence about the venous plexus in the floor of the oral cavity, although venous injury can elicit late postoperative bleeding after oral surgery and it is difficult to identify the exact location of such an injury. The aim of this study was to assess the relative risk for venous injury during surgery. We investigated the course patterns of the venous plexus in the floor of the oral cavity and analyzed their relationships to those of the arteries using 23 human cadavers (41 halves) in the anatomy course at Niigata University during 2016-2018. The venous plexus in the floor of the oral cavity comprised the perforating submental vein, the vena comitans of the hypoglossal nerve, the vena comitans of the submandibular duct, the vena comitans of the lingual nerve, the sublingual vein, and the deep lingual vein. Individual variations of this plexus include duplications or absences of some veins. There is a high incidence of a submental branch running above the mylohyoid or perforating submental artery in the sublingual fossa among individuals with the perforating submental vein piercing the mylohyoid muscle, whereas the sublingual artery has a high incidence there when there is no perforating submental vein. The course patterns of arteries in the floor of the oral cavity can be predicted by estimating the course patterns of the submental veins. The course patterns of the submental veins or veins associated with the nerves and submandibular duct need to be carefully considered during surgery.

Morphological and functional assessment of the flexor carpi radialis brevis using conventional ultrasound and elastography.

PURPOSE: The flexor carpi radialis brevis (FCRB) is a supernumerary musculotendinous structure of the wrist that has been the focus of some interest in the last decade. While its anatomy is well known, its in vivo function remains unknown as it has never been studied. METHODS: Eleven cases of FCRB underwent a multimodal ultrasound consisting of B-mode, color Doppler and shear wave elastography. RESULTS: A pennate shape was observed in all cases and the mean value of the cross-sectional area was 0.8 cm2 (SD 0.3 cm2). Young's modulus was significantly (p < 0.01) different between the resting position and active flexion or passive extension. CONCLUSION: Our study demonstrates that the FCRB shows biomechanics of a typical skeletal muscle and is voluntarily controlled by flexing the wrist. Absent in other vertebrate taxa, the FCRB probably plays a role in active stability of the wrist in Human.

Value of Performing Routine Vascular Mapping Synchronous with Radiographic Assessment of Endodontic Lesions: Case Series.

With the adoption of limited-volume cone beam computed tomographic (CBCT) imaging in dentistry, high resolution of the maxillomandibular complex has led to the recognition of numerous accessory neurovascular canals. The preoperative identification of these structures is essential to facilitate the safe performance of an assortment of invasive dental procedures; however, there is limited information in the endodontic literature regarding mapping of these neurovascular canals and their anatomic variants. To emphasize the utility of accessory neurovascular channel mapping in conjunction with endodontic therapy, we have presented the clinical findings of 4 diverse cases. Comprehensive evaluation of the CBCT scans showed relevant underlying etiopathologies, prompting clinical modifications that led to enhanced patient outcomes.

Evaluation of persons with suspected lumbosacral and cervical radiculopathy: Electrodiagnostic assessment and implications for treatment and outcomes (Part I).

Persons with back, neck, and limb symptoms constitute a major referral population to specialists in electrodiagnostic (EDX) medicine. The evaluation of these patients involves consideration of both the common and less common disorders. The EDX examination with needle electromyography (EMG) is the most important means of testing for radiculopathy. This test has modest sensitivity but high specificity and well complements imaging of the spine. Needle EMG in combination with nerve conduction testing is valuable in excluding entrapment neuropathies and polyneuropathy-conditions that frequently mimic radicular symptoms. In this first of a two-part review, the optimal EDX evaluation of persons with suspected radiculopathy is presented. In part two, the implications of EDX findings for diagnosis and clinical management of persons with radiculopathy are reviewed.

Bifid mandibular canals: CBCT assessment and macroscopic observation.

