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Rajasekhar SSSN, Kaliyamoorthy K, Dinesh Kumar V, Sivadasan N. Critical appraisal of Genelyn soft embalming for cadaveric surgical skill training: A systematic review. Clin Anat 2024. [PMID: 39385528 DOI: 10.1002/ca.24236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 08/29/2024] [Accepted: 09/25/2024] [Indexed: 10/12/2024]
Abstract
Genelyn is a proprietary embalming solution used for preserving cadavers for surgical skill training (SST) and undergraduate teaching. The aim of this review is to examine the Genelyn embalming method critically by analyzing scientific publications that have employed this method for SST and undergraduate education. The systematic review process involved searching for all relevant articles in PubMed, Google Scholar, and Embase using the keywords "Genelyn," Genelyn embalming," "Genelyn embalmed cadaver," and "surgical skill training. All studies on Genelyn embalming published up to August 14, 2024, in the English language were eligible for inclusion. The literature review yielded 92 studies, 43 of which met the inclusion criteria. The Anatomical Quality Assurance (AQUA) tool from the International Evidence-Based Anatomy (iEBA) working group was used to assess and analyze the risk of bias in all the selected full-text articles. The selected studies reported that Genelyn embalming provided life-like joint range of motion, tissue pliability, and color. Cadaveric studies assessing embalming solutions typically had smaller sample sizes, and few of them compared Genelyn embalmed cadavers (GECs) with the other soft embalming solutions. Unlike Theil's embalming, Genelyn embalming is cost-effective, with easy steps for the preparation and storage of the solution and convenient handling of cadavers. Therefore, GECs serve as an efficient tool for SSTs.
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Affiliation(s)
- S S S N Rajasekhar
- Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | - V Dinesh Kumar
- Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Neethu Sivadasan
- Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Triantafyllou G, Belimezakis N, Lyros O, Tsakotos G, Botis G, Piagkou M. Surgical anatomy of the cystic artery: A systematic review with meta-analysis. Ann Anat 2024; 257:152343. [PMID: 39369802 DOI: 10.1016/j.aanat.2024.152343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 09/29/2024] [Accepted: 10/02/2024] [Indexed: 10/08/2024]
Abstract
BACKGROUND The current evidence-based systematic review with meta-analysis presents a detailed overview of the cystic artery (CA) surgical anatomy, including its origin, number, topography, and morphometry. Moreover, the surgical implications of these variants are further discussed. METHODS According to the Evidence-Based Anatomy Workgroup and PRISMA 2020 guidelines, the systematic review was performed using four online databases. The Anatomical Quality Assurance Tool was used to evaluate the risk of bias. Meta-analysis was performed with the R programming software. The pooled prevalence and pooled mean of different CA parameters were calculated. RESULTS The CA most commonly originated from the right hepatic artery (a pooled prevalence of 85.75 %). Other described origins (in order of frequency) were the aberrant right hepatic artery, the common hepatic, the left hepatic, the gastroduodenal, the superior mesenteric, and the middle hepatic arteries. The CA was single in 88.59 %, while it can be identified as double, triple, or absent. Most commonly, it was located inside the cystohepatic triangle in 83.83 %. Most commonly, it was superomedially to the cystic duct (77.80 %) and posteriorly to the common hepatic duct (35.08 %). The CA pooled mean length was 21.34 mm, and its diameter was more commonly over 1 mm. CONCLUSION The CA surgical anatomy is paramount when operating on the gallbladder. The CA's altered anatomy and adjacent area could lead to confusion, iatrogenic injury, and prolonged surgical time. The CA depicts high morphological variability; therefore, surgeons should consider the typical anatomy and possible (usual and unusual) variants.
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Affiliation(s)
- George Triantafyllou
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece.
| | - Nektarios Belimezakis
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Orestis Lyros
- Fourth Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Greece
| | - George Tsakotos
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - George Botis
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece; Biomedical Engineering Laboratory, School of Electrical and Computer Engineering, National Technical University of Athens, Greece
| | - Maria Piagkou
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece
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Srichaphan N, Yurasakpong L, Taradolpisut N, Senarai T, Kruepunga N, Suwannakhan A. The thyroid foramen: a systematic review and meta-analysis. Surg Radiol Anat 2024; 46:1673-1681. [PMID: 39191992 DOI: 10.1007/s00276-024-03470-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 08/19/2024] [Indexed: 08/29/2024]
Abstract
PURPOSE To systematically review published studies on the prevalence of the thyroid foramen (TF), perform a meta-analysis to generate pooled prevalence estimates, and identify factors associated with its presence. METHODS A systematic literature search was conducted in Google Scholar, PubMed, and Journal Storage databases. Studies reporting the prevalence of the thyroid foramen were included without language or date restrictions. Quality assessment was performed using AQUA tool. A random-effects meta-analysis was performed with subgroup analyses. Heterogeneity was assessed using Higgins' I2 statistics, and publication bias was evaluated using funnel plots and Egger's test. RESULTS Out of 271 entries, 38 studies met the inclusion criteria, comprising 3,030 subjects from various continents. The overall TF prevalence was 24.5% (95% CI: 19.2-29.8%, I2 = 93.44%), with unilateral TF present in 16.9% and bilateral TF in 6.2%. Prevalence was highest in North America (31.4%,) and lowest in Africa (12.3%). No significant prevalence difference was found between adults and younger populations (p = 0.15). Publication bias, or the small-study effect, was detected (p < 0.01). CONCLUSION This meta-analysis reveals a 24.5% overall prevalence of TF, with significant heterogeneity primarily explained by geographical differences. The TF's clinical relevance necessitates awareness among surgeons and radiologists to avoid complications during laryngeal surgeries and prevent misdiagnosis in imaging studies.
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Affiliation(s)
- Narathip Srichaphan
- Biomedical Science Program, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Laphatrada Yurasakpong
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand
- In Silico and Clinical Anatomy Research Group (iSCAN), Bangkok, Thailand
| | - Napawan Taradolpisut
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand
- In Silico and Clinical Anatomy Research Group (iSCAN), Bangkok, Thailand
| | - Thanyaporn Senarai
- Microscopy Unit, Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nutmethee Kruepunga
- In Silico and Clinical Anatomy Research Group (iSCAN), Bangkok, Thailand
- Department of Anatomy, Faculty of Medicine, Kasetsart University, Bangkok, Thailand
| | - Athikhun Suwannakhan
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand.
- In Silico and Clinical Anatomy Research Group (iSCAN), Bangkok, Thailand.
