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1.
Surg Radiol Anat ; 44(3): 491-494, 2022 Mar.
Article de Anglais | MEDLINE | ID: mdl-35254492

RÉSUMÉ

In the routine dissections study for medical postgraduates, a rare anatomical variation between the right leg and the ankle was observed on the Asian male cadaver. The peronaeus tertius muscle in this cadaver's right leg divided into two tendons: the first tendon was attached to the base of the fifth metatarsal bone, and the second tendon was inserted into the base of the fourth metatarsal bone. The purpose of this paper is to provide detailed anatomical case reports, and to discuss the possible causes and mechanisms of the variation by reviewing relevant literature, so as to provide some reference for future anatomical and clinical related disease research.


Sujet(s)
Variation anatomique , Tendons , Cheville , Articulation talocrurale , Cadavre , Humains , Jambe , Mâle , Muscles squelettiques
2.
Biomed Res Int ; 2022: 5542030, 2022.
Article de Anglais | MEDLINE | ID: mdl-35198636

RÉSUMÉ

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.


Sujet(s)
Tomodensitométrie à faisceau conique , /imagerie diagnostique , Adulte , Variation anatomique , Femelle , Humains , Mâle , Adulte d'âge moyen , Interprétation d'images radiographiques assistée par ordinateur
3.
Biomed Res Int ; 2022: 9569101, 2022.
Article de Anglais | MEDLINE | ID: mdl-35224103

RÉSUMÉ

INTRODUCTION: The quadriceps femoris consists of four muscles: the rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis. However, the effect of additional quadriceps femoris heads on the vasti muscles and patellar ligaments is unknown. The aims of the present study are to determine the relationship between additional quadriceps femoris heads and the vasti muscles and patellar ligaments and to review the morphology of the vastus lateralis, vastus medialis, and vastus intermedius. MATERIALS AND METHODS: One hundred and six lower limbs (34 male and 19 female cadavers) fixed in 10% formalin were examined. RESULTS: On all lower extremities, the vastus lateralis consisted of superficial, intermediate, and deep layers. The vastus medialis, on the other hand, consisted of only the longus and obliquus layers. The quadriceps head had one or more supplementary heads in 106 dissected limbs from 68 cadavers (64.1%). The distal portion of the patella was wider in lower limbs without supplementary heads than in type IA but narrower than in type IIIA. In general, the distal portion of the patella was narrower in specimens with a supplementary head than in those without (19.03 SD 3.18 mm vs. 20.58 SD 2.95 mm, p = 0.03817). Other patellar ligament dimensions did not differ significantly. CONCLUSION: The quadriceps femoris muscle is characterized by high morphological variability. Occurrence of extra heads is at the level of 64.1%. The vastus lateralis consists of three parts (superficial, intermediate, and deep), and vastus medialis consists of two (longus and oblique).


Sujet(s)
Ligament patellaire/anatomie et histologie , Muscle quadriceps fémoral/anatomie et histologie , Variation anatomique , Cadavre , Femelle , Humains , Mâle
4.
Surg Radiol Anat ; 44(3): 485-489, 2022 Mar.
Article de Anglais | MEDLINE | ID: mdl-35192041

RÉSUMÉ

The fibularis brevis and fibularis longus muscles belong to the lateral compartment of the leg. The fibularis brevis is morphologically variable, especially in the number of tendons and place of insertion. Its type of insertion is correlated with the presence of a fibularis digiti quinti, which is also anatomically variable. We present a case study based on dissection of a seventy-three-year-old female cadaver with an unusual insertion of the fibularis brevis muscle. The tendon had three bands inserting into the fifth metatarsal bone. There was a coexisting fibularis digiti quinti, which was fused with the fibularis tertius muscle. Awareness of such anatomical variation could be useful during reconstructive surgery and planning rehabilitation protocols.