PURPOSE: The bifid mandibular canal is an anatomical variation, which causes anesthetic failure and surgical accidents occasionally. The purpose of this study is to observe the prevalence and anatomical location of bifid mandibular canals, providing clinical value in reducing the occurrence of surgical accidents and postoperative complications. METHODS: A total of 321 outpatients were selected in this study. Their CBCT images were observed, and the prevalence of bifid mandibular canals as well as the composition ratios of each branch type was evaluated according to the classification of Naitoh. The bifid mandibular canals and their branches' diameter, length, horizontal distance to the buccal/lingual wall of the mandible, and vertical distance to the mandibular alveolar ridge were measured. Furthermore, 194 dry adult mandibles from the Department of Oral Anatomy and Physiology of Tianjin Medical University were observed to evaluate the prevalence and the average diameter of retromolar foramina. RESULTS: Of all the 321 patients, 84 (26.17%) cases of bifid mandibular canals and 105 (16.36%) sides of unilateral bifurcation were observed. Based on Naitoh's classification, the retromolar canals were the most common types (46.67%), followed by the forward canals (40.00%), the dental canals (10.48%) and the buccolingual canals (2.86%). In 194 dry adult mandibles, 23 cases (11.86%) and 29 sides (7.47%) of retromolar foramina were found and the average diameter of retromolar foramina was 0.94 ± 0.30 mm. CONCLUSION: More than a quarter of the population has the bifid mandibular canal, which is a potential factor of the onset of surgery accidents. CBCT is an effective method to identify the branches of mandibular canals. Preoperative CBCT examination can help reduce various postoperative complications.

Nasal cavities and the nasal septum: Anatomical variants and assessment of features with computed tomography.

The nasal cavities are complex anatomical structures with high inter-individual variability that relates to different functions. Different anatomic variants may manifest at this site, mainly belonging to the nasal septum and turbinates. Precise knowledge of the anatomy and variants is fundamental for both radiologists and ENT surgeons. This article provides an overview of the main anatomic variants and their frequency, according to the existing literature, as well as ongoing research on nasal cavity segmentation in order to obtain personal 3D models and to predict post-surgical results.

Relationship between sphenoid sinus volume and accessory septations: A 3D assessment of risky anatomical variants for endoscopic surgery.

Sphenoid sinus accessory septations involve serious complications during their removal for the injury of the internal carotid artery (ICA) and the optic nerve (ON). The relationships of this anatomical variant with sphenoid size still remain unclear. In the present study, 260 patients (equally divided among sexes, aged between 18 and 92 years) were retrospectively assessed. Number of accessory septations and their relationship with ICA and ON were recorded. The 3D model of sphenoid sinuses was extracted. Pearson's coefficient was calculated to assess correlations between the volume of sphenoid sinuses and the number of septations (P < 0.05). Sex-related differences in prevalence of septations inserted onto ICA or ON were assessed through chi-square test (P < 0.05). Differences in volume between patients with and without ICA or ON septal insertions were assessed through Mann-Whitney test (P < 0.05). In most of the cases, two septations were found (24.6%), whereas only 21.9% of patients did not show any septum. ICA and ON septal insertions were found in 20.8% and 7.7% of cases, respectively. Number of septations significantly increased with sinus volume, independently from sex (P < 0.001). Moreover, volume was significantly higher in patients with ICA septal insertion (P < 0.001), whereas no difference was found between subjects with and without ON septal insertion (P > 0.05). The present study first proved that septations and probability of ICA insertion are related with sphenoid volume. On the other side, ON insertion does not depend upon sphenoid sinuses size. Anat Rec, 303:1300-1304, 2020. © 2019 American Association for Anatomy.

An assessment of the effects of variations in the Palmaris longus tendon and the fifth superficial flexor digitorum on pinch and grip strength.

INTRODUCTION: The effect of the absence or presence of the Palmaris longus tendon on pinch and grip strength was investigated in this study. Similarly, the effect of the presence or absence of the fifth superficial flexor digitorum on grip strength in the hand was studied. The aim of the present study was to assess the combined effect of these anatomical variations on pinch and grip strength. MATERIALS AND METHODS: In this cross-sectional study, 523 volunteers and their 1046 hands were enrolled. Each hand was assessed for the presence or absence of the Palmaris longus tendon and for variations in the fifth superficial flexor digitorum function. Then the grip and pinch power of the hands were measured with the Jammar Dynamometer. RESULTS: The presence or absence of Palmaris longus had no effect on grip strength in the individuals studied. Likewise, variations in fifth superficial flexor digitorum function had no effect on grip and pinch strengths. But the results of statistical testing showed the effect of the presence of Palmaris longus on pinch strength (25.38 lbs in hands with Palmaris present vs 24.43 lbs in hands without Palmaris). Pinch and grip power was higher in men than in women and in the right hand than in the left. CONCLUSION: Based on the findings of the present study, it seems that absence of the Palmaris longus tendon is associated with a reduction in pinch strength but has no effect on grip strength, and the variations in the fifth superficial flexor digitorum (flexor digitorum superficialis, or FDS) have no effect on pinch and grip strengths.

Assessment of the temporal crest canal using cone-beam computed tomography.

