A preliminary investigation of digital media supplements for head and neck anatomy: Does production format matter?

From cassettes to digital, use of video in education has evolved. Supplemental digital media is a common educational adjunct within gross anatomy courses. As these aids have advanced technologically, so has production cost. Traditional lecture (T-lect) productions tend to be more efficient. Traditional gross anatomy laboratory (T-lab) productions requiring cadaver dissection and high-definition video are comparatively less efficient. This preliminary study pragmatically assessed T-lect and T-lab supplemental learning tools in a head and neck anatomy course for first-year dental students. Two videos of similar length were developed for different anatomical regions. Learning objectives were similar while format differed. A carotid triangle supplement was created using a T-lab production format and an infratemporal fossa aid was created using a T-lect format. Both incorporated recommended elements for facilitating learning. Development time and costs were documented. Student exam performance on topic specific questions was collected along with survey data. Group mean exam score comparisons between students who viewed (n = 74 T-lect, n = 70 T-lab) versus did not view (n = 27 T-lect, n = 30 T-lab) each aid revealed higher scores for the "viewed" group. The T-lab production cost ($15,190 versus $10,003) and time (19 hr. versus 18 hr) were greater than T-lect. Descriptive survey data did not reveal a format preference. Students valued previews/summaries and structure highlighting/labeling within the supplements. Students appreciated the supplemental learning aids and mean exam scores were higher for users. Since production format did not noticeably alter exam performance and satisfaction was similar, production efficiency should take precedence.

Stylohyoid Syndrome.

A 26-year-old male presented with an ache deep to the angle of the left mandible and moderate, constant pain with swallowing, symptoms that had begun 3 years earlier. He was diagnosed with Eagle syndrome, characterized by cervical oropharynx pain due to an elongated styloid process. The patient consulted a physical therapist, who instructed the patient on a home exercise program based on imaging and examination findings. Six weeks later, the patient reported that he was able to swallow with only minimal, intermittent discomfort. J Orthop Sports Phys Ther 2019;49(8):621. doi:10.2519/jospt.2019.8759.

Master in oral biology program: A path to addressing the need for future dental educators.

In dental education, the anatomical sciences, which include gross anatomy, histology, embryology, and neuroanatomy, encompass an important component of the basic science curriculum. At Creighton University School of Dentistry, strength in anatomic science education has been coupled with a solid applicant pool to develop a novel Master of Science in Oral Biology, Anatomic Sciences track degree program. The program provides a heavy emphasis on developing teaching skills in predoctoral students as well as exposure to research processes to encourage the cohort to pursuing a career in academic dentistry. The individuals considered for this program are applicants for admission to the School of Dentistry that have not been accepted into the entering dental class for that year. The students undertake a two year curriculum, studying anatomic sciences with a special emphasis on teaching. The students also must complete a research project that requires a thesis. The students in the program are guaranteed acceptance to dental school upon successful completion of the program. After six years, the first ten students have received their Master of Science degrees and continued in dental school. The program is favorably viewed by the faculty and participating students. It is also considered successful by metrics. Nine of the ten graduates have said they would like to participate in academic dentistry in some capacity during their careers. Anat Sci Educ 10: 607-612. © 2017 American Association of Anatomists.

Cone beam computed tomography of plastinated hearts for instruction of radiological anatomy.

Radiological anatomy education is an important aspect of the medical curriculum. The purpose of this study was to establish and demonstrate the use of plastinated anatomical specimens, specifically human hearts, for use in radiological anatomy education. Four human hearts were processed with routine plastination procedures at room temperature. Specimens were subjected to cone beam computed tomography and a graphics program (ER3D) was applied to generate 3D cardiac models. A comparison was conducted between plastinated hearts and their corresponding computer models based on a list of morphological cardiac features commonly studied in the gross anatomy laboratory. Results showed significant correspondence between plastinations and CBCT-generated 3D models (98 %; p < .01) for external structures and 100 % for internal cardiac features, while 85 % correspondence was achieved between plastinations and 2D CBCT slices. Complete correspondence (100 %) was achieved between key observations on the plastinations and internal radiological findings typically required of medical student. All pathologic features seen on the plastinated hearts were also visualized internally with the CBCT-generated models and 2D slices. These results suggest that CBCT-derived slices and models can be successfully generated from plastinated material and provide accurate representations for radiological anatomy education.

The development of a core syllabus for the teaching of head and neck anatomy to medical students.