Sujet(s)
Jambe , Tendons , Sujet âgé , Variation anatomique , Cadavre , Femelle , Humains , Jambe/anatomie et histologie , Muscles squelettiques/anatomie et histologie , Tendons/anatomie et histologie
5.
BMC Med Imaging ; 22(1): 12, 2022 01 20.
Article de Anglais | MEDLINE | ID: mdl-35057756

RÉSUMÉ

BACKGROUND: To evaluate the distribution of lingual foramina (LF) and their correlation with demographic characteristics and mandible width, shape, and bone thickness in Caucasian Italian patients subjected to cone-beam CT (CBCT). METHODS: CBCTs were reviewed to assess the number of all LF, midline and lateral LF. We also assessed the relationship of the number of lateral LF with gender and mandibular width, shape, and bone thickness using the Chi Square test. A p value < 0.05 was considered statistically significant. RESULTS: Three-hundred patients (180 males; age range: 21-87 years) were included. The highest frequency per patient was of 2 LF (97/300, 32.3%), followed by 3 (81/300, 27%) and 4 (53/300, 17.7%). No LF were observed in 2/300 patients (0.7%), while the highest number was of 8 LF in one patient. The highest frequency of midline LF per person was of 2 LF (57.3%, 172/300), while the highest number per person was 5 LF in one patient (0.3%). The highest frequency of midline LF located above and below the genial tubercle was of 1 in 197/300 patients (65.7%) and in 169/300 patients (56.3%), respectively. Concerning lateral LF, the highest frequencies were of 0 (113/300, 37.7%) and of 1 (112/300, 37.3%). We did not observe any significant difference of the number of midline and lateral LF based on gender (P = .438 and P = .195, respectively) or mandible width (P = .069 and P = .114, respectively). The mandible shape was normal in 188 cases, with facial constriction in 42, lingual constriction in 54, and hour glass constriction in 16. The mean bone thickness was 10.76 mm in the symphysis, 10.92 mm in the right hemiarches, and 10.68 in the left hemiarches. No significant differences in the distribution of LF were observed also based on mandibular shape and bone thickness (both with P > .05). CONCLUSIONS: We have shown the high variability of number and anatomic distribution of LF in an Italian group of patients subjected to CBCT without reporting any association with gender and mandible width, shape, and bone thickness.


Sujet(s)
Variation anatomique , Tomodensitométrie à faisceau conique , Mandibule/anatomie et histologie , Mandibule/imagerie diagnostique , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Traitement d'image par ordinateur , Mâle , Adulte d'âge moyen , Études rétrospectives , Jeune adulte
6.
ScientificWorldJournal ; 2022: 4766305, 2022.
Article de Anglais | MEDLINE | ID: mdl-35087327

RÉSUMÉ

The aim of this study was to evaluate the root canal morphology of permanent maxillary molars by cone-beam computed tomography (CBCT) using the classifications of Weine et al. and Vertucci and to correlate the findings with sex, age, position in the dental arch, and prevalence of a second canal in the mesiobuccal root (MB2). A total of 414 scans were evaluated, corresponding to 1,000 teeth. The assessment consisted of coronal, axial, and sagittal reconstructions using i-CAT Workstation®. Type 0 was assigned when neither classification could be applied. The data were entered into an Excel spreadsheet and analyzed using SPSS. The chi-squared test or Fisher's exact test was used to compare the distribution of root canal morphology classified using the two systems. Analysis of the distribution of Weine types showed a predominance of type III in mesiobuccal roots, while type 0 predominated in distobuccal and palatal roots. Vertucci type IV predominated in mesiobuccal and distobuccal roots and type VII in palatal roots. There was no difference in the distribution of morphological canal types in permanent maxillary molars evaluated by CBCT according to sex, age group, or position in the dental arch of the patients. MB2 canals were identified in 68.4% of the teeth evaluated.