The temporal crest canal (TCC) is a rare variant of the mandibular canal, and it is important to locate the presence and site of mandibular canals and their variants before operation. We have examined the anatomical features and prevalence of TCC with cone-beam computed tomography (CT) in south-east Anatolia. The cone-beam CT images of 1023 patients (2026 sides) referred to the Department of Dentomaxillofacial Radiology between 2015 and 2017 years were evaluated retrospectively. Sagittal, cross-sectional, and reformatted panoramic images were analysed to see if a TCC was present. The canals were grouped as Type 1 and Type 2 according to their configuration. Seven (0.7%) were found in 1023 patients. Two of them (0.2%) were in female, and five (0.5%) in male, patients. Four (0.4%) were increasingly narrow and noticeably curved (Type 1), and three (0.3%) were uniformly wide and slightly curved (Type 2). All TCC were unilateral: two on the right and five on the left. We conclude that knowledge of the presence of a TCC and its anatomical variants in the mandibular ramus is important to ensure a proper local anaesthetic nerve block for surgical operations. Cone-beam CT is an important diagnostic tool in dentistry, and clearly recognises a TCC.

Cone-beam CT assessment of implant-related anatomy landmarks of the anterior mandible in a Chinese population.

PURPOSE: To investigate the prevalence, location, and morphology of the mandibular lingual foramen (MLF), mandibular incisive canal (MIC), and anterior loop of the inferior alveolar canal (ALC) in a Chinese population using cone-beam CT (CBCT). MATERIALS AND METHODS: From 2014 to 2016, CBCT images from patients with various scanning purposes were obtained from the database of the Affiliated Stomatology Hospital of Kunming Medical University, China. Imaging analyses of the MLF, MIC, and ALC were performed via the NNT viewer software. The prevalence, location, length, classification of MLF, and its distances to the alveolar crest and the lower border of mandible were investigated, and the prevalence and length of MIC and the prevalence of ALC were also studied. RESULTS: This study examined 1008 subjects, 521 (51.7%) males, and 487 (48.3%) females. 916 (90.9%) subjects showed the medial lingual foramina (LF), a single medial LF with the supraspinous-type predominating. Lateral LF were observed in 547 (54.3%) subjects mostly located in the premolar areas. 876 (86.9%) subjects had the MIC on the left side, whereas 877 (87.0%) had the MIC on the right side. The ALC was present in 147 (14.6%) subjects. CONCLUSIONS: This study showed a high prevalence of LF and MIC in the Southwest Chinese population. Therefore, caution should be taken during the implant treatment at the anterior mandible region.

Anatomical assessment of the digastric branch of the facial nerve as a landmark to localize the extratemporal facial nerve trunk.

PURPOSE: Localization of the facial nerve trunk (FNT) [i.e., the portion of the facial nerve between the stylomastoid foramen (SMF) and pes anserinus] may be required during various surgical interventions such as parotidectomy and hypoglossal-facial anastomosis. Several landmarks have been proposed for efficient identification of the FNT. We sought to assess the anatomical features of the digastric branch of the facial nerve (DBFN) and its potential as a landmark to identify FNT. METHODS: Fifteen sides of eight cadaveric heads were dissected to find the DBFN. Anatomic features of DBFN including its point of origin relative to SMF, length, and important relationships, as well as the distance between the insertion point on the digastric muscle and mastoid tip were recorded. RESULTS: DBFN was found in all specimens originating from the FNT outside the SMF with an average length (± standard deviation) of 15.4 ± 3.4 mm. In all specimens, the DBFN inserted on the superomedial aspect of the posterior belly of the digastric muscle (PBD). In 8/15 specimens, DBFN was accompanied by the stylomastoid artery on its anteromedial side. Average distance (± standard deviation) between the mastoid tip and the nerve insertion point on PBD was 13.6 ± 2.0 mm (range 10-17). CONCLUSIONS: The DBFN is a reliable landmark for identifying the FNT. It could be consistently identified within 15-20 mm of the mastoid tip on the superomedial aspect of the PBD. The DBFN may be used as a supplementary landmark for efficient localization of the FNT. LEVEL OF EVIDENCE: Not applicable (anatomic study).

Review of Risk Assessment of Major Anatomical Variations in Clinical Dentistry: Accessory Foramina of the Mandible.

