Trifurcation of the facial artery at the inferior border of the mandible: a case report.

PURPOSE: The facial artery is known to show variations in its origin, course, termination, and branching pattern. This study aimed to present a case with trifurcation of the facial artery at the inferior border of the mandible accompanied by variable branches. METHODS: During our routine head dissection, it was observed that a 67-year-old male cadaver had a trifurcation of the facial artery at the level of the lower border of the mandible on the left. The skin was reflected, and the subcutaneous fatty tissue and subcutaneous layers were dissected to reveal the triple facial artery. RESULTS: The left facial artery arising from the external carotid artery entered the face with three branches as it crossed the lower border of the mandible. The three branches are the anterior, intermediate, and posterior branches. The posterior branch passed in front of the anterior border of the masseter muscle along with the facial vein and gave off muscular branches with a straight course, whereas the anterior thickest curved branch terminated by the inferior labial artery, and a tortuous intermediate branch initially gave off the superior labial artery and then terminated by the angular artery. CONCLUSION: Understanding these variational branches of the triple facial artery and their relationships is crucial for avoiding complications in reconstructive and reparative maxillofacial, craniofacial and plastic surgery in order to mitigate the risk of damage to the facial artery during flap surgery.

Abnormal type III fusion between lunate and triquetrum: A case report.

INTRODUCTION: The lunotriquetral coalition is the fusion of the lunate and triquetral bones of the wrist and is the most frequent carpal coalition type. It is frequently asymptomatic and discovered as an incidental due to chronic wrist pain, trauma, or fracture. This case aims to present an unusual unilateral lunotriquetral coalition and clinical significance for diagnosis and treatment. PRESENTATION OF CASE: In this case, we presented a 37-year-old male who exhibited with right-sided trauma and wrist pain. He was diagnosed to had a type III complete osseous lunotriquetral coalition on the right side and detected by plain radiography and CT without lytic, destructive, and sclerotic lesions. DISCUSSION: An avulsion fracture was recognized in the distal end of the right radius. A fragmented fracture was identified in the scaphoid bone, and an internal fixator extending from scaphoid bone to lunate bone. The internal fixators were observed among the lunate, capitate, and distal end of the radius bones. The plain anteroposterior, lateral radiograph and CT of the right wrist exhibited a right-sided unilateral type III osseous coalition between the lunate and triquetrum bones. CONCLUSION: Knowledge of type III complete fusion is essential to the proper diagnosis and management of this variation when a subject exhibits unexplained wrist pain, trauma, or fracture. It should be noted that plain radiographs and CT can provide an accurate diagnosis in type III complete lunotriquetral coalition without pathological evidence.

Anatomo-radiological importance and the incidence of os odontoideum in Turkish subjects: a retrospective study.

PURPOSE: Os odontoideum is a rare anatomical and morphological variation of the odontoid process and associated with a range of symptoms such as spinal cord and vertebral artery injuries. This study aimed to evaluate the frequency of os odontoideum in Turkish cases by sagittal/coronal cervical magnetic resonance imaging (MRI) and computed tomography (CT) and analyze the relationship with age, gender and related symptoms. METHODS: The incidence of os odontoideum was retrospectively diagnosed by sagittal/coronal cervical CT and MRI out of 16,122 subjects aged 20-70 years (mean 46) in the period between 2014 and 2018. The relationship of os odontoideum with age, gender, and symptoms was recorded. RESULTS: The statistical analysis of the study was performed by the χ² test and two-way mixed ANOVA. Os odontoideum was detected in 18 (0.11%) (11 males; 7 females) out of 16,122 patients. The mean age was 47.5 ± 1.4 years in the females and 43.5 ± 2.5 years in the males (p < 0.05). 6 odontoideum were detected out of 6467 (3756 males, mean 48 ± 0.7, 2711 females, mean 46 ± 1.2) subjects by CT and 12 odontoideum were detected out of 9655 patients (5607 males and 4048 females) by MRI. CONCLUSION: Neck pain was the most frequent symptom. The prevalence of os odontoideum especially round type is more frequent in older male patients over 40 years old with head and neck pain or atlantoaxial instability, and is less common in Turkish subjects when compared to various ethnic groups.