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Wolf TG, Rempapi T, Wierichs RJ, Waber AL. Morphology and root canal configuration of maxillary lateral incisors: a systematic review and meta-analysis. Sci Rep 2024; 14:22418. [PMID: 39341889 PMCID: PMC11439037 DOI: 10.1038/s41598-024-74026-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 09/23/2024] [Indexed: 10/01/2024] Open
Abstract
The purpose of this study was to explore maxillary lateral incisors (MxLI) intern morphology by analyzing existing literature. We searched five electronical databases (Cochrane, Embase, LILACS, Scopus, MEDLINE via PubMed) using keywords and predefined search terms. Additional studies were identified by cross-referencing and reviewing bibliographies of relevant articles. From 92 initial studies, 27 duplicates were removed, and 65 records screened. After full-text review and hand searching were 19 studies included. The most reported root canal configurations (RCC) of MxLI were Vertucci (Ve) I (1-1-1/1; 78.1-100%), Ve II (2-2-1/1; 0.2-5%), Ve III (1-2-1/1; 0.1-14.6%), Ve IV (2-2-2/2; 0.5%), and Ve V (1-1-2/2; 0.5-4.9%). A meta-analysis of six studies from Europe and Asia indicated sex-differentiated patterns in RCC prevalence: higher occurrences of Ve II (2-2-1/1; OR [95%CI] = 1.19 [0.51, 2.73]), Ve III (1-2-1/1; (OR [95%CI] = 1.72 [0.61, 4.85]), and Ve V (1-1-2/2; (OR [95%CI] = 2.95 [1.02, 8.55]) configurations were noted in males, whereas females predominantly exhibited Ve I (1-1-1/1; [95%CI] = 0.99 [0.97, 1.02]), and Ve IV (2-2-2/2; (OR [95%CI] = 0.11 [0.01, 2.02]). Examination methods varied, with cone beam computed tomography (CBCT) being most commonly (n = 11), followed by staining & clearing (n = 5), and radiographic analysis (n = 1). The predominant RCC in MxLI is type Vertucci I. CBCT is the most common method for assessing the morphology of root canals. However, up to 20% of cases may present with complex and sex-specific patterns, highlighting the need for clinicians to be aware of these differences to prevent complications during endodontic treatments.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Theodora Rempapi
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
| | - Andrea Lisa Waber
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland
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Triantafyllou G, Vassiou K, Duparc F, Vlychou M, Paschopoulos I, Tsakotos G, Tudose RC, Rusu MC, Piagkou M. The lingual and facial arteries' common origin: a systematic review with meta-analysis and a computed tomography angiography study. Surg Radiol Anat 2024:10.1007/s00276-024-03490-y. [PMID: 39331140 DOI: 10.1007/s00276-024-03490-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 09/16/2024] [Indexed: 09/28/2024]
Abstract
PURPOSE The present evidence-based systematic review with meta-analysis aimed to investigate the fusion morphology of the lingual artery and facial artery (in the form of the linguofacial trunk-LFT) pooled prevalence and morphometry. After carefully investigating the data literature, a retrospective computed tomography angiography (CTA) study was performed to investigate a few parameters that were not well-studied. MATERIALS An evidence-based systematic review retrieved 41 studies that met our inclusion criteria to identify the LFT pooled prevalence. The literature search was performed using PubMed, Google Scholar, Scopus, and Web of Sciences databases. Then, a meta-analysis of the literature was performed using the open-source R programming language and the RStudio software. Moreover, two hundred CTAs were randomly selected and retrospectively studied to identify LFT topography, morphology, and morphometry. RESULTS The LFT pooled prevalence was calculated at 16.41%. The subgroup analyses for nationality, type of study, laterality, and gender retrieved no statistically significant association. The unilateral appearance was estimated at 15.92%, compared to the bilateral at 3.28% (p < 0.001). Concerning the findings of our original study, 50 LFTs were identified (12.5%) unilaterally in 34 patients and bilaterally in 8 patients. A significant correlation was observed between the distance LFT origin from the carotid bifurcation (CCB) (p < 0.001) and the distances LA and FA origin from the CCB (p = 0.004). CONCLUSIONS A systematic review with meta-analysis of the LFT were presented, along with an original imaging retrospective study investigating detailed parameters of LFT topography, morphology and morphometry. Knowledge of LFT presence is essential for interventionists in the head and neck region.
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Affiliation(s)
- George Triantafyllou
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece.
| | - Katerina Vassiou
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, University of Thessaly, Thessaly, Greece
| | - Fabrice Duparc
- Department of Anatomy, Faculty of Medicine-Pharmacy, University of Rouen-Normandy, Rouen, France
| | - Marianna Vlychou
- Department of Radiology, School of Medicine, Faculty of Health Sciences, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Ioannis Paschopoulos
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece
| | - George Tsakotos
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece
| | - Razvan Costin Tudose
- Division of Anatomy, Faculty of Dentistry, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Mugurel Constantin Rusu
- Division of Anatomy, Faculty of Dentistry, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Maria Piagkou
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece
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Antonopoulos I, Pechlivanidou E, Olewnik ŁH, Zielinska N, Chrysikos D, Samolis A, Tsikouris G, Troupis T. Morphology and Prevalence of the Inferior Transverse Scapular Ligament: Systematic Review, Meta-Analysis, and Proposal for Classification. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1504. [PMID: 39336545 PMCID: PMC11433838 DOI: 10.3390/medicina60091504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 08/23/2024] [Accepted: 08/28/2024] [Indexed: 09/30/2024]
Abstract
Background/Objectives: The suprascapular nerve is most vulnerable to entrapment at the suprascapular and spinoglenoid notches, causing neuropathy. Numerous studies have examined the suprascapular notch and ligament and its relationship with suprascapular nerve entrapment, but few have examined the spinoglenoid notch and the inferior transverse scapular ligament (ITSL). This study summarizes all existing ITSL morphology studies and presents a simple and comprehensive classification system for different ITSL subtypes. Methods: A systematic review of the literature was conducted according to the PRISMA guidelines, searching the online databases PubMed and Embase. The references of each relevant article were further screened to find more eligible studies. The Anatomical Quality Assessment tool was used in order to further evaluate the quality of the records extracted. STATA MP 14 was used for the analysis in this study. Results: In total, 14 studies (995 scapulae; minimum: 1 and maximum: 268) were included in the present study. The overall ITSL prevalence was 5.8 (95% CI: 4.5-7.1) and the estimated odds for ligamentous vs. membranous type was 0.5 (95% CI: 0.3-0.7). The basic different morphological subtypes of the ITSL reported in the included studies are the band-like ligament, the fan-shaped ligament, the membranous ITSL, and the perforated membranous types. Conclusions: The ITSL represents an anatomical structure of mostly ligamentous nature. A single ITSL definition and standardization of its basic morphological subtypes along with an easy-to-remember and thus widely used classification system could greatly facilitate the comprehensive description, identification, and proper handling of this element across many surgical procedures.
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Affiliation(s)
- Ioannis Antonopoulos
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.A.)
- 1st Department of Orthopaedics, General Children’s Hospital of Athens “P. & A. Kyriakou”, 11527 Athens, Greece;
| | - Evmorfia Pechlivanidou
- 1st Department of Orthopaedics, General Children’s Hospital of Athens “P. & A. Kyriakou”, 11527 Athens, Greece;
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Łukasz Hubert Olewnik
- Department of Anatomical Dissection and Donation, Lodz Medical University, 90-419 Lodz, Poland
| | - Nicol Zielinska
- Department of Anatomical Dissection and Donation, Lodz Medical University, 90-419 Lodz, Poland
| | - Dimosthenis Chrysikos
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.A.)
| | - Alexandros Samolis
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.A.)
| | - George Tsikouris
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.A.)
| | - Theodore Troupis
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.A.)