Most of the studies of the mandible's anatomical variations have presented the authors' speculations, and only a limited number has provided evidence that demonstrated the actual complications injury to the variant structures caused. To our knowledge, no study has evaluated the risks associated with these variant anatomical structures' injury. We reviewed articles that described clinical cases of the injury to, and anatomical studies of, three anatomical variants of the mandible-the accessory mental, lingual, and retromolar foramina-with which dentists are relatively familiar and that are mentioned often in the context of implant and third molar surgeries, to describe risk assessment methods with which to evaluate potential complications preoperatively. Only a limited number of the clinical reports of injury to the mandible's accessory foramina were available. The potential severe complication of injury of the accessory mental foramen (AMF) is sensory disturbance of the lower lip. Risk of neurosensory disturbance of lower lip can be assessed by AMF/MF ratio and positional relations to the MF. Potential severe complication of injury of the lingual foramen is bleeding and hemorrhage in the oral cavity's floor. Risk of bleeding can be assessed by diameter and positional relation between the mental spine/mylohyoid line. A risk assessment of the retromolar foramen could not be made because of inadequate data. We hope the risk assessments suggested will encourage dentists to predict intraoperative/postoperative complications caused by damaging the mandible's accessory foramina. Clin. Anat. 32:672-677, 2019. © 2019 Wiley Periodicals, Inc.

The radioanatomical assessment of the Körner's septum.

PURPOSE OF THE STUDY: Körner's septum (KS) is a developmental remnant formed at the junction of mastoid and temporal squama, representing the persistence of the petrosquamosal suture. During mastoid surgery, it could be taken as a false medial wall of the antrum so that the deeper cells might not be explored. The aim of the study was to assess a Körner's septum prevalence and to analyze its topography. METHODS: The study was performed on 80 sets of cone-beam computed tomography (CBCT) images of temporal bone (41 male, 39 female, 160 temporal bones). Körner's septum was identified and its thickness was measured on axial sections at three points: at the level of superior semicircular canal (SCC), at the level of head of malleus (HM) and at the level of tympanic sinus (TS). RESULTS: KS was encountered at least in one point of measurements in 50 out of 80 sets of CBCT images (62.5%). The average thickness at the level of SCC was 0.87 ± 0.34 mm, at the level of HM was 0.99 ± 0.37 mm and at the level of TS was 0.52 ± 0.17 mm. CONCLUSIONS: Körner's septum is a common structure in the temporal bone-air cell complex. It is more often encountered in men. In half of the patients, it occurs bilaterally. However, in most of the cases it is incomplete with anterior and superior portions being the most constant.

Assessment of scapular morphometry / Evaluación de la morfometría escapular

The current study was undertaken to assess the incidence of different types of suprascapular notch, acromion dimensions and the lower and upper scapular angles. The suprascapular notch and variations of the acromion are clinically important in suprascapular nerve compression and subacromial impingement. Measurements were taken from 73 Anatolian dry scapulae of unknown age or sex. The suprascapuar notch was classified according to that of Rengachary et al. (1979). Its width and depth, the distance between supraglenoid tubercle and the deepest point of notch, as well as the upper and lower scapular angles were also determine measured. The type of acromion was assessed according to shape (type I (cobra), type II (square), type III (intermediate)) and tilt (type I (flat), type II (curve). Acrmion length and the distance between acromion and coracoid process were also measured. The frequency of different types of suprascapular notch were type I (28.8 %), type II (23.3 %), type III (13.7 %), type IV (20.5 %), type V (2.7 %), type VI (5.5 %)and absence (5.5 %). Acromion type were type I (45.5 %), type II (7.5 %) and type III (47.0 %), acromion tilt type I (15.2 %), and type II (84.8 %). An understanding of the association between the anatomical structures of the scapula and morphometric measurements is clinically important.

En este trabajo se evaluó la incidencia de diferentes tipos de incisura supraescapular, dimensiones de acromion y los ángulos escapulares superior e inferior. La incisura supraescapular y las variaciones del acromion son clínicamente importantes en la compresión del nervio supraescapular y el pinzamiento subacromial. Las mediciones se tomaron de 73 escápulas secas de Anatolia, de edad y sexo desconocidos. La incisura supraescapular se clasificó según Rengachary et al. (1979). Se determinaron también el ancho y la profundidad, la distancia entre el tubérculo supraglenoide y el punto más profundo de la incisura, así como los ángulos escapulares superior e inferior. El tipo de acromion se evaluó de acuerdo con la forma [tipo I (cobra), tipo II (cuadrado), tipo III (intermedio)] y la inclinación [tipo I (plano), tipo II (curvo)]. También se midieron la longitud del elemento y la distancia entre el acromion, como así también el proceso coracoide. La frecuencia de los diferentes tipos de incisura supraescapular fueron: tipo I (28,8 %), tipo II (23,3 %), tipo III (13,7 %), tipo IV (20,5 %), tipo V (2,7 %), tipo VI (5,5 %) y ausencia (5,5 %). Los tipos de acromion fueron: tipo I (45,5 %), tipo II (7,5 %) y tipo III (47,0 %), tipo de inclinación de acromion I (15,2 %) y tipo II (84,8 %). En conclusión, el conocimiento de la asociación entre las estructuras anatómicas de la escápula y las mediciones morfométricas es clínicamente importante.