Horizontal alveolar transport distraction osteogenesis followed by implant placement.

Alveolar transport distraction osteogenesis (ATDO) is an alternative treatment method to vertical alveolar distraction osteogenesis in cases of large bony defects, especially when the bone is limited in size. ATDO was performed in 10 patients with 12 defects. The mean age of the patients was 39.1years. The average bone length gain was 18.2mm. Implants were inserted following a 3-month consolidation period. Three patients needed additional bone grafting for horizontal widening. Final prosthetic rehabilitation was performed at least 3 months following implant insertion. The mean follow-up period was 63 months and the survival rate of the 25 implants placed was 92%. All failures (n=2) occurred during the early healing period. Although the results are not totally predictable, it can be concluded that ATDO can be effective in the reconstruction of the alveolar crest prior to implant placement.

Effect of sitting, standing, and supine body positions on facial soft tissue: detailed 3D analysis.

Medical imaging techniques require various body positions. Gravity causes changes in the facial soft tissue and acts in different directions according to the position of the head during imaging. The aim of this study was to evaluate the effect of positional changes on the facial soft tissue. The faces of subjects were scanned in the standing, sitting, and supine body positions. Differences in the positions were compared using the root mean square (RMS), mean absolute deviation (MAD), and mean signed distance (MSD). The displacement of 15 midsagittal and 20 bilateral landmarks was evaluated. The RMS, MAD, and MSD values of the sitting-standing comparison were significantly lower than those of the sitting-supine and standing-supine comparisons. There were no significant differences between the sitting-supine and standing-supine comparisons. Sixteen out of 135 measurements (12%) of the midsagittal landmarks and 94 out of 180 (52%) measurements of the bilateral landmarks showed significant displacements among the body positions. These results demonstrate a significant change in the facial soft tissue caused by body position. Furthermore, these data show the different susceptibilities of the facial soft tissue landmarks to the effect of body position along the x, y, and z axes.

Melatonin is protective against 6-hydroxydopamine-induced oxidative stress in a hemiparkinsonian rat model.

Melatonin is known to reduce detrimental effects of free radicals by stimulating antioxidant enzymes; however, its role has not been studied in 6-hydroxydopamine (6-OHDA)-induced rat model of Parkinson's disease (PD). Therefore, we aimed to elucidate the effects of melatonin on motor activity and oxidative stress parameters in 6-OHDA-induced rat model of PD. Three-month-old male Wistar rats were divided into 5 groups: vehicle (V), melatonin-treated (M), 6-OHDA-injected (6-OHDA), 6-OHDA-injected + melatonin-treated (6-OHDA-Mel), and melatonin-treated + 6-OHDA-injected (Mel-6-OHDA) group. Melatonin was administered intraperitoneally at a dose of 10 mg/kg/day for 30 days in M and Mel-6-OHDA groups, for 7 days in 6-OHDA-Mel group. Rats received a unilateral stereotaxic injection of 6-OHDA into the right medial forebrain bundle. The 6-OHDA-Mel group started receiving melatonin when experimental PD was created and the treatment was continued for 7 days. In the Mel-6-OHDA group, experimental PD was created on the 23rd day of melatonin treatment and continued for the remaining 7 days. Locomotor activity decreased in 6-OHDA group compared with that in vehicle group; however, melatonin treatment did not improve this impairment. 6-OHDA injection caused an obvious reduction in tyrosine-hydroxylase-positive dopaminergic neuron viability as determined by immunohistochemistry. Melatonin supplementation decreased dopaminergic neuron death in 6-OHDA-Mel and Mel-6-OHDA groups compared with that in 6-OHDA group. Biochemical analysis confirmed the beneficial effects of melatonin displaying higher superoxide dismutase, catalase, and glutathione peroxidase activities and lower lipid peroxidation in substantia nigra samples in comparison to non-treated 6-OHDA group. Starting melatonin treatment before creating experimental PD was more effective on observed changes.