The Relationship of the Temporal Branch of the Facial Nerve to the Fascial Planes of Temporal Region in Human Fetuses.

The aim of this study was to obtain information by assessing the relationship between temporal region fascial structures, fat pads, and temporal branches of facial nerve in human fetuses to use the knowledge on treatment of early childhood period surgeries. This anatomic dissection study was conducted on 40 hemifaces with no visible external abnormalities on their faces. Fascial layers and related fat pads of temporal region were dissected layer by layer beginning from superficial to deep. The relations of temporal branches of facial nerve and temporoparietal fascia and the structures of these fascial layers were evaluated. Temporoparietal fascia showed continuity below zygomatic arc with superficial musculoaponeurotic system. Temporal branches of facial nerve showed a multiple branching. Parotid-masseteric fascia became very thin on the superficial of zygomatic arch and ran with superficial layer of temporal fascia above without attaching to periosteum. Temporal branches of facial nerve entered between multilayered layers of temporoparietal fascia. Temporoparietal fascia became thicker on anterior and middle parts because of the localization of superficial temporal fat pad. Temporal fascia was a 2-layered thick and fibrous tissue enveloping intermediate fat pad. Deep layer connected to periosteum of zygomatic arch and superficial layer continued passing superficial of zygomatic arch and connected to the parotid-masseteric fascia. Deep temporal fat pad was found on the deep to deep layer of temporal fascia and surface of temporal muscle. The findings of this study may contribute to the knowledge of the topographical localization of temporal branches of facial nerve with temporal region fascial structures and fat pads in fetuses.

A rare combination of vascular variations of both kidneys.

Bilateral variations of renal vessels were encountered during the dissection of a 54-year-old male cadaver. There were triple renal arteries bilaterally, double renal veins on the right, and an unusual formation of renal vein on the left side. A bilateral occurrence of triple renal arteries has not been encountered in the literature, so does an incidence. Additional renal vessels have the potential to cause clinical complications such as hydronephrosis. Their existence has utmost importance in surgical and radiological interventions and radiological examinations.

Measurements for the direct approach to the oval foramen to apply mandibular nerve blockade.

PURPOSE: The lack of certain quotable landmarks and not taking the morphometric variations into consideration for mandibular nerve blockade can cause some complications. The aim of this study was to ensure there are data for more feasible and successful lateral extraoral approach to block the mandibular nerve by proposing reliable and quotable landmarks. METHODS: The current study was carried out on 55 skulls at the anatomy departments of the Universities of Mersin and Ankara. The length of the zygomatic arch, measurements indicating the puncture point (PP), injection depth, and injection angle were revealed. The differences between sides and the relationships between the parameters were evaluated by using paired t-test and Pearson correlation test, respectively. RESULTS: Of all skulls, it is observed that the injection line passed anterior to the articular surface of the temporomandibular joint. The distance between external acoustic opening and PP showed positive correlation with the distance between oval foramen and the midpoint of the zygomatic arch on the left side (r = 0.364, P = 0.001). On the right, the correlation was close to the statistically significant level (r = 0.280, P = 0.072). The distance between external acoustic opening and PP that can be adapted to the living subjects was found as 26.31 ± 1.95 mm. Injection angle to the coronal plane was measured to be 16.39 ± 2.96 degrees. The difference between sides for this parameter was not statistically significant. CONCLUSIONS: The determined parameters are suggested to be convenient and quotable to help in successful direct application under three-dimensional computed tomography or computed tomography-fluoroscopy for blocking the mandibular nerve.

Accessory head of flexor pollicis longus muscle in fetuses and adult cadavers and its relation to anterior interosseous nerve.