Sujet(s)
Variation anatomique , Tomodensitométrie à faisceau conique/statistiques et données numériques , Cavité pulpaire de la dent/imagerie diagnostique , Maxillaire/imagerie diagnostique , Molaire/imagerie diagnostique , Adolescent , Adulte , Sujet âgé , Enfant , Cavité pulpaire de la dent/anatomie et histologie , Femelle , Humains , Mâle , Maxillaire/anatomie et histologie , Adulte d'âge moyen , Molaire/anatomie et histologie
7.
Surg Radiol Anat ; 44(2): 293-298, 2022 Feb.
Article de Anglais | MEDLINE | ID: mdl-35094129

RÉSUMÉ

PURPOSE AND BACKGROUND: Previous studies have identified variations regarding the morphology and location of the carotid sinus, a phenomenon still not commonly approached or studied on computed tomography angiography (CTA). Detailed characterization of the carotid sinus was performed on CTAs, determining its position, diameter and length. METHODS: The study group included 43 patients with disease-free carotid trunks subjected to cervical CTA. We measured the terminal caliber of the common carotid artery (CCA), as well as the calibers of the internal (ICA) and external carotid arteries (ECA) at their origin. The diameters were correlated with the location and the shape of the carotid sinus. We also measured the length of the sinus dilatation (carotid bulb), in regard to its location on the terminal branches of the common carotid artery. RESULTS: Mean diameters of the studied arteries were 7.39 ± 1.04 mm for the CCA, 6.71 ± 1.49 mm for the ICA and, respectively, 4.27 ± 0.75 mm for the ECA. The classical position of the carotid sinus was seen in 80% of cases, the rest being considered anatomical variants. The length of the carotid bulb on the ICA was 9.99 ± 2.22 mm, showing variability between genders. CONCLUSIONS: The carotid sinus does not always extend to the ICA, presenting different distribution patterns that might be relevant in sinus pathology from a clinical point of view, respectively from a surgical point of view during invasive or minimally invasive interventions on the carotid axis.


Sujet(s)
Sinus carotidien , Sténose carotidienne , Variation anatomique , Angiographie , Artère carotide commune/imagerie diagnostique , Artère carotide externe , Artère carotide interne , Sinus carotidien/imagerie diagnostique , Femelle , Humains , Mâle , Tomodensitométrie
8.
Surg Radiol Anat ; 44(1): 137-141, 2022 Jan.
Article de Anglais | MEDLINE | ID: mdl-34837499

RÉSUMÉ

Appreciation of the potential anatomical variation of the hepatic arterial supply and branches of the abdominal aorta is of paramount importance in pancreatic and hepatobiliary surgery. Here we describe a hitherto un-reported coelio-mesenteric anastomotic connection between a replaced right hepatic artery, originating from the superior mesenteric artery, and the left hepatic branch of the proper hepatic artery. The embryological origins of the variant anatomy as well as its potential surgical implications are discussed with a view to encourage thorough pre-operative interrogation of available imaging by radiologists and surgeons to successfully identify such variants and take advantage of their potentially useful functionality.


Sujet(s)
Artère hépatique , Artère mésentérique supérieure , Anastomose chirurgicale , Variation anatomique , Artère hépatique/imagerie diagnostique , Artère hépatique/chirurgie , Humains , Foie/imagerie diagnostique , Foie/chirurgie
9.
Anat Histol Embryol ; 51(2): 308-313, 2022 Mar.
Article de Anglais | MEDLINE | ID: mdl-34866224

RÉSUMÉ

The kinkajou (Potos flavus) is a carnivoran that has special morphological adaptations in its thoracic limbs to climb threes and handling food. This study aimed to describe the craniolateral muscles of the antebrachium in P. flavus. Five specimens were used. The extensor carpi radialis longus and brevis were seen as two separate muscles. The extensor carpi ulnaris muscle can present two bellies with different insertions. An extensor digit III muscle was found. The P. flavus has anatomical variants on the craniolateral antebrachial muscles that were previously reported in other procyonids. Thus, those variants are phylogenetically related within the family Procyonidae, except the doubled bellies of the extensor carpi ulnaris muscle which is exclusive of P. flavus.


