Anatomical evaluation of P1 segment of posterior cerebral artery and posterior communicanting artery in 340 human hemispheres: a proposal for morphological classification.

PURPOSE: The aim of our study is to examine the morphometry of the P1 segment of the posterior cerebral artery (P1) and the posterior communicating artery (PcomA) and to present a descriptive classification according to morphometric findings. METHODS: 340 hemispheres from 170 cadavers were included. The outer diameters of P1 and PcomA were measured with ImageJ software. Then, the configurations of the posterior cerebral artery were revealed as fetal, adult and transitional. The findings were correlated with the demographic information of the cadavers such as gender, body mass index (BMI), age. RESULTS: According to the morphometric findings, 83.75%, 13.85% and 2.40% of the posterior cerebral arteries were found to be adult, fetal and transitional, respectively. The fetal type was more common in cadavers aged 60 years and older (13.73%) compared to the 18-39 and 40-59 age groups. In addition, P1 and PcomA diameters also increased with age. Fetal and transtional types showed a similar low distribution in people with low (< 18.5), normal (18.5-24.9), overweight (25-29.9) and obese (> 30) BMI, whereas adult type was found in cadavers with a normal BMI of 140/303. CONCLUSION: We believe that the findings of our study will contribute to the planning of neurointerventional procedures, the development of endovascular devices, the success of invasive procedures and the reduction of complications.

Analysis of the Thigh Aesthetic Profiles: One of Physical Ideal Body Proportions.

BACKGROUND: The contour of the thigh is increasingly being recognized as crucial component of the ideal human physique, giving rise to heightened interest in attaining the perfect thigh profile. Notwithstanding, the contemporary landscape of cosmetic surgery appears to be bereft of efficient and precise objective methodologies to evaluate the outcomes of thigh contouring treatments. The present study is aimed to investigate the aesthetic appeal of varying thigh contours, employing specialized software as an indispensable instrument for quantitative and qualitative analysis. METHODS: Standardized photographs of the lower body were obtained from a sample of 200 healthy volunteers. A linear analysis was conducted, examining aspects such as the vertical length and transvers width of the thigh, as well as angular measurements including the posterior gluteal angle (PGA) and lateral angle thigh (LAT). Variables relating to thigh measurements and body mass index (BMI) were documented, with the relationships between them ascertained through Pearson's correlation and regression analysis. RESULTS: In males, the LAT was measured at 168 ± 3.9, and the PGA at 170 ± 3.4, while in females, these measurements were 166 ± 2.8 ve 166 ± 2.8, respectively. Linear analyses, including the vertical length of thigh (VLT), transverse width of thigh (TWT), lateral width (LW), and posterior width (PW), were conducted. Based on the LW inferior/LW superior ratio values, the most commonly observed thigh types were Type III (0.90) at 45% and Type II (0.85) at 24.75% while the least common was Type V at 4% (0.99). PW inferior/PW superior was 84.7%. The PWI/PWS ratio was highest for Type V, at 0.99, accounting for 84.70% of the total. Furthermore, an increase in the LWI/LWS ratio leads to an increase in the PWI/PWS ratio.  The frequency of the VLT/TW1 ratio 0.31-0.35 (Type 3) was found to be on the left side and Type 4 on the right side. A strong correlation was found between BMI and all thigh indexes, with a significant positive correlation between the index and factors tied to the buttocks and upper thigh. CONCLUSIONS: The concept of an ideal thigh may vary based on an individual's gender, race, country of residence, and self-esteem, aiming to achieve a more natural silhouette. Focusing on the different ratios of hip and thigh varieties in the study is quite intriguing. Further inquiry and rigorous exploration are warranted to delineate the optimal techniques and methodologies for attaining ideal thigh proportions. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The variations of osseous structure of the internal acoustic canal: an anatomical study.

OBJECTIVES: The internal acoustic meatus is an osseous canal that connects the inner ear to the posterior cranial fossa. It is located in the petrous portion of the temporal bone. A thin cribriform osseous plate known as the fundus is situated at the lateral end of the canal. This study assesses the structural and numerical variations of the fundus formations. METHODS: Fifty-four temporal bones of unknown gender and age were examined with the surgical microscope. RESULTS: The temporal bones analyzed were 46.2% right-sided and 53.7% left-sided. Only one temporal bone had two parallel transverse crests, while three had a single anterior crest that split into two branches posteriorly. The number of foramina at the transverse crest varied, with 29.6% having none, 48.1% having a single foramen, and 22.2% having several foramina. An anterior crest structure was seen in 53.7% of the temporal bones, with 5% having a slightly constricted entry to the facial canal. In cases with a single nerve foramen, 48.1% had one, while 51.8% had more than one, including examples with three or four foramina. A crest was found between the foramina of the single nerve in 7% of patients. Furthermore, a crest between the saccular nerve foramen and the high fiber foramina was seen in 25.9% of cases, and 5% had two saccular nerve foramina. CONCLUSION: We think that revealing the anatomical, structural and numerical variations in the fundus will be useful in explaining the disease-symptom relationship. LEVEL OF EVIDENCE: Level 4.