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Ilgaz HB, Vatansever A. Triticeal cartilage: a meta-analysis of prevalence and morphologic evaluation. Surg Radiol Anat 2024; 46:1531-1541. [PMID: 38990323 DOI: 10.1007/s00276-024-03431-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 06/26/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE The triticeal cartilage, situated within the lateral thyrohyoid membrane, remains elusive in function yet crucial in clinical contexts. Composed of hyaline cartilage, it is prone to ossification, potentially leading to diagnostic challenges such as misidentification with atherosclerosis or fractures. METHODS This study, aiming to establish its prevalence and highlight clinical relevance, conducted a systematic review across several electronic databases such as Medline, PUBMED, Scopus, Google Scholar, Web of Science, SpringerLink and Sciencedirect using keywords "triticeal cartilage", "triticeous cartilage" or "cartilago triticea". An assurance tool for anatomical investigations was used to assess the quality of the methodology (AQUA). A random effects model was utilized to determine the pooled prevalence. RESULTS The true prevalence of triticeal cartilage was found to be variable, with an overall pooled proportion of 43% while crude prevalence were 50.6%. Its crude prevalence was notably higher in women compared to men, in contrary true prevalence was higher in men, posing sex-related disparities. It was mostly seen bilaterally. When the morphologic characteristics of the cartilage were evaluated, classification differences were observed in terms of shape, with a mean length of 5.48 mm, a mean width of 3.04 mm and a mean weight of 62.32 mg. The vertebral level at which the TC was located was mostly C4. The degree of calcification of the cartilage was most commonly mild. CONCLUSION In conclusion, triticeal cartilage holds significant clinical importance, necessitating vigilance during diagnostic evaluations and surgical approaches. Further studies are imperative to elucidate its function comprehensively and refine diagnostic strategies, ensuring optimal patient care in neck-related pathologies.
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Affiliation(s)
- Hasan Baris Ilgaz
- Department of Anatomy, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara, 06230, Turkey.
| | - Alper Vatansever
- Department of Anatomy, Uludag University Faculty of Medicine, Bursa, Turkey
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Asghar A, Priya A, Narayan RK, Patra A, Walocha J, Skrzat J. An evaluation of morphometry and dehiscence of facial canal: a systematic review and meta-analysis of observational studies. Surg Radiol Anat 2024; 46:1501-1516. [PMID: 38997588 DOI: 10.1007/s00276-024-03435-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024]
Abstract
INTRODUCTION The facial canal (FC) is an extensive bony canal that houses the facial nerve and occupies a central position in the petrous part of temporal bone. It is of utmost significance to otologists due to its dehiscence and relationship to the inner or middle ear components. The main objectives of current investigation are to detect variations in the reported values of FC anatomy that may occur due to different methodology and to elucidate the influence of age and ethnic factors on the morphological features of FC. METHODS The methodology is adapted to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled weighted estimation was performed to calculate the mean length, angle, and prevalence of dehiscence. RESULTS The cross-sectional shape of FC varied from circular to ellipsoid index and is 1.45 [95% CI, 0.86-2.6]. The mean length of the FC is 34.42 mm [95% CI, 27.62-40.13 mm] and the mean width or diameter is 1.35 mm [95% CI, 1.013-1.63 mm]. The length of the FC in fetuses and children is 21.79 mm [95% CI, 18.44-25.15 mm], and 26.92 mm [95% CI, 23.3-28.3 mm], respectively. In meta-regression, age is observed as a predictor and accounts for 36% of the heterogeneity. The prevalence of FC dehiscence in healthy temporal bones is 29% [95% CI, 20-40%]. CONCLUSION The different segments of the FC exhibit significant variability and an unusually high incidence of dehiscence, which could potentially have clinical implications for the etiopathogenesis of facial nerve dysfunction.
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Affiliation(s)
- Adil Asghar
- Department of Anatomy, All India Institute of Medical Sciences, Patna, India
| | - Ananya Priya
- Department of Anatomy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Ravi Kant Narayan
- Department of Anatomy, All India Institute of Medical Sciences, Bhubaneshwar, India
| | - Apurba Patra
- Department of Anatomy, All India Institute of Medical Sciences, Bathinda, India.
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Janusz Skrzat
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
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Triantafyllou G, Paschopoulos I, Duparc F, Tsakotos G, Tsiouris C, Olewnik Ł, Georgiev G, Zielinska N, Piagkou M. The superior thyroid artery origin pattern: a systematic review with meta-analysis. Surg Radiol Anat 2024; 46:1549-1560. [PMID: 39043951 DOI: 10.1007/s00276-024-03438-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 07/08/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE The current systematic review with meta-analysis aimed to investigate the pooled prevalence of the superior thyroid artery (STA) pattern of origin (distinct or fused-common origin with adjacent arteries in the form of a common trunk). The standard and uncommon variants were also studied, considering the STA's exact surface of origin and the relationship with the upper border of the thyroid cartilage (TC, reference point), considering the laterality effect. Thus, the STA topographical anatomy was considered. METHODS An evidence-based systematic review with meta-analysis was performed according to the PRISMA 2020 guidelines. A literature search was conducted in four online databases using specific keywords, the pooled prevalence was calculated using statistical analysis in the R programming language, and multiple subgroup analyses were performed. RESULTS The most common distinct origin of the STA was from the external carotid artery (ECA) (56.94% pooled prevalence, 95%CI: 50.89-62.89), and the rarest one was from the internal carotid artery (ICA) (< 0.01%, 95%CI: 0.00-0.00). Common trunks were also investigated, with the thyrolingual trunk emanating from the ECA estimated at 0.61% (95%CI: 0.21-1.14), representing the most common. Subgroup analysis based on the nationality, type of study, and sample size, as well as a comparison between left and right sides and males and females, were investigated. CONCLUSIONS The most common STA origin was estimated as the ECA, the medial surface of origin, and above the TC upper border. Adequate knowledge of STA origin is paramount for surgeons, especially during thyroidectomy, not to cause iatrogenic injury to the external branch of the superior laryngeal nerve.