Sujet(s)
Procyonidae , Variation anatomique , Animaux , Avant-bras/anatomie et histologie , Muscles squelettiques/anatomie et histologie
10.
Surg Radiol Anat ; 44(2): 299-301, 2022 Feb.
Article de Anglais | MEDLINE | ID: mdl-34741640

RÉSUMÉ

PURPOSE: To describe an uncommon anatomical variant of the anterior cerebral artery and the imaging findings. METHODS: A 2-month-old infant with known history of atrial and ventricular septal defects was admitted to our institution for evaluation and management of growth failure. Given the clinical presentation and medical history, magnetic resonance imaging (MRI) of the brain and MR angiography (MRA) were performed to exclude congenital hypopituitarism and any vascular abnormality. RESULTS: Time of flight MRA revealed trifurcation of the anterior cerebral artery with one of the vessels arising from the ophthalmic segment of the right internal carotid artery; thus, the A1 segment of the left anterior cerebral artery (ACA) was absent, and the right posterior cerebral artery (PCA) had a fetal origin. CONCLUSION: Anatomical variants of the cerebral circulation are asymptomatic and found incidentally. Knowledge of these variants and careful examination of CT/MRI angiograms are important for diagnosis and treatment planning.


Sujet(s)
Artère cérébrale antérieure , Angiographie par résonance magnétique , Variation anatomique , Artère cérébrale antérieure/imagerie diagnostique , Artère carotide interne/imagerie diagnostique , Angiographie cérébrale , Humains , Nourrisson , Imagerie par résonance magnétique
11.
Eur J Surg Oncol ; 48(1): 237-244, 2022 Jan.
Article de Anglais | MEDLINE | ID: mdl-34583878

RÉSUMÉ

PURPOSE: The sigmoid take-off (STO) was recently introduced as a preferred landmark, agreed upon by expert consensus recommendation, to discern rectal from sigmoid cancer on imaging. Aim of this study was to assess the reproducibility of the STO, explore its potential treatment impact and identify its main interpretation pitfalls. METHODS: Eleven international radiologists (with varying expertise) retrospectively assessed n = 155 patients with previously clinically staged upper rectal/rectosigmoid tumours and re-classified them using the STO as completely below (rectum), straddling the STO (rectosigmoid) or completely above (sigmoid), after which scores were dichotomized as rectum (below/straddling STO) and sigmoid (above STO), being the clinically most relevant distinction. A random subset of n = 48 was assessed likewise by 6 colorectal surgeons. . RESULTS: Interobserver agreement (IOA) for the 3-category score ranged from κ0.19-0.82 (radiologists) and κ0.32-0.72 (surgeons), with highest scores for the most experienced radiologists (κ0.69-0.76). Of the 155 cases, 44 (28%) were re-classified by ≥ 80% of radiologists as sigmoid cancers; 36 of these originally received neoadjuvant treatment which in retrospect might have been omitted if the STO had been applied. Main interpretation pitfalls were related to anatomical variations, borderline cases near the STO and angulation of axial imaging planes. CONCLUSIONS: Good agreement was reached for experienced radiologists. Despite considerable variation among less-expert readers, use of the STO could have changed treatment in ±1/4 of patients in our cohort. Identified interpretation pitfalls may serve as a basis for teaching and to further optimize MR protocols.


Sujet(s)
Repères anatomiques , Carcinomes/imagerie diagnostique , Tumeurs du rectum/imagerie diagnostique , Tumeurs du sigmoïde/imagerie diagnostique , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Variation anatomique , Carcinomes/anatomopathologie , Carcinomes/thérapie , Chimioradiothérapie , Colectomie , Femelle , Humains , Imagerie par résonance magnétique , Mâle , Adulte d'âge moyen , Traitement néoadjuvant , Biais de l'observateur , Proctectomie , Tumeurs du rectum/anatomopathologie , Tumeurs du rectum/thérapie , Reproductibilité des résultats , Tumeurs du sigmoïde/anatomopathologie , Tumeurs du sigmoïde/thérapie
12.
J Laryngol Otol ; 136(1): 64-67, 2022 Jan.
Article de Anglais | MEDLINE | ID: mdl-34725000