Morphometric and morphological evaluation of the nasolacrimal groove in 150 dry bones in the Anatolian population.

PUPOSE: In this study, we aimed to evaluate the anatomical features of the nasolacrimal groove in detail by providing a morphological classification based on morphometric evaluations of the nasolacrimal groove. METHODS: A total of 150 sagittal dry bones in the Department of Anatomy, Faculty of Medicine, Istanbul University were evaluated. The length and the width at different points of the nasolacrimal canal were calculated. According to the widths of the nasolacrimal canal ten different morphological types were revealed. RESULTS: The length of the canal was found as mean 13.62 ± 2.42 mm on the right and 12.44 ± 2.68 mm on the left side. The entrance, the base, the upper and the lower thirds of nasolacrimal canal were 6.22 ± 1.19 mm, 7.95 ± 1.85 mm, 5.85 ± 1.06 mm, 6.60 ± 1.54 mm, on the right and 6.08 ± 1.16 mm, 7.24 ± 1.64 mm, 5.45 ± 1.29 mm, 6.23 ± 1.48 mm, on the left side, respectively. The width of the entrance of the nasolacrimal canal was the narrowest width compared to the base, upper and lower thirds in 7/10 types of 71/150 cranial bones. CONCLUSION: This comprehensive morphological classification of the nasolacrimal groove sheds new light on its complex variations. We support that the finding of this study has the potential to improve the precision of diagnostic assessments and guide specific therapeutic interventions for patients with lacrimal drainage disorders.

Anatomical Features of Posterior Cerebral Arteries and Basilar Artery in 170 Anatolian Fresh Cadavers: Implications for Surgical Planning and Intervention.

BACKGROUND: The posterior cerebral arteries (PCAs) are terminal branches of the basilar artery (BA) and are responsible for the primary supply of the occipital lobe. Saccular aneurysm is most commonly seen close to the bifurcation of the BA. Various surgical interventions are performed for aneurysms. Therefore, the anatomy and localization of the BA and PCA are crucial. The aim of this study was to determine the characteristics of these arteries in a large Anatolian population. METHODS: The study included 170 Anatolian fresh cadavers. The diameters of the BA and PCA were measured. Correlations according to sex and age groups were analyzed. The Q1, Q2, and Q3 angles between the right and left PCA, between the right PCA and BA, and between the left PCA and BA, respectively, were measured. The location of the PCA relative to the sulcus pontocruralis (pontocrural groove) was also evaluated. RESULTS: The diameter of the artery increased with age and was higher in males than in females. Q1 and Q2 diameters were larger in males, while the Q3 diameter was larger in females. The Q1 angle between the right and left PCAs was found to be higher in age range 40-59 years with a mean of 87.33 ± 17.91 mm. Finally, the bifurcation point of the PCA was most frequently located above the sulcus pontocruralis (pontocrural groove) and least frequently located on the sulcus pontocruralis (pontocrural groove). CONCLUSIONS: The findings of our study will contribute to the planning of surgical approaches, the development of endovascular devices, the success of invasive procedures, and the reduction of complications.

Anatomical variations of the zygomaticofacial foramen and its related canal through the zygomatico-orbital and zygomaticotemporal foramina in dry human skulls.

PURPOSE: The aim of this study is to reveal the location of the zygomaticofacial foramina, the variations of their numbers, and their connections between the zygomatico-orbital and zygomaticotemporal foramina. METHODS: Ethics committee approval of our study was received by the Istanbul Medical Faculty Clinical Research Ethics Committee (date:30.07.2021, number:358356). 171 zygomatic bones of unknown gender from the Department of Anatomy, Istanbul University, were included in this study. The number of zygomaticofacial foramina and their connections with the zygomatico-orbital foramen and the zygomaticotemporal foramina were examined. Also, the morphometric distances between the zygomaticofacial foramen were calculated. Evaluation of the data was done with SPPS v.21. RESULTS: The number of zygomaticofacial foramina was found as 299. It was found single, double, three, four, five and six foramina, in 52 (30.4%), 52 (30.4%), 24 (14.03%), 10 (5.85%), 5 (2.93%), 1 (0.58%) zygomatic bone, respectively. Zygomaticofacial foramen was absent in 27 (15.8%) bones. Of these 299 foramina, 129 were found to be connected with zygomatico-orbital foramen and 23 with zygomaticotemporal foramen. It was noted that 147 zygomaticofacial foramina had no connection with any foramina. The distances between the zygomaticofacial foramen and the frontozygomatic suture, temporal process, maxillary process, the lowest point of the zygomatic bone, and orbital rim were found as 25.30 ± 2.81mm, 18.74 ± 3.56mm, 21.56 ± 4.16mm, 18.72 ± 2.57mm, 6.67 ± 3.27mm, respectively. CONCLUSION: Consequently, the location and variations of ZFF are of great importance for maxillofacial surgery and regional block anesthesia. Knowing its location and variations will help prevent complications during any surgical intervention in this region.