Anterior inferior iliac spine morphology: quantitative and qualitative assessment in an asymptomatic population.

PURPOSE: To assess the prevalence of anterior inferior iliac spine (AIIS) types, and to investigate the quantitative measurements that characterize AIIS morphology in an asymptomatic adult population. METHODS: In this prospective study, 358 hips from 179 consecutive subjects (age range, 19-82 years; 91 males, 88 females), who underwent CT examination for reasons other than hip problems and were negative for hip impingement test, were analyzed. AIIS types were determined (1, flat wall of the ilium between distal end of AIIS and acetebular rim; 2, bony eminence between distal end of AIIS and acetebular rim; and 3, extension of AIIS to the anterior superior acetebular rim) and AIIS tip angle (TA), direct distance (DD) of the anterior acetabular rim to AIIS as well as projectional distances in vertical (VD) and horizontal (HD) planes were measured. Age- and gender-related factors were searched using two-way ANOVA test under three age groups (18-39, 40-59, and ≥ 60 years). RESULTS: There were 238 (66.5%) type 1, 118 (33.0%) type 2, and two (0.5%) type 3 AIISs, with significant difference between AIIS types among age groups and genders (P < 0.001). VD and DD showed age- and gender-related (P < 0.001, P < 0.001), and TA demonstrated gender-related differences (P < 0.001). Inter-observer agreement was good for TA and moderate to poor for other measurements. CONCLUSIONS: Type 1 AIIS is the most common shape across all age groups in adult females and in young and middle-aged adult males. TA, DD, and VD might be reliably used for the evaluation of AIIS morphology.

Assessment of morphological and anatomical characteristics of mental foramen using cone beam computed tomography.

PURPOSE: To determine the shape, position, vertical height, surrounding bone characteristics, and opening angle of mental foramen (MF) using dental cone beam computed tomography (CBCT). METHODS: A retrospective study was performed on 663 patients. CBCT records analyzed for the shape, position, and surrounding bone measurements of the MF using Simplant 3D software (Hasselt, Belgium). Opening angle of MF was also assessed. Kruskal-Wallis and Mann-Whitney U tests were employed to test significant differences between parameters, genders and ages. RESULTS: All mental foramina were visualized. Regarding location, 49.2% of the MFs were located between first and second premolars, 7.7 distal and 39.7% coincident to the apex of the mandibular second premolar. The mean MF opening angle was 45.4° on the right side, and 45.9° on the left. There were no statistically differences between gender groups with regard to the opening angle degrees. CONCLUSIONS: This study may provide useful information about variations in the position, shape and size, angle of mental foramen, which may help the practitioners to perform safer mental nerve blocks and surgical procedures.

Quantitative assessment of vertebral artery anatomy in relation to cervical pedicles: surgical considerations based on regional differences.

OBJECTIVE: To quantify the anatomic relationship between the Cervical pedicle screw (CPS), vertebral artery (VA), and related anatomic structures in the Saudi population. METHODS: This retrospective single center study included 50 consecutive patients (35 males) with normal neck findings on computed tomography angiography performed for trauma or vascular evaluation between 2012 and 2014. Radiologic parameters were assessed and correlated with age, weight, height, and body mass index (BMI). RESULTS: Mean age, weight, height, and BMI were 45.74+/-18.93 years, 79.72+/-21.80 kg, 164.74+/-11.53 cm, and 29.38+/-6.13 kg/m2, respectively. Mean cervical pedicle diameter (PD) increased from the cranial to caudal vertebrae (p=0.0001). Mean free zone (FZ) value, defined as the distance between the lateral CP border and medial VA border, was 1 mm (range 0.95-1.16 mm). The VA entry into the transverse foramina was at C6 level on both the right 92% and left side in most patients 94%. However, the right and left side level of VA entry differed in 14% of individuals. CONCLUSION: The PD and FZ are smaller in Saudi Arabians than in western populations. Assessment of VA entry at each level should be performed on an individual basis as the level of VA entry can differ in the same patient. Anatomic variations between different geographic areas should be studied to provide better surgical guidance.