RÉSUMÉ

BACKGROUND: The aetiology and significance of internal carotid artery variations at the skull base remain controversial after decades, with limited available literature. Approximately 10-40 per cent of the general population has parapharyngeal internal carotid artery variations. METHOD: A prospective observational study was conducted on internal carotid artery variations in 36 cadavers, in a tertiary care hospital, between March 2019 to March 2020. RESULTS: The most common internal carotid artery variation observed in the specimens was tortuosity, in 30 per cent, followed by kinking in 18 per cent and coiling in 10 per cent. Thirty per cent of specimens had variations present bilaterally. A loop pattern of the internal carotid artery was identified. Coiling of the internal carotid artery may present as a node; hence, meticulous dissection is advocated near the skull base to avoid complications. These variations hold utmost importance for otorhinolaryngologists performing pharyngeal and nasopharyngeal surgical procedures. CONCLUSION: A detailed knowledge of anatomy, along with its variations, and surgical expertise, will help reduce the incidence of surgical complications.


Sujet(s)
Variation anatomique , Artère carotide interne/anatomie et histologie , Base du crâne/anatomie et histologie , Cadavre , Artère carotide interne/chirurgie , Humains , Microchirurgie , Études prospectives
13.
Morphologie ; 106(352): 37-42, 2022 Feb.
Article de Anglais | MEDLINE | ID: mdl-33744125

RÉSUMÉ

An important accessory anatomical variation, exclusively human, and related to the muscular ventres of the flexor pollicis longus and flexor digitorum profundus is frequently denominated Gantzer. These variations have close relations with the anterior interosseous nerve (AIN), which provides, for many authors, by direct compression, one of the rare neuropathic syndromes. In this work, thirty-four forearms were dissected from the collections of the Medical School of the Federal University of Minas Gerais and the Department of Basic Sciences of the Federal University of Juiz de Fora, with a prevalence of 50% of the 34 forearms studied for the Gantzer muscle. The muscle relationship was mainly with the flexor pollicis longus muscle and only one occurrence related to the flexor digitorum profundus muscle, described as a rare occurrence of unilateral double formation of Gantzer muscle. Bilaterality was observed in 88.23% of the findings and the dominant innervation for this muscle variation occurred in 82.35% by the anterior interosseous nerve (AIN). The type morphological in all forms found was the fusiform, with 10.5cm of total length and an average of 0.3cm in diameter and all related, as origin, in the medial aspect of the coronoid process of the ulna, next to the origin of the flexor digitorum superficialis muscle. Our work largely reflected the findings of most publications and, considering the controversy of the occurrence of a compressive neuropathy, the data were not sufficient, from a strictly anatomical point of view, to confirm or refute the hypothesis.


Sujet(s)
Avant-bras , Muscles squelettiques , Variation anatomique , Cadavre , Main , Humains
14.
Acta Radiol ; 63(1): 76-83, 2022 Jan.
Article de Anglais | MEDLINE | ID: mdl-33455411

RÉSUMÉ

BACKGROUND: It is vital to know the anatomical variations of the wrist to avoid iatrogenic injuries during carpal tunnel (CT) surgery. PURPOSE: To determine the anatomical variations of the median nerve (MN) and the prevalence of persistent median artery (PMA) on wrist magnetic resonance imaging (MRI). MATERIAL AND METHODS: A total of 300 wrists evaluated by MRI during 2013-2015 were retrospectively identified. While branching of the MN distal to the CT is accepted as the normal anatomy, proximal to the tunnel and within the tunnel were considered as variations. The prevalence of PMA was also evaluated. The patients were assigned to groups according to age, gender, and wrist side and compared to determine whether there was any significant difference in terms of these variations. All evaluations were assessed with the shared decision of a musculoskeletal radiologist and a radiology resident. RESULTS: Of the 300 wrists, 38 (12.7%) and 34 (11.3%) had a bifid MN proximal to the CT and within the CT, respectively. Only one nerve trifurcation was seen within the CT. The MN exhibited branching distal to the CT in 227 (76%) patients. PMA was observed in 44 (14.7%) patients. Of the 44 PMA cases, 28 (63.6%) also had a coexisting MN variation. There was no significant difference in the prevalence of MN variations and PMA in the subgroups (P > 0.05). CONCLUSION: Nearly one in four patients (24.4%) have MN variations and 14.8% had PMA. Preoperative evaluation of these common anatomical variations with MRI will be protective against postoperative complications of CT surgery.