Angles of Needle Insertion for True Vocal Fold Access Via the Thyrohyoid and Cricothyroid Membranes of the Larynx.

OBJECTIVE: This study aims to provide an analysis of the cricothyroid and thyrohyoid membrane approaches for laryngeal injections in cadaveric vocal cords. The primary objective is to determine the optimal techniques, needle trajectories, and anatomical landmarks for accessing different regions of the vocal cords percutaneously. MATERIALS AND METHODS: The study was conducted on 23 adult cadavers, consisting of 8 females and 15 males. The cadaveric larynges were mounted vertically to ensure proper anatomical positioning. Both the cricothyroid and thyrohyoid membrane approaches were utilized for reaching the vocal cords. Measurements were taken for needle trajectories, angles, and distances to determine the optimal approach for accessing the anterior, middle, and posterior thirds of the vocal cord. RESULTS: Through the thyrohyoid membrane approach, the anterior, middle, and posterior thirds of the vocal cords can be accessed with the optimal needle insertion coronal angles of 15.46 ± 7.86°, 16.52 ± 7.15° and 18.29 ± 14.46°, and sagittal angles of 126.01 ± 9.65°, 116.67 ± 8.04° and 111.02 ± 8.86° respectively at a lateral distance of 1.92 ± 1.62 mm from the midline and 8.48 ± 2.73 mm below the vertical line. From the cricothyroid membrane approach, optimal coronal and sagittal insertion angles of the anterior, middle, and posterior thirds of the vocal cord were respectively: 158.95 ± 9.3°, 156.09 ± 11.59°, 152.4 ± 14.46°, 11.5 ± 7.77°, 21.83 ± 12.47° and 32.91 ± 12.59°. CONCLUSION: This analysis of the cricothyroid and thyrohyoid membrane approaches in cadaveric larynges provides valuable insights for clinicians and researchers in the field of laryngology. The findings serve as a reference for optimizing laryngeal injection techniques, enhancing patient outcomes, and minimizing complications.

Accessory Muscles Associated With the Levator Palpebrae Superioris Muscle in 100 Cadavers.

PURPOSE: This study aimed to determine the variations of the levator palpebrae superioris muscle and to reveal its morphological features. METHODS: This study conducted on 100 adult orbit cadavers in the Department of Anatomy, Istanbul University, used an exploratory, descriptive research design. The anatomical and morphological variations of the levator palpebrae superioris muscle and its relationship with the superior ophthalmic vein were evaluated. RESULTS: Variations of levator palpebrae superioris muscle were discovered in 11 of 100 orbits. Single (9%), double (1%), and triple (1%) accessory muscle slips were observed. The origin of accessory muscle slips showed variation as the accessory muscle slips originated either from the proximal or distal half of the levator palpebrae superioris muscle. Also, the insertions of accessory muscle slips were variable, as they were inserted into levator aponeurosis, trochlea, lacrimal gland, lateral orbital wall, or the fascia of the superior ophthalmic vein. CONCLUSIONS: Accessory muscles associated with levator aponeurosis were found in a significant proportion of cadavers. These muscles may cause confusion in orbital surgery and should be taken into account during surgical planning and orientation in the superior orbit.

Variations in the course of the externalbranch of the superior laryngeal nerveand their importance in surgicalprocedures: an experimental cadaveric study.