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Affiliation(s)
- George Triantafyllou
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece.
| | - Ioannis Paschopoulos
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece
| | - Fabrice Duparc
- Department of Anatomy, Faculty of Medicine-Pharmacy, University of Rouen-Normandy, Rouen, France
| | - George Tsakotos
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece
| | - Christos Tsiouris
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece
| | - Łukasz Olewnik
- Department of Clinical Anatomy, Masovian Academy in Płock, Płock, Poland
| | - Georgi Georgiev
- Department of Orthopaedics and Traumatology, University Hospital Queen Giovanna - ISUL, Medical University of Sofia, Sofia, Bulgaria
| | - Nicol Zielinska
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Maria Piagkou
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias str, Goudi, Athens, 11527, Greece
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Triantafyllou G, Tsiouris C, Chrysanthou I, Paschopoulos I, Tsakotos G, Kalamatianos T, Piagkou M. Extratemporal Facial Nerve Interconnections and Trunk's Variability: A Systematic Review with Meta-Analysis. Diagnostics (Basel) 2024; 14:1862. [PMID: 39272647 PMCID: PMC11393905 DOI: 10.3390/diagnostics14171862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2024] [Revised: 08/19/2024] [Accepted: 08/22/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND The present systematic review with meta-analysis is a significant contribution to the understanding of the morphological variability of the facial nerve (FN) extratemporal segment, i.e., the facial trunk (FT) variability, its division, and terminal branching patterns. The study also provides a comprehensive overview of the clinical significance of the FN extracranial division. METHODS Four online databases were utilized to conduct the systematic review according to evidence-based anatomy guidelines. A meta-analysis of the studies included was carried out using R programming software. The combined prevalence of the FN variants was calculated, along with subgroup and cumulative analysis. RESULTS From the systematic review, 29 studies were retrieved as eligible for our initial purpose. However, 19 studies followed the same classification system and were selected for the meta-analysis, with a total sample of 2453 nerves. The most common pattern of the FN morphology was the FT bifurcation (typical pattern), with a pooled prevalence of 94.1% and a single interconnection (IC) between the temporofacial and cervicofacial branches (23.1% pooled prevalence). Two ICs between these branches were the rarest pattern (8.9% pooled prevalence). CONCLUSIONS Our findings underscore the extensive morphological variability of the FN extratemporal anatomy, which has led to confusion among researchers. While several classification systems have been developed, none accurately represent the typical and variant anatomy. Our meta-analysis provided a small range between 8.9-23.1% for the rarest and most common pattern; thus, diversity is the rule. Therefore, it is not safe to conclude the typical morphology of FN extratemporal anatomy for its whole distribution before the FT's division (proximally) and its terminal branches (distally). Nevertheless, the bifurcation of the FT can be considered the typical morphology, and it is far more constant than the distal branching pattern. These findings have significant implications for surgical procedures, particularly parotidectomy, where surgeons must exercise utmost caution due to the potential clinical implications of FN injury.
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Affiliation(s)
- George Triantafyllou
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Christos Tsiouris
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Ioannis Chrysanthou
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Ioannis Paschopoulos
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - George Tsakotos
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Theodosis Kalamatianos
- Department of Neurosurgery, Evangelismos Hospital, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 10676 Athens, Greece
| | - Maria Piagkou
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Wolf TG, Rempapi T, Wierichs RJ, Waber AL. Morphology and root canal configuration of maxillary canines: a systematic review and meta-analysis. BMC Oral Health 2024; 24:944. [PMID: 39143543 PMCID: PMC11325658 DOI: 10.1186/s12903-024-04682-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/29/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND This study assessed the internal morphology of maxillary canines (MxC) through a systematic review of existing literature. METHODS Research articles up to June 2024 were retrieved from five electronic databases (MEDLINE via PubMed, Embase, Scopus, LILACS, and Cochrane). Predefined search terms and keywords were used, and potential studies were identified by cross-referencing and bibliographies of the selected articles reviewed. RESULTS Two hundred studies were identified, 73 duplicates were removed, 127 records were screened, and 113 were removed after consultation of title and abstract. After full-text consultation and hand searching, finally 22 studies were included. Using the method for describing the root canal configuration (RCC) of Briseño Marroquín et al. (2015) and Vertucci (Ve) (1984), the most frequently reported RCC of MxC were 1-1-1/1 (Ve I, 75.4-100%), 2-2-1/1 (Ve II, 0.1-20%), 1-2-1/1 (Ve III, 0.1-11.6%), 2-2-2/2 (Ve IV, 0.1-0.4%), 1-1-2/2 (Ve V, 0.1-2.4%), 2-1-2/2 (Ve VI, 0.5-1.2%), and 1-2-1/2 (Ve VII, 0.1-0.2%). The meta-analysis of six studies (Europe/Asia) showed that a significantly higher number of RCC of 2-2-1/1 (Ve II) (OR [95%CI] = 1.34 [0.53, 3.41]), 1-2-1/1 (Ve III) (OR [95%CI] = 2.07 [1.01, 4.26]), and 1-1-2/2 (Ve V) (OR [95%CI] = 2.93 [1.07, 8.07]), were observed in males, and 2-2-2/2 (Ve IV) (OR [95%CI] = 0.08 [0.00, 4.00]) in females. No sex differences in the RCC of 1-1-1/1 (Ve I) and 1-2-1/2 (Ve VII) were observed. CONCLUSIONS Cone beam computed tomography is the most frequently used method for research on the RCC of MxC. Despite the high prevalence of type 1-1-1/1 (Ve I) RCC in MxC, clinicians should remain vigilant for more complex and sex-differentiated patterns in up to 25% of cases to prevent endodontic treatment complications or failures.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Theodora Rempapi
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Richard Johannes Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Lisa Waber
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
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Tabassum A, Singh MKC, Ibrahim N, Sanjeevan V, Yusof MYPM. Trabecular bone microstructure parameters as predictors for chronological age: a systematic review. Forensic Sci Med Pathol 2024:10.1007/s12024-024-00864-x. [PMID: 39098862 DOI: 10.1007/s12024-024-00864-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2024] [Indexed: 08/06/2024]
Abstract
Estimating chronological age is crucial in forensic identification. The increased application of medical imaging in age analysis has facilitated the development of new quantitative methods for the macroscopic evaluation of bones. This study aimed to determine the association of age-related changes in the trabecular microstructure with chronological age for age estimation in forensic science through different non-invasive imaging techniques. This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. An electronic search was performed with PubMed/MEDLINE, Scopus, and Cochrane databases as well as with a Google Scholar search. Qualitative synthesis was performed using the Anatomical Quality Assessment tool. A detailed literature search yielded 3467 articles. A total of 14 articles were ultimately included in the study. A narrative approach was employed to synthesize the data. Microcomputed tomography, high-resolution peripheral quantitative computed tomography, and cone beam computed tomography have been used for the quantitative estimation of age. These imaging techniques aid in identifying the trabecular bone microarchitectural parameters for chronological age estimation. Age-related changes in trabecular bone included a decrease in the bone volume fraction, trabecular number, and connectivity density and an increase in trabecular separation. This study also revealed that morphometric indices vary with age and anatomical site. This study is registered with the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CDRD42023391873.
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Affiliation(s)
- Arshiya Tabassum
- Center for Oral and Maxillofacial Diagnostics and Medicine Studies, Faculty of Dentistry, Universiti Teknologi MARA Selangor, Sungai Buloh, Selangor, Malaysia
| | - Mansharan Kaur Chainchel Singh
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA Selangor, Sungai Buloh, Selangor, Malaysia
| | - Norliza Ibrahim
- Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Vinita Sanjeevan
- Department of Public Health Dentistry, Goa Dental College & Hospital, Bambolim, North Goa- Goa, 403202, India
| | - Mohd Yusmiaidil Putera Mohd Yusof
- Center for Oral and Maxillofacial Diagnostics and Medicine Studies, Faculty of Dentistry, Universiti Teknologi MARA Selangor, Sungai Buloh, Selangor, Malaysia.
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA Selangor, Sungai Buloh, Selangor, Malaysia.