Sujet(s)
Variation anatomique , Artères/anatomie et histologie , Imagerie par résonance magnétique/méthodes , Nerf médian/imagerie diagnostique , Poignet/vascularisation , Poignet/innervation , Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Études rétrospectives
15.
Med Oral Patol Oral Cir Bucal ; 27(2): e142-e149, 2022 Mar 01.
Article de Anglais | MEDLINE | ID: mdl-34704980

RÉSUMÉ

BACKGROUND: The retromolar canal (RMC) is an anatomical variation of the mandibular canal (MC) whose identification and study should be considered given its implication in the surgical procedures of the retromolar area. The prevalence of the RMC widely varies according to previous studies and may be influenced by the followed study method. This work aimed to evaluate the prevalence of the RMC in a Spanish population sample. MATERIAL AND METHODS: For this purpose, 225 CT scan images (with a higher resolution than the cone beam CT used in other previous studies) from the Hospital Clínico Universitario de Valencia were analyzed. The Osirix MD® radiological image analysis system was applied to analyse the dimensions, location in the retromolar area and morphologic characteristics of the RMC by classifying them according to their typology. Furthermore, the relations between the RMC and gender, age and laterality were studied. RESULTS: RMC prevalence was 23.1%. No significant relation between the presence of the canal and gender, age or laterality was found. Type Ia was the commonest type with a prevalence of 40.8%. CONCLUSIONS: Based on the results of this study, the RMC should be considered a frequent anatomical variation whose complete study is very important in daily clinical practice.


Sujet(s)
Tomodensitométrie à faisceau conique , Mandibule , Variation anatomique , Tomodensitométrie à faisceau conique/méthodes , Humains , Mandibule/chirurgie , Prévalence , Tomodensitométrie hélicoïdale
16.
Anat Rec (Hoboken) ; 305(1): 144-155, 2022 01.
Article de Anglais | MEDLINE | ID: mdl-34021732

RÉSUMÉ

Large intestine 4 (LI4) is a major acupoint used in various treatments in acupuncture and Traditional Chinese Medicine. There are structures associated within the region of LI4 that have three-dimensional anatomical relationship that needs further characterization. The aims of this study were: (a) to observe the anatomical variation of structures around LI4; (b) to observe specific overlap of structures around LI4. A 1256 mm2 area was dissected in 25 cadaveric hands around LI4. Nondissected areas were marked with pins as reference points. Dissections were photographed with a fixed camera. Subsequently, images were imported to Adobe Photoshop 2020 and analyzed. Descriptive statistics and graphs were compiled using Graphpad Prism 2020. The tributaries of the dorsal venous plexus (22.3%), branches of superficial radial nerve (18.9%), first dorsal interosseous muscle (52.4%), arterial branches in the first interosseous space (10.2%), and deep ulnar nerve (4.0%) were observed in the area of LI4. One branch of the superficial radial nerve passed through LI4. The deep ulnar nerve was found in the bulk of the first dorsal interosseous muscle. Several structures observed intersected at LI4. The superficial radial nerve interweaved with the dorsal venous plexus superficially. The deep ulnar nerve passed anterior to the second palmar metacarpal artery before entering into the first dorsal interosseous muscle. These results provide anatomical evidence and variation into the vascular contributions at LI4.