This study was conducted to examine the accessory head of flexor pollicis longus muscle (ahFPL) and its relation with the anterior interosseous nerve (AIN) in human fetuses and adult cadavers. Ninety fetus forearms and 52 adult cadaver forearms were dissected to evaluate the incidence, morphology, and innervation of the ahFPL. The ahFPL was observed in 29/90 (32%) of the fetus forearms and 20/52 (39%) of the adult cadaver forearms. The overall side incidence was 34.5% (49/142) among total forearms examined. On the other hand, the population incidence of ahFPL was 42% (19/45) in fetuses while it was 50% (12/24) in adult cadavers. So, the overall incidence in humans was 44.9% (31/69) in the population studied. Compression of the AIN in the forearm by the ahFPL is known as one of the causes of the anterior interosseous nerve syndrome (AINS). So, the relation of ahFPL with the AIN was evaluated, and in light of previous classifications a modified new classification is proposed. The most common relation detected in this study was Type IVa (71.4%) (AIN and its branches coursed posterior to the ahFPL). While Type I was not observed in this study, the incidences of Type II, Type III, and Type IVb (all AIN branches 'without AIN itself' coursed posterior to the ahFPL) were 2%, 14.3%, and 12.3%, respectively. The Types I, IVa, and IVb are thought to be associated with complete or incomplete types of AINS and Type III with incomplete type of AINS only.

Frequency, anatomical properties and innervation of axillary arch and its relation to the brachial plexus in human fetuses.

PURPOSE: "Axillary Arch" (AA) is the main musculotendinous variation of the axillary region. The aim of this study was to reveal the frequency, anatomical properties, and innervation of AA and its relation with brachial plexus in human fetuses. METHODS: In this study, 50 human fetuses (male: 20, female: 30), gestation age varied between 16 and 38 weeks (mean ± SD: 23.3 ± 5.3 week), were dissected at the anatomy laboratory of Mersin University, Faculty of Medicine. RESULTS: AA was found in 11 of the 50 fetuses, and in 3 of 11, it was bilateral. Among both sides, 6 of 14 AAs were on the right and 8 were on the left side. Seven of AA's (7% of the specimens) were in muscular and 7 (7%) of them were in musculotendinous structure. With regard to Testut's classification, six (6%) of them were of complete type, six (6%) were incomplete and two (2%) were concordant with both types. Three different types of AA were defined considering the shapes of the arches. According to our classification, seven of the AAs were of type 1, two of them were of type 2 and five of them were of type 3. Additionally, the incidence of the T2 spinal nerve joining the brachial plexus was significantly higher in the specimens with AA (p = 0.001). CONCLUSIONS: Each type of AA described in this study is thought to have individual clinical significance. Being aware of AA and its types can be important to determine a safe approach to the axillary region for surgeons. In addition, our results show the relation between the occurrence of AA and the variations in the formation of the proximal part of brachial plexus.

Examination of the accessory tendons of extensor hallucis longus muscle in fetuses.

There are various data about the incidence of accessory tendons (AT) of extensor hallucis longus (EHL) muscle; however, their function is unknown. This study aimed to determine the incidence and morphometric features of the AT of EHL muscle in fetuses in order to provide more information to discuss its possible function. Forty-five fetuses (26 female and 19 male) were used in this study. Fetuses were grouped as Group A (16-21 weeks), Group B (22-27 weeks), and Group C (28-34 weeks) according to their age. In 23 (51%) out of 45 fetuses, there were AT. These were bilateral in 15 fetuses (65%) and unilateral in eight fetuses (35%). Fifty-two percent of the fetuses in group A, 43% in group B, and 67% in group C had AT. AT were observed in 14 female (54%) and 9 male (47%) fetuses. In all cases, the AT were always diverging to the medial side of the main EHL tendons and attached to the metatarsophalangeal joint capsule distal to the joint space. Significant correlations were observed in this study between EHL and AT widths as well as between EHL width and EHL-AT distance on both sides. The present study is the first to provide morphometric data about the AT of EHL muscle in fetuses which will be of use in understanding their function, particularly in biomechanics of the great toe.

Left sided-right portal joined round ligament with an anomaly of the intrahepatic portal vein.

Anomalous branching of the intrahepatic portal veins and a round ligament variation were encountered in a 70-year-old male cadaver, with a positional variation of the liver. The liver was not extending to the left of the xiphoid process. The fissure for the round ligament was not present at the visceral surface, and the ligament was embedded inside the parenchyma. The round ligament was joining with the anterior branch of the right portal vein instead of the left. Portal blood supply of the quadrate lobe and most of the left lobe was provided by the variative branch of the right portal vein. By considering both settlements of the round ligament according to the gallbladder and the intrahepatic portal joining of it, we termed the case as left sided-right portal joined round ligament. The clinical importance of similar variations is emphasized as they can cause complications during liver transplantation and lobectomy.