<br><b>Introduction:</b> Injury of the external branch of the superior laryngeal nerve can cause a hoarse or weak voice due to the functional loss (dysergia) of the cricothyroid muscle. Defining the anatomical variations of the external branch of the superior laryngeal nerve and estimating their frequency are crucial for surgical interventions.</br> <br><b>Aim:</b> To reveal the topography of the external branch in the Anatolian population, to prevent injury of it during the surgical intervention in the anterior neck region.</br> <br><b>Material and methods:</b> 26 bilateral hemilarynges (4 females, 22 males) were dissected. The morphometric and morphological features of the external branch were examined. The obtained results were compared statistically, left and right.</br> <br><b>Results:</b> Landmarks such as the thyroid gland and laryngeal prominence were determined for the detection of the external branch. The variations of the course of the external branch and the points of piercing the cricothyroid muscle or inferior pharyngeal constrictor muscle were evaluated.</br> <br><b>Discussion:</b> Although safe approaches have been described for nerve protection during neck surgeries, injuries may occur during preliminary surgery as the mentioned nerve is thinner and more superficial than other branches of the vagus nerve. However, it can be detected more easily and safely by knowing the defined anatomical landmarks and morphological variations of the external branch.</br> <br><b>Conclusion:</b> The anatomical variations described can be a safe and important guide in surgeries of the anterior neck region.</br>.

Publication rates of congress abstracts is associated with abstract quality: Evaluation of Turkish National Medical Education Congresses and Symposia between 2010 and 2014 using MERSQI.

There are many parameters that could be used to evaluate the quality of scientific meetings such as publication rates of meeting abstracts as full-text articles after the meeting or scoring with validated quality scales/tools that evaluate individual papers, project proposals, or submitted abstracts. This study aimed to determine the full-text publication rates for abstracts presented at Turkish National Medical Education Congresses and Symposia and to assess the quality of given abstracts. Abstracts presented at national medical education congresses and symposia between 2010 and 2014 in Türkiye were evaluated. Initially, the abstracts were evaluated if they were published as full-text articles in international and national peer-reviewed journals following the meeting. Secondly, the quality of presented abstracts was assessed with the Medical Education Research Study Quality Instrument (MERSQI) scale. Overall publication rate for the abstracts was 11.3%. The publication rate of oral and poster presentations were 26.6% and 8.1%, respectively. Oral presentations had a statistically higher publication rate than poster presentations (p = .000). The mean MERSQI score for abstracts was 7.73 ± 2.59. The oral presentations had higher MERSQI mean scores than poster presentations (8.28 ± 2.46 vs. 7.61 ± 2.6; p = .032). Similarly, published abstracts had a significantly higher score compared to unpublished abstracts (10.07 ± 2.74 vs. 7.43 ± 2.41; p = .000). Interestingly, there was no statistical difference between the mean MERSQI scores of the published oral and poster presentations (9.33 ± 2.45 vs. 10.61 ± 2.72; p = .101). This study showed that the main factor for a meeting abstract to be published as a full-text article is the scientific quality of the study. The quality of presentations at annual medical education meetings in Türkiye were low compared with international meetings which did not improve over five years. An institutional policy that would set quality standards for medical education research and increase the awareness of researchers on the topic might help improve the design, execution, and reporting of such studies in Türkiye. The MERSQI could be a valuable tool to monitor the quality of submitted abstracts and to increase the awareness of novice researchers on high quality research.

Frequency Morphologic and Morphometric Properties and Osseous Relationships of Whitnall's Tubercle.

Whitnall tubercle (WT) of the zygomatic bone is used as an anatomical landmark in some surgical approaches to the orbit. The authors aimed to determine the localization of WT by using some palpable bony landmarks and to reveal its morphological and morphometric features. Three hundred twenty-two zygomatic bones (167 right and 155 left) belonging to adults of unknown sex, were examined. An acetate prepared by drawing a clock with a dial on it was used to determine the localization of WT according to marginal tubercle and zygomatic arch. Distances between WT and frontozygomatic suture and lateral margin of the orbital rim were measured with digital calipers. One zygomatic bone had double tubercles, thus 321 bones were taken into consideration. Whitnall tubercle was determined in 284 of 321 zygomatic bones. 181 were classified as small, 10 as medium, and 93 as large. The position of the WT according to the marginal tubercle was at the 8, 9, and 10 o'clock positions on the left, and at 2, 3, and 4 o'clock on the right. The position of the WT according to the zygomatic arch was at the 9,10 and 11 o'clock positions on the left, and at the 1 and 2 o'clock positions on the right. Distances between the WT and lateral margin of the orbital rim and the frontozygomatic suture were measured meanly as 1.94±0.31 mm and 8.17±5.82 mm, respectively. The authors believe that the data obtained regarding WT will contribute to anatomy and surgical procedures of the related region.

Variations of the external branch of the superior laryngeal nerve during its course and its importance in surgical approaches: an experimental cadaveric study.