Sujet(s)
Points d'acupuncture , Main , Variation anatomique , Humains , Gros intestin , Artère radiale
17.
Am J Otolaryngol ; 43(1): 103161, 2022.
Article de Anglais | MEDLINE | ID: mdl-34375794

RÉSUMÉ

BACKGROUND: Devascularization of the parathyroid glands is generally accepted as the most common mechanism for iatrogenic hypocalcemia, a frequently seen complication of both total and completion thyroidectomy procedures. Much has been written about iatrogenic hypoparathyroidism, but few papers have precisely delineated the arterial supply of the parathyroid glands and the common anatomical variations that may impact parathyroid preservation during thyroid surgery. METHODS: We offer an illustrated review and discussion of the only two anatomic studies published in the medical literature focusing on parathyroid vasculature. In addition, we examine current techniques of parathyroid identification, preservation, and classification. FINDINGS: A surgical technique that preserves the parathyroid arteries is vital to preserving the viability of the parathyroid gland(s) during thyroid surgery. In 1907, Halsted and Evans described a technique of ligating the distal branches of the thyroid arteries beyond the origin of the parathyroid arteries, a technique termed ultra-ligation. In 1982, Flament et al.. reported three distinct anatomical variations of the parathyroid arteries which place the parathyroid blood supply at risk for devascularization during thyroid surgery. Our review also highlights novel techniques that aid surgeons in identification and assessment of the parathyroid glands. CONCLUSIONS: Recognition of the variations of parathyroid anatomy and their potential to lead to devascularization aids thyroid surgeons in their pursuit of parathyroid preservation. An awareness of the variety of novel parathyroid identification and preservation techniques can assist surgeons to achieve this goal.


Sujet(s)
Variation anatomique , Traitements préservant les organes/méthodes , Glandes parathyroïdes/anatomie et histologie , Glandes parathyroïdes/vascularisation , Glande thyroide/chirurgie , Thyroïdectomie/effets indésirables , Thyroïdectomie/méthodes , Femelle , Humains , Hypocalcémie/étiologie , Hypoparathyroïdie/étiologie , Maladie iatrogène , Complications peropératoires/étiologie , Période peropératoire , Mâle , Complications postopératoires/étiologie
18.
Sci Rep ; 11(1): 23863, 2021 12 13.
Article de Anglais | MEDLINE | ID: mdl-34903785

RÉSUMÉ

Our study aimed to describe the root and canal morphology of mandibular second molars in Emirati population and to study the prevalence and types of morphological change in C-shaped canal configuration along the root length in an effort to describe C-shaped molars as a unit. Cone beam computed tomography (CBCT) scans of Emirati patients were analyzed in multiple plans and root and canal configuration of mandibular second molars were evaluated. Moreover, specific types of morphological change in C-shaped canal configuration along root length were studied and reconstructed using 3D reconstruction software. A total of 508 mandibular second molars were evaluated. Among the non-C-shaped mandibular second molars, two separate roots were the most prevalent root morphology (78.3%). The mesial root's most common root canal configuration was Vertucci Type II (46.5%), and in the distal root, Vertucci Type I (90.5%). The prevalence of C-shaped mandibular second molars was 17.9% and was significantly prevalent (P < 0.001) in females. Specific types of morphological change in C-shaped molars along the root length were observed and described for the first time, in which the most common types of morphological change were C1-C2-C3d (18%), C1-C3c-C3d (15.4%), C4-C3c-C3d (7.7%), and C3c-C3c-C3d (7.7%). This study showed wide variations in the root and canal morphology in mandibular second molars in Emirati population with a relatively high prevalence of C-shaped canal configuration (17.9%). Moreover, specific types of morphological change in C-shaped configuration were detected and described for the first time in this population.