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13
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Chau P, Moses D, Pather N. Normal morphometry of the biliary tree in pediatric and adult populations: A systematic review and meta-analysis. Eur J Radiol 2024; 176:111472. [PMID: 38718450 DOI: 10.1016/j.ejrad.2024.111472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/01/2024] [Accepted: 04/15/2024] [Indexed: 06/17/2024]
Abstract
PURPOSE This study aimed to characterise the normal morphometry of the biliary tree in pediatric and adult populations, through a systematic review and meta-analysis. METHODS This study, conducted using the PRISMA guidelines and registered with PROSPERO, searched MEDLINE, EMBASE, SCOPUS and Web of Science databases up to October 2022, and updated to August 2023. Studies that reported extractable data on diameter and length of the right, left and common hepatic ducts (LHD, RHD and CHD), and common bile duct (CBD) were included. Quality of the included studies were assessed using the Anatomical Quality Assessment (AQUA) tool. Statistical analysis included subgroup analyses according to sex, age, geographical location, and imaging modality. RESULTS In total, 60 studies were included, of which 44 studies reported adequate data for meta-analysis on 23,796 subjects. Overall, the pooled mean diameter of the CBD was 4.69 mm (95 % CI: 4.28-5.11). Significant differences were found between pediatric (1.32 mm, 95 % CI: 1.03-1.61) and adult (4.97 mm, 95 % CI: 4.67-5.27) subjects, as well as US (3.82 mm, 95 % CI: 3.15-4.49) and other imaging modalities, including MRI (6.21 mm, 95 % CI: 4.85-7.57) and ERCP (7.24 mm, 95 % CI: 6.08-8.40). The CBD diameter measured significantly larger distally (5.20 mm, 95 % CI: 4.60-5.80) than proximally (4.01 mm, 95 % CI: 3.51-4.51). CONCLUSIONS The results obtained from this evidence-based study may guide the establishment of standardised reference values and ranges of the normal biliary tree in pediatric and adult populations and aid clinical understanding.
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Affiliation(s)
- Patrick Chau
- Department of Anatomy, School of Biomedical Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Daniel Moses
- Department of Radiology, Prince of Wales Hospital, Sydney, Australia
| | - Nalini Pather
- Department of Anatomy, School of Biomedical Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia; Academy of Medical Education, Medical School, Faculty of Medicine, University of Queensland, Australia.
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Kumar A, Kumar R, Narayan RK, Nath B, Datusalia AK, Rastogi AK, Jha RK, Kumar P, Pareek V, Prasoon P, Faiq MA, Agrawal P, Prasad SN, Kumari C, Asghar A. Anatomical correlates for the newly discovered meningeal layer in the existing literature: A systematic review. Anat Rec (Hoboken) 2024. [PMID: 38924700 DOI: 10.1002/ar.25524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/07/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
The existence of a previously unrecognized subarachnoid lymphatic-like membrane (SLYM) was reported in a recent study. SLYM is described as an intermediate leptomeningeal layer between the arachnoid and pia mater in mouse and human brains, which divides the subarachnoid space (SAS) into two functional compartments. Being a macroscopic structure, having missed detection in previous studies is surprising. We systematically reviewed the published reports in animals and humans to explore whether prior descriptions of this meningeal layer were reported in some way. A comprehensive search was conducted in PubMed/Medline, EMBASE, Google Scholar, Science Direct, and Web of Science databases using combinations of MeSH terms and keywords with Boolean operators from inception until 31 December 2023. We found at least eight studies that provided structural evidence of an intermediate leptomeningeal layer in the brain or spinal cord. However, unequivocal descriptions for this layer all along the central nervous system were scarce. Obscure names like the epipial, intermediate meningeal, outer pial layers, or intermediate lamella were used to describe it. Its microscopic/ultrastructural details closely resemble the recently reported SLYM. We further examined the counterarguments in current literature that are skeptical of the existence of this layer. The potential physiological and clinical implications of this new meningeal layer are significant, underscoring the urgent need for further exploration of its structural and functional details.
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Affiliation(s)
- Ashutosh Kumar
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Patna, India
| | - Rajesh Kumar
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Patna, India
| | - Ravi K Narayan
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Patna, India
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Banshi Nath
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Patna, India
| | - Ashok K Datusalia
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research-Raebareli, Lucknow, India
| | - Ashok K Rastogi
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences (AIIMS), Patna, India
| | - Rakesh K Jha
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Patna, India
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Pankaj Kumar
- Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, India
| | - Vikas Pareek
- Haskins Laboratories, Yale Child Study Centre, Yale School of Medicine, University of Connecticut, New Haven, Connecticut, USA
| | - Pranav Prasoon
- Department of Anatomy and Cell Biology, George Washington University, Washington, DC, USA
| | - Muneeb A Faiq
- New York University (NYU) Langone Health Center, NYU Robert I Grossman School of Medicine, New York, New York, USA
| | - Prabhat Agrawal
- Spine Surgery Clinic, Department of Orthopedics, All India Institute of Medical Sciences (AIIMS), Patna, India
| | - Surya Nandan Prasad
- Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), Patna, India
| | - Chiman Kumari
- Department of Anatomy, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Adil Asghar
- Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Patna, India
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15
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Xu M, Ren H, Liu C, Zhao X, Li X. Systematic review and meta-analysis of root morphology and canal configuration of permanent premolars using cone-beam computed tomography. BMC Oral Health 2024; 24:656. [PMID: 38835024 DOI: 10.1186/s12903-024-04419-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024] Open
Abstract
INTRODUCTION The efficacy of root canal treatment is greatly impacted by a thorough understanding of root canal anatomy. This systematic review and meta-analysis aim to thoroughly investigate the root morphology and canal configuration (RMCC) of permanent premolars (PMs). METHODOLOGY A comprehensive analysis was conducted following the PRISMA guidelines. Literature exploration was carried out across four electronic databases (PubMed, Embase, Cochrane, and Web of Science). The risk of bias assessment was conducted for the included studies utilizing the Anatomical Quality Assessment (AQUA) tool. Data analysis was performed utilizing SPSS and RevMAN5.3.3. The meta-analysis was applied with a 95% confidence interval to calculate odds ratios (OR). RESULTS Among the 82 selected studies, 59 studies exhibited potential bias in domain one (objective(s) and subject characteristics), followed by domain three (methodology characterization). The majority of maxillary PM1s had either single root (46.7%) or double roots (51.9%), while three-rooted variants were uncommon (1.4%). Conversely, most other PMs exhibited a single root. In terms of canal configuration, maxillary PM1s predominantly featured double distinct canals (87.2%), with the majority of maxillary PM2s displaying either a single canal (51.4%) or double canals (48.3%). Mandibular PMs were primarily characterized by single canals, accounting for 78.3% of mandibular PM1s and 90.3% of mandibular PM2s. Subgroup analyses revealed higher incidences of single-rooted and single-canalled PMs among Asians compared to Caucasians. Additionally, women exhibited a higher incidence of single-rooted PMs, while men showed a greater frequency of double-rooted PMs. CONCLUSIONS The comprehensive analysis indicated that maxillary PM1s predominantly possess double roots and double canals, whereas maxillary PM2s and mandibular PMs were primarily characterized by single-rooted with a single canal. Notably, single root and single canal were more prevalent among women and Asian samples.