The study of human anatomy has traditionally served as a fundamental component in the basic science education of medical students, yet there exists a remarkable lack of firm guidance on essential features that must be included in a gross anatomy course, which would constitute a "Core Syllabus" of absolutely mandatory structures and related clinical pathologies. While universal agreement on the details of a core syllabus is elusive, there is a general consensus that a core syllabus aims to identify the minimum level of knowledge expected of recently qualified medical graduates in order to carry out clinical procedures safely and effectively, while avoiding overloading students with unnecessary facts that have less immediate application to their future careers as clinicians. This paper aims to identify consensus standards of essential features of Head and Neck anatomy via a Delphi Panel consisting of anatomists and clinicians who evaluated syllabus content structures (greater than 1,000) as "essential", "important", "acceptable", or "not required." The goal is to provide guidance for program/course directors who intend to provide the optimal balance between establishing a comprehensive list of clinically relevant essential structures and an overwhelming litany, which would otherwise overburden trainees in their initial years of medical school with superficial rote learning, which potentially dilutes the key and enduring fundamental lessons that prepare students for training in any medical field.

Length and geometric patterns of the greater palatine canal observed in cone beam computed tomography.

The greater palatine canal is an important anatomical structure that is often utilized as a pathway for infiltration of local anesthesia to affect sensation and hemostasis. Increased awareness of the length and anatomic variation in the anatomy of this structure is important when performing surgical procedures in this area (e.g., placement of osseointegrated dental implants). We examined the anatomy of the greater palatine canal using data obtained from CBCT scans of 500 subjects. Both right and left canals were viewed (N = 1000) in coronal and sagittal planes, and their paths and lengths determined. The average length of the greater palatine canal was 29 mm (±3 mm), with a range from 22 to 40 mm. Coronally, the most common anatomic pattern consisted of the canal traveling inferior-laterally for a distance then directly inferior for the remainder (43.3%). In the sagittal view, the canal traveled most frequently at an anterior-inferior angle (92.9%).

The prevalence of concha bullosa and nasal septal deviation and their relationship to maxillary sinusitis by volumetric tomography.

The objective of this study was to determine the prevalence of concha bullosa and nasal septal deviation and their potential relationships to maxillary sinusitis. 883 CT scans taken at Creighton University School of Dentistry from 2005 to 2008 were retrospectively reviewed for the presence of concha bullosa, nasal septal deviation, and maxillary sinusitis. 67.5% of patients exhibited pneumatization of at least one concha, 19.4% of patients had a deviated septum, and 50.0% had mucosal thickening consistent with maxillary sinusitis. 49.3% of patients who had concha bullosa also had evidence of maxillary sinusitis. Only 19.5% of patients with concha bullosa also had nasal septal deviation, whereas 19.7% of patients with sinusitis also presented with nasal septal deviation. Although concha bullosa is a common occurrence in the nasal cavity, there did not appear to be a statistically significant relationship between the presence of concha bullosa or nasal septal deviation and maxillary sinusitis.

Developmental oronasal fistula of the incisive papilla.

Various terms (including patent nasopalatine fistula and patent nasopalatine duct) have been used to describe the presence of a developmental fistulous tract that connects the oral and nasal cavities through an oral opening located at the incisive papilla. Reportedly, this condition is a rare developmental variant; approximately 40 cases have been reported in the literature. Because awareness of this entity is important to avoid misdiagnosis, this article presents the clinical and conebeam computed tomography findings of two cases. Based on a review of the development of the nasopalatine structures in man, the authors propose that this entity be classified as a developmental oronasal fistula of the incisive papilla.

Dental education in a flat world: advocating for increased global collaboration and standardization.

Globalization is a broad term referring to the increasing connectivity, integration, and interdependence of economies, societies, technologies, cultures, and political and ecological spheres across the world. This position paper was developed by a working group of the 2007 American Dental Education Association (ADEA) Leadership Institute. The authors explore the effect that globalization has had on dentistry and dental education to date and hypothesize what dental education could look like in the years ahead. While the paper is written from a North American perspective, some of the authors bring international expertise and experience to the topic of global dental education in a flat world. Specific issues and barriers addressed in this position paper include variations in accreditation and licensure requirements in dental education throughout the world; the historical development of dental education models (odontology and stomatology) and the need for congruency of these models in the global environment; the competency-based model of education and its relevance to development and implementation of global dental competencies; and the slow adoption of technological advances in dental education for promoting collaborations and encouraging resource sharing among countries. These challenges are discussed as they affect the implementation of a standardized global dental education that can lead to improved access to oral health care services and better oral and overall health for the citizens of the world.