Sujet(s)
Variation anatomique , Cavité pulpaire de la dent/anatomie et histologie , Mandibule/anatomie et histologie , Molaire/anatomie et histologie , Adolescent , Adulte , Sujet âgé , Tomodensitométrie à faisceau conique , Cavité pulpaire de la dent/malformations , Cavité pulpaire de la dent/imagerie diagnostique , Femelle , Humains , Mâle , Mandibule/imagerie diagnostique , Adulte d'âge moyen , Molaire/imagerie diagnostique , Émirats arabes unis
19.
J Craniofac Surg ; 32(7): 2542-2545, 2021 Oct 01.
Article de Anglais | MEDLINE | ID: mdl-34705363

RÉSUMÉ

OBJECTIVES: Aimed to explore the correlation between the volume of the sphenoid sinuses (SS) and sex, age, pneumatization and its anatomical variant types. MATERIAL AND METHODS: Retrospectively evaluated high-resolution computed tomography images of 170 individuals; were studied by ITK-SNAP software to measure the volume of SS. RESULTS: The average volume of SS was a significant difference between the gender, the volume of SS in the elderly group (≥65 years old) showed a downward trend. The volume of the SS in the variants of the anterior clinoid processes, pterygoid processes, greater wings, and clivus were significantly higher than in the nonvariants (P < 0.05). With the expansion of pneumatization, the optic nerve (CNII) type 3-4, the internal carotid artery (ICA) type 2-3 and the septal insertion on the ICA have a larger volume, while the occurrence of septal insertion on only the CNII was not correlated with the volume (P > 0.05). CONCLUSIONS AND SIGNIFICANCE: The volume of SS is closely related to age, sex, the type of pneumatization and anatomical variation. High-resolution computed tomography can facilitate a precise study of anatomical variations and adjacent structures and help ensure the safety of an operation.


Sujet(s)
Os sphénoïde , Sinus sphénoïdal , Sujet âgé , Variation anatomique , Humains , Études rétrospectives , Os sphénoïde/imagerie diagnostique , Sinus sphénoïdal/imagerie diagnostique , Tomodensitométrie
20.
Plast Reconstr Surg ; 148(5): 1005-1010, 2021 Nov 01.
Article de Anglais | MEDLINE | ID: mdl-34705773

RÉSUMÉ

BACKGROUND: The literature regarding the route of the dorsal nerve of the clitoris is sparse and lacks surgical focus. With an increasing number of procedures being performed on the labia, it is important to elucidate the route and note any variation from normal of the nerve. METHODS: Fifty-one cadavers were dissected to yield 97 dorsal nerve of the clitoris samples. Measurements were taken from (1) the dorsal nerve of the clitoris penetration point of the perineal membrane to the urethra, (2) the nerve's penetration point of the perineal membrane to the pubic bone, (3) the angle of the clitoris to the branch point of the dorsal nerve of the clitoris, and (4) the branch point of the nerve to the distalmost point of the glans clitoris. Any anomalous branching patterns of the dorsal nerve of the clitoris were recorded and classified. RESULTS: The means and standard deviations of each measurement were used to create a surgical danger zone. The mean of each measurement was (1) 34.63 mm, (2) 5.74 mm, (3) -3.07 mm, and (4) 30.40 mm, respectively. In addition, six distinct branching patterns were observed, organized, and classified based on the location and number of branches observed. CONCLUSIONS: The dorsal nerve of the clitoris has multiple branching patterns and typically travels along the same course in most women. Further investigation of the course and three-dimensional position of the dorsal nerve of the clitoris is warranted to preserve sexual sensation as the frequency of procedures involving the female pudendum increases.


Sujet(s)
Clitoris/innervation , Procédures de chirurgie gynécologique/effets indésirables , Lésions des nerfs périphériques/prévention et contrôle , Nerf pudendal/anatomie et histologie , Variation anatomique , Cadavre , Clitoris/physiologie , Femelle , Procédures de chirurgie gynécologique/méthodes , Humains , Lésions des nerfs périphériques/étiologie , Plaisir/physiologie , Nerf pudendal/traumatismes , Nerf pudendal/physiologie
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