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Affiliation(s)
- Mengchen Xu
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
| | - Huiying Ren
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
| | - Congrui Liu
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China
- Science and Technology Innovation Committee of Shenzhen Municipality, Shenzhen Research Institute of Shandong University, A301 Virtual University Park in South District of Shenzhen, Shenzhen, Guangdong, 518000, China
| | - Xinyu Zhao
- Department of stomatology, Jinan Hospital, Jinan, Shandong, 250013, China.
| | - Xiaoyan Li
- Department of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Shandong University, Jinan, Shandong, 250012, China.
- Science and Technology Innovation Committee of Shenzhen Municipality, Shenzhen Research Institute of Shandong University, A301 Virtual University Park in South District of Shenzhen, Shenzhen, Guangdong, 518000, China.
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Ludi Z, Liau MYQ, Yong BSJ, Auyong ASY, Lynette QHT, Yeo SJ, Tan KSE, Mogali SR, Chandrasekaran R, Perumal V, Vallabhajosyula R. Morphometry of the sural nerve in diabetic neuropathy: a systematic review. J Ultrasound 2024; 27:225-239. [PMID: 38457087 PMCID: PMC11178711 DOI: 10.1007/s40477-024-00875-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/16/2024] [Indexed: 03/09/2024] Open
Abstract
PURPOSE The aim of this systematic review is to evaluate the usefulness of sural nerve ultrasonography in diagnosing diabetes mellitus (DM) and diabetic polyneuropathy (DPN), the latter of which is a common long-term complication for diabetic patients that frequently involves the sural nerve. METHODOLOGY A meta-analysis of the cross-sectional areas (CSAs) of sural nerves in healthy individuals and patients with diabetes mellitus based on a total of 32 ultrasonographic-based studies from 2015 to 2023 was performed. Sub-analyses were performed for factors such as geographical location and measurement site. RESULTS The meta-analysis showed that the mean CSA of the sural nerve was significantly larger in DM patients with DPN only compared to healthy individuals across all regions and when pooled together. An age-dependent increase in the CSA of healthy sural nerves is apparent when comparing the paediatric population with adults. CONCLUSION Sural nerve ultrasonography can distinguish diabetic adults with DPN from healthy adults based on cross-sectional area measurement. Future studies are needed to clarify the relationships between other parameters, such as body metrics and age, with sural nerve CSAs. Cut-offs for DPN likely need to be specific for different geographical regions.
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Affiliation(s)
- Zhang Ludi
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore
| | - Matthias Yi Quan Liau
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore
| | - Bryan Song Jun Yong
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore
| | - Amanda Sze Yen Auyong
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore
| | - Quah Hui Ting Lynette
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore
| | - Samuel Jianjie Yeo
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore
| | - Khin Swee Elizabeth Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore
| | - Sreenivasulu Reddy Mogali
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore
| | - Ramya Chandrasekaran
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore
| | - Vivek Perumal
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore
| | - Ranganath Vallabhajosyula
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, 308232, Singapore.
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Łazarz DP, Yika ADC, Pękala JR, Walocha JA, Pękala PA. Clinical anatomy of the human Achilles subtendons twist - meta-analysis. Ann Anat 2024; 254:152271. [PMID: 38677622 DOI: 10.1016/j.aanat.2024.152271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/10/2024] [Accepted: 04/23/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE This study aimed to provide a comprehensive and current overview of the anatomy of the Achilles tendon (AT) twisted structure, as there is a discrepancy in the literature regarding its rotating morphology. METHODS An extensive literature search was conducted across multiple databases to identify all studies that reported relevant data on the AT torsion, with no date or language restrictions applied. Data was extracted and assessed for this meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the included articles was examined using the anatomical quality assessment (AQUA) tool. RESULTS Seven articles (n=690 limbs) were pooled into this meta-analysis. The prevalence of Achilles tendon torsion types was as follows: type II was the most common (46.7%, 95% CI: 31.6-60.9%), followed by type I (44.7%, 95% CI: 29.8-59.0%), and least commonly, type III (8.6%, 95% CI: 1.8-18.8%). Additionally, morphometric analysis, utilizing the method described by van Gils et al., revealed a mean Achilles tendon torsion of 46.5° (95% CI: 25.1-67.9°). CONCLUSIONS This meta-analysis underscores the prominent and variable twist within the Achilles tendon among individuals, emphasizing the inherent diversity in AT morphology. Furthermore, the study highlights the importance of considering torsion angle as a potential factor influencing AT pathologies and biomechanical function.
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Affiliation(s)
- Dominik P Łazarz
- International Evidence-Based Anatomy Working Group, Cracow, Poland; Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Alicia Del Carmen Yika
- International Evidence-Based Anatomy Working Group, Cracow, Poland; Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Jakub R Pękala
- International Evidence-Based Anatomy Working Group, Cracow, Poland; Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Jerzy A Walocha
- International Evidence-Based Anatomy Working Group, Cracow, Poland; Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Przemysław A Pękala
- International Evidence-Based Anatomy Working Group, Cracow, Poland; Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland.
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Cirocchi R, Matteucci M, Randolph J, Duro F, Properzi L, Avenia S, Amato B, Iandoli R, Tebala G, Boselli C, Covarelli P, Sapienza P. Anatomical variants of the intercostobrachial nerve and its preservation during surgery, a systematic review and meta-analysis. World J Surg Oncol 2024; 22:92. [PMID: 38605346 PMCID: PMC11007944 DOI: 10.1186/s12957-024-03374-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/28/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The anatomic variants of the intercostobrachial nerve (ICBN) represent a potential risk of injuries during surgical procedure such as axillary lymph node dissection and sentinel lymph node biopsy in breast cancer and melanoma patients. The aim of this systematic review and meta-analysis was to investigate the different origins and branching patterns of the intercostobrachial nerve also providing an analysis of the prevalence, through the analysis of the literature available up to September 2023. MATERIALS AND METHODS The protocol for this study was registered on PROSPERO (ID: CRD42023447932), an international prospective database for reviews. The PRISMA guideline was respected throughout the meta-analysis. A systematic literature search was performed using PubMed, Scopus and Web of Science. A search was performed in grey literature through google. RESULTS We included a total of 23 articles (1,883 patients). The prevalence of the ICBN in the axillae was 98.94%. No significant differences in prevalence were observed during the analysis of geographic subgroups or by study type (cadaveric dissections and in intraoperative dissections). Only five studies of the 23 studies reported prevalence of less than 100%. Overall, the PPE was 99.2% with 95% Cis of 98.5% and 99.7%. As expected from the near constant variance estimates, the heterogeneity was low, I2 = 44.3% (95% CI 8.9%-65.9%), Q = 39.48, p = .012. When disaggregated by evaluation type, the difference in PPEs between evaluation types was negligible. For cadaveric dissection, the PPE was 99.7% (95% CI 99.1%-100.0%) compared to 99.0% (95% CI 98.1%-99.7%). CONCLUSIONS The prevalence of ICBN variants was very high. The dissection of the ICBN during axillary lymph-node harvesting, increases the risk of sensory disturbance. The preservation of the ICBN does not modify the oncological radicality in axillary dissection for patients with cutaneous metastatic melanoma or breast cancer. Therefore, we recommend to operate on these patients in high volume center to reduce post-procedural pain and paresthesia associated with a lack of ICBN variants recognition.