Transitory paresis of the lateral pterygoid muscle during a posterior superior alveolar nerve block--a case report.

The posterior superior alveolar nerve (PSAN) is a major sensory branch of the maxillary division of the trigeminal nerve. A PSAN block is a dental nerve block used for profound anesthesia of the maxillary molars. Complications arising from the PSAN block include hematoma formation, transient diplopia, blurred vision, and temporary blindness. This article presents a case of temporary paresis in the lateral pterygoid muscle following a PSAN block that utilized a 27-gauge long needle. The anatomical parameters and pathogenesis of such a complication are reviewed.

Long-term safety evaluation of a novel oxygen-coordinated niacin-bound chromium (III) complex.

Chromium (III) is an essential micronutrient required for normal protein, fat and carbohydrate metabolism, as well as helps insulin metabolize fat, turn protein into muscle and convert sugar into energy. A broad spectrum of research investigations including in vitro, in vivo and clinical studies demonstrated the beneficial effects of novel oxygen- coordinated niacin-bound chromium (III) complex (NBC) in promoting glucose-insulin sensitivity, lipid profile, cardioprotective ability and lean body mass. This study examined the long-term safety of NBC by orally administering either 0 or 25 ppm or the human equivalency dose of 1000 microg elemental chromium (III) as NBC per day for 52 consecutive weeks to male and female Sprague-Dawley rats. Animals of each group and each gender were sacrificed on 26, 39, or 52 weeks of treatment. Body weight, physical and ocular health, feed and water intake, selected organ weights as such and as a percentage of liver and brain weight, hepatic lipid peroxidation and DNA fragmentation, hematology and clinical chemistry, and histopathological evaluations were conducted. At 26, 39, or 52 weeks of treatment, body weight gain was significantly reduced by 7.7%, 8.1% and 14.9% in male rats, and 5.5%, 11.4% and 9.6% in female rats, respectively, in the NBC treatment groups. No significant changes were observed in hepatic lipid peroxidation and DNA fragmentation, hematology and clinical chemistry, and histopathological evaluation between control and NBC groups at these time points. These findings, thus far, are in agreement with the subchronic studies in terms of the safety of NBC.

Unique origin of the inferior alveolar artery.

The inferior alveolar artery is the major blood supply to the mandible and mandibular teeth. This artery has a very consistent path, originating from the maxillary artery and passing inferiorly until it enters the mandibular foramen, accompanied by the inferior alveolar nerve and vein. During routine dissection of a 90-year-old female cadaver, a unique origin of the inferior alveolar artery was observed on the left side. The artery branched off the external carotid artery, just superior to the stylohyoid and posterior belly of the digastric muscle in the posterior region of the submandibular triangle. From its starting point the artery passed superiorly in the stylomandibular fascia and made a curving arch into the pterygomandibular space to enter the mandibular foramen with the inferior alveolar nerve. The position and branching pattern of the maxillary artery were otherwise typical. The inferior alveolar artery on the right side displayed a normal branching pattern within the infratemporal fossa. Results of surgical procedures in this area, such as sliding osteotomy of the mandible, could be impacted by this anomaly.

Surgical anatomy of the parotid duct with emphasis on the major tributaries forming the duct and the relationship of the facial nerve to the duct.

Although there is a great amount in the literature to describe the anatomy of the parotid gland as a whole, little attention is given to the parotid duct. The purpose of this study is to examine the surgical anatomy of the parotid duct with special emphasis placed on the major tributaries forming the parotid duct and the relationship of the facial nerve to the duct. Twenty-nine fresh cadaver halves were dissected and the branching pattern of the ducts, position within the parotid, and their relationship to the facial nerve were studied. Of the complete heads studied, the parotid duct had the same pattern in 78.6% on the right and left sides. The parotid ducts in 31.0% of the half heads presented as a single discernible duct from parotid papilla to within the gland. In 62.1% of the half heads, the ducts were formed by a branching pattern within the gland. In the ducts with a branching pattern, 48.3% displayed a bifurcated pattern, 6.9% were trifurcated, and 6.9% had multiple branches. In 6.9% of the half heads studied, the parotid ducts bifurcated distal to the parotid gland. In all cases, the deep lobe of the parotid enveloped the parotid duct; only small ductules connected the superficial lobe with the duct. The facial nerve and its branches were always observed lateral to the parotid duct. Because one dissects lateral to the facial nerve during a superficial parotidectomy, generally the parotid duct remains intact and potential complications such as facial paralysis, sialoceles, and fistulizations are thereby minimized.