INTRODUCTION: Injury of the external branch of the superior laryngeal nerve can cause a hoarse or weak voice due to the functional loss (dysergia) of the cricothyroid muscle. Defining the anatomical variations of the external branch of the superior laryngeal nerve and estimating the frequency of it, it makes crucial for surgical interventions. AIM: To reveal the topography of the external branch in the Anatolian population, to prevent injury of it during the surgical intervention in the anterior neck region. MATERIALS AND METHODS: Twenty-six bilateral hemilarynges (4 females, 22 males) were dissected. The morphometric and morphological features of the external branch were examined. The obtained results were compared statistically left and right. RESULTS: Landmarks such as the thyroid gland and laryngeal prominence were determined for the detection of the external branch. The variations of the course of the external branch and the points of piercing the cricothyroid muscle or inferior constrictor pharyngeal muscle were evaluated. DISCUSSION: Although safe approaches have been described for nerve protection during neck surgeries, it can expose injuries during preliminary surgery approaches as the nerve is thinner and more superficial than other branches of the vagus nerve. However, it can be detected more easily and safely during the surgical approach by knowing the defined anatomical landmarks and morphological variations of the external branch. CONCLUSION: The anatomical variations described can be a safe and important guide in surgical approaches to be applied in the anterior neck region.

The life of the prince of anatomists Jean Riolan, Jr. (the Younger) (1577-1657).

For the first time in the history of anatomy, the important French anatomist Jean Riolan, Jr., clarifies several conditions that anatomy adepts should accomplish during their preparation in his work Anthropographia. Anatomists should be physically, mentally, culturally, and ethically ready for their work. The anatomy teacher should consider three rules: have experience in anatomical dissection, have the essential knowledge and approach to dissection, and use a suitable teaching method.

Variable Lower Limb Alignment of Clinical Measures With Digital Photographs and the Footscan Pressure System.

OBJECTIVE: This study examines the effect of the lower limb misalignment and its possible compensatory effect on plantar pressure in a normal population. The aim of this paper is to present a structured method for the analysis of posture and its changes using a standardized digital photography technique and plantar pressure measuring device. DESIGN: Cohort. SETTING: Laboratory. PARTICIPANTS: A total of 200 adult volunteers between 18 and 22 years of age who had no current symptoms of pain and foot or ankle pathology participated in the study. MAIN OUTCOME MEASURES: The gold standard measure of lower limb alignment with weight-bearing status is the mechanical axis and their angles using Image J software. Structural and functional measurements of the same foot were taken using a plantar pressure measuring device. In this study, 5 alignment (thigh, knee, leg, ankle, and foot) characteristics were measured on the lower limb using the 2 techniques, and, additionally, the foot contact area, peak pressure, foot axis, rearfoot angle, and subtalar joint flexibility score were analyzed in 10 different regions of the foot. RESULTS: This study has shown a reasonable correlation between digitalized measurements and plantar pressures values. Quadriceps angle affected midfoot impulse, foot axis angle, subtalar joint minimum angle, and rearfoot angle positively. Subtalar joint flexibility scores were analyzed in 10 different regions of the foot. There was a positive correlation between rearfoot angle and quadriceps angle (P = .009, r = .261). Results of both methods show that they endorse each other. CONCLUSIONS: The posture of the standing feet may have influence on lower limb alignment. Currently, there are no studies carried out by using digital photogrammetry and foot scan. The authors claim that patient-friendly digital photogrammetry would have a positive contribution to the monitoring of patients, even including new ones in the treatment programs, reducing any possible loss in the personal and national economy.

Macroscopic observations of muscular bundles of accessory iliopsoas muscle as the cause of femoral nerve compression.

Compression of the femoral nerve (FN) to the iliac fossa has been reported as a consequence of several pathologies as well as due to the aberrant muscles. The purpose of this research was to investigate the patterns of the accessory muscles of iliopsoas muscles and the relationship of the FN in fifty semi pelvis. Accessory muscular slips from iliacus and psoas, piercing or covering the FN, were found in 19 specimens (7.9%). Based on the macroscopic structure, the muscle was categorized into two types. Pattern 1 as the more frequent variation, was sheet muscular type covering the FN (17 specimens, 89.5%). Pattern 2, the less frequent variation was found on a muscular slip covering the FN (2 specimens, 10.5%). Iliac and psoas muscles and their variants on both types were defined. Appraising the relation between the muscle and the nerves, each disposition of the patterns may be a potential risk for nerve entrapment. The knowledge about the possible variations of the iliopsoas muscle complex and the FN may also give surgeons confidence during pelvic surgery. Recognition of these variations in normal anatomy may be useful to the clinicians when treating patients with refractory leg pain.