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Affiliation(s)
- Roberto Cirocchi
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy.
| | - Matteo Matteucci
- Department of Medicine and Surgery, University of Milan, Milan, 20122, Italy
| | - Justus Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, 30341, USA
| | - Francesca Duro
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy
| | - Luca Properzi
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy
| | - Stefano Avenia
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy
| | - Bruno Amato
- Department of Public Health, University of Naples "Federico II", Naples, 80131, Italy
| | - Ruggiero Iandoli
- Department of General Surgery, P.O Frangipane Ariano Irpino, Avellino, 83031, Italy
| | - Giovanni Tebala
- Department of Digestive and Emergency Surgery, AOSP of Terni, Terni, 05100, Italy
| | - Carlo Boselli
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy
| | - Piero Covarelli
- Department of Medicine and Surgery, University of Perugia, Perugia, 06132, Italy
| | - Paolo Sapienza
- Department of Surgery, "Sapienza" University of Rome, Roma, 00161, Italy
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19
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Fernandes ALVC, Shetti A, Lagali-Jirge V, Keluskar V. Accuracy of sex estimation by morphometric evaluation of foramen magnum using computed tomography - a systematic review and meta-analysis. Forensic Sci Med Pathol 2024; 20:268-279. [PMID: 36971895 DOI: 10.1007/s12024-023-00613-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 03/29/2023]
Abstract
The objective of this study is to determine whether the morphometric evaluation of the foramen magnum using computed tomography can be used as an accurate tool in estimating the sex of an individual. An extensive search of the databases, PubMed, ProQuest, Google Scholar, and Scopus, was carried out to procure articles that fulfilled the inclusion criteria. The AQUA tool was used to assess the quality of the included studies. A random effects model was used for the meta-analysis of the eligible studies using the STATA software, version 16, 2019 at 95% CI and p ≤ 0.05. Eleven eligible articles that measured the transverse and sagittal diameters of the foramen magnum using computed tomography were included in this study. The sagittal diameter of the foramen magnum was greater than the transverse diameter, and both the diameters were greater in males than in females. Meta-analysis revealed that both transverse and sagittal diameters were more reliable for male sex estimation. Since there is a dimensional variation between the male and female foramen magnum, it can be used for initial sex identification and also as an auxiliary to other advanced methods of sex estimation.
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Affiliation(s)
- Anabelle Louise Veiga Coutinho Fernandes
- Department of Oral Medicine and Radiology, KAHER's KLE Vishwnath Katti Institute of Dental Sciences, Constituent Unit of KLE Academy of Higher Education & Research, Nehru Nagar, Belagavi, Karnataka, 590010, India.
| | - Arvind Shetti
- Department of Oral Medicine and Radiology, KAHER's KLE Vishwnath Katti Institute of Dental Sciences, Constituent Unit of KLE Academy of Higher Education & Research, Nehru Nagar, Belagavi, Karnataka, 590010, India
| | - Vasanti Lagali-Jirge
- Department of Oral Medicine and Radiology, KAHER's KLE Vishwnath Katti Institute of Dental Sciences, Constituent Unit of KLE Academy of Higher Education & Research, Nehru Nagar, Belagavi, Karnataka, 590010, India
| | - Vaishali Keluskar
- Department of Oral Medicine and Radiology, KAHER's KLE Vishwnath Katti Institute of Dental Sciences, Constituent Unit of KLE Academy of Higher Education & Research, Nehru Nagar, Belagavi, Karnataka, 590010, India
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20
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Dos Santos Menezes Siqueira GV, Dos Santos Rodrigues MH, Santos CNN, Gonçalves PE, Garção DC. Anatomical variations of recurrent laryngeal nerve: a systematic review and meta-analyses. Surg Radiol Anat 2024; 46:353-362. [PMID: 38329522 DOI: 10.1007/s00276-023-03293-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/27/2023] [Indexed: 02/09/2024]
Abstract
PURPOSE The aim of this systematic review and meta-analysis was to systematically review and perform a meta-analysis on the anatomical variations of the RLN. METHODS We performed online research for studies that addressed anatomical variations of the RLN and laterality, published between 2015 and 2021. We found 230 articles, and nine were included. RESULTS Eight variations were found, with Type I prevailing (41.17%; 95% CI 19.44-64.88), extra laryngeal divergence of the RLN. The other types were: II-fan shape; III-distance greater than 5 mm to the cricothyroid joint; IV-thickening and adipopexy in the elderly; V-non-recurrent laryngeal nerve; VI-intracranial branch; VII-tortuous ascending RLN; and VIII-combination between the inferior branch of the NV and the ascending trunk of the RLN. Types I (p = 0) and III (p < 0.01) prevailed on the left and types II (p < 0.01) and V (p < 0.01) on the right. CONCLUSIONS It was observed that variations occurred due to the path of the RLN to the entrance to the larynx, its shape, and the age of the evaluated individual. The most frequent variation and side were, respectively, Type I, extra laryngeal divergence and left.
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Affiliation(s)
| | | | - Caio Nemuel Nascimento Santos
- Department of Morphology, Federal University of Sergipe, Marechal Rondon Jardim Avenue, Rosa Elze, São Cristóvão, Sergipe, 49100-000, Brazil
| | - Paulo Eduardo Gonçalves
- Department of Morphology, Federal University of Sergipe, Marechal Rondon Jardim Avenue, Rosa Elze, São Cristóvão, Sergipe, 49100-000, Brazil
| | - Diogo Costa Garção
- Department of Morphology, Federal University of Sergipe, Marechal Rondon Jardim Avenue, Rosa Elze, São Cristóvão, Sergipe, 49100-000, Brazil
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21
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Marvanova Z, Kachlik D. The anatomical variability of obturator vessels: Systematic review of literature. Ann Anat 2024; 251:152167. [PMID: 37865385 DOI: 10.1016/j.aanat.2023.152167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/01/2023] [Accepted: 10/10/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE To systematically assess available information about all variations of obturator vessels and to present the most surgically relevant types, their prevalence and calibre in order to provide a comprehensive overview for both anatomists and clinicians. MATERIALS AND METHODS A total of 2689 studies were found via searching the online databases. After applying exclusion criteria 44 studies were assessed. The cadaveric studies, CT angiographies, and clinical studies were included. Number of hemipelves, prevalence of each variation and calibre of identified vessels were studied. Each variation was classified as aberrant obturator artery/vein, aberrant accessory obturator artery/vein or anastomosis. RESULTS In included studies the average incidence of the variant obturator artery was 26% with the aberrant obturator artery being the most frequent type (with the mean calibre 2.10 mm, SD = 0.35 mm), while the overall incidence of the variant obturator vein was 55%. Presented venous structures had the mean calibre of 2.98 mm (SD = 0.56 mm). CONCLUSIONS According to reviewed studies, variant obturator vessels are present in a great number of patients. Due to their possible calibre larger than 3 mm they represent a structure of high clinical importance. It is important to unify the terminology and to stress out the significance to all clinicians.
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Affiliation(s)
- Zuzana Marvanova
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Centre for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Kachlik
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Centre for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic.
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22
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Koliarakis I, Manatakis DK, Tsitsipanis C, Drakonaki E, Tsamandouras I, Tsiaoussis J. Spinal accessory nerve anatomy in the posterior cervical triangle: A systematic review with meta-analysis. Clin Anat 2024; 37:130-139. [PMID: 37767816 DOI: 10.1002/ca.24119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/10/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023]
Abstract
This study aimed to investigate the anatomy of the spinal accessory nerve (SAN) in the posterior cervical triangle, especially in relation to adjacent anatomical landmarks, along with a systematic review of the current literature with a meta-analysis of the data. Overall, 22 cadaveric and three prospective intraoperative studies, with a total of 1346 heminecks, were included in the analysis. The major landmarks relevant to the entry of the SAN at the posterior border of the SCM muscle (PBSCM) were found to be the mastoid apex, the great auricular point (GAP), the nerve point (NP), and the point where the PBSCM meets the upper border of the clavicle. The SAN was reported to enter the posterior cervical triangle above GAP in 100% of cases and above NP in most cases (97.5%). The mean length of the SAN along its course from the entry point to its exit point from the posterior triangle of the neck was 4.07 ± 1.13 cm. The SAN mainly gave off 1 or 2 branches (32.5% and 31%, respectively) and received either no branches or one branch in most cases (58% and 23%, respectively) from the cervical plexus during its course in the posterior cervical triangle. The major landmarks relevant to the entry of the SAN at the anterior border of the TPZ muscle (ABTPZ) were found to be the point where the ABTPZ meets the upper border of the clavicle and the midpoint of the clavicle, along with the mastoid apex, the acromion, and the transverse distance of the SAN exit point to the PBSCM. The results of the present meta-analysis will be helpful to surgeons operating in the posterior cervical triangle, aiding the avoidance of the iatrogenic injury of the SAN.
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Affiliation(s)
- Ioannis Koliarakis
- Department of Anatomy, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | | | - Christos Tsitsipanis
- Department of Anatomy, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Elena Drakonaki
- Department of Anatomy, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Ioannis Tsamandouras
- Department of Otorhinolaryngology - Head and Neck Surgery, University General Hospital of Heraklion, Heraklion, Crete, Greece
| | - John Tsiaoussis
- Department of Anatomy, School of Medicine, University of Crete, Heraklion, Crete, Greece
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Chau P, Yoon JS, Moses D, Pather N. A systematic review and meta-analysis of portal vein morphometry in pediatric and adult populations: Drawing the line between normal and abnormal findings. Eur J Radiol 2023; 168:111016. [PMID: 37742371 DOI: 10.1016/j.ejrad.2023.111016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 07/13/2023] [Accepted: 07/26/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE The morphometry of the hepatic portal vein is of clinical importance, particularly in pre-operative assessments, surgical management, and diagnoses of liver conditions. This systematic review and meta-analysis aimed to characterize the morphometry of the normal portal vein in both pediatric and adult patients. METHODS The study, conducted using the PRISMA guidelines and registered with PROSPERO, utilized the MEDLINE, EMBASE, SCOPUS and Web of Science databases up to May 2020, and updated to May 2023. All studies reporting extractable data on diameter, length, and cross-sectional area (CSA) of the main, left, and right portal veins (PV, LPV, RPV, respectively) were included. The AQUA Tool was used to assess the quality of the included studies. Data analysis included subgroup analyses based on geographical location, sex, age, and imaging modality. RESULTS A total of 122 studies with 11,637 subjects were eligible for inclusion. Overall, the pooled mean diameter of the PV (PVD) was 10.09 mm (95% CI: 9.56-10.62). Significant differences in diameter were found between pediatric (6.60 mm; 95% CI: 5.38-7.82) and adult (10.72 mm; 95% CI: 10.25-11.19) subjects. Additionally, there was a significantly larger PVD measurement from computed tomography (CT) than other imaging modalities: CT, 13.28 mm (95% CI: 11.71-14.84); magnetic resonance imaging (MRI), 10.50 mm (95% CI: 9.35-11.66) and ultrasound (US), 9.81 mm (95% CI: 9.47-10.16). The mean diameters of the LPV and RPV were 8.27 mm (95% CI: 6.78-9.77) and 8.33 mm (95% CI: 6.70-9.95), respectively. Mean PV length in adults is 48.63 mm (95% CI: 35.63-61.64). Mean CSA of the PV was 1.09 cm2. CONCLUSIONS The study obtained aim to improve the understanding of portal vein anatomy, especially with relevance to surgical interventions of the liver in both pediatric and adult patients. Measurements from ultrasound imaging closely approximates the generated pooled PVD mean for pediatric and adult patients. CT imaging, however, significantly exceeded the established 13 mm threshold for adults. For pediatric patients, a threshold of 8 mm is proposed as a diagnostic upper limit for a normal PVD. Although not significant, the PVD decreased from the portal confluence towards its bifurcation.
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Affiliation(s)
- Patrick Chau
- Department of Anatomy, School of Biomedical Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Ji Soo Yoon
- Department of Anatomy, School of Biomedical Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Daniel Moses
- Department of Radiology, Prince of Wales Hospital, Sydney, Australia
| | - Nalini Pather
- Department of Anatomy, School of Biomedical Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia; Academy of Medical Education, Medical School, Faculty of Medicine, University of Queensland, Australia; Medical Education, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia.
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Pękala JR, Tempski J, Krager E, Johansen J, Łazarz DP, Walocha JA, Tubbs RS, Tomaszewski KA. Systematic review and meta-analysis of the prevalence of the retrotransverse foramen of the atlas. J Anat 2023; 243:570-578. [PMID: 37278337 PMCID: PMC10485574 DOI: 10.1111/joa.13894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/07/2023] Open
Abstract
The retrotransverse foramen (RTF) is a nonmetric variant of the atlas vertebra that can accommodate an anastomotic vertebral vein and occipital nerve. An understanding of this variation and its occurrence is crucial, as it could aid in explanation of the unidentified cause of the high prevalence of variability in this region. The aim of this meta-analysis was to obtain data on the prevalence of the RTF and its variations according to anatomy, sex, and ethnicity. A large-scale search was conducted through the major online databases to establish and determine the pool of studies reporting data relevant to the RTF. No date or language restrictions were applied. The data collection was categorized by prevalence, type (incomplete/complete), side, sex, ethnicity, laterality, and diameter. A total of 17 studies (n = 1979 subjects) were incorporated into our analysis. The overall pooled prevalence for a complete RTF was 11.4% and the overall pooled prevalence of an incomplete (partial) RTF was 9.6%. A complete RTF was most prevalent in Africa (Sub-Saharan population) (12.1%), followed by Europe (11.8%) and Asia (9.7%). As this variant occurs in a significant number of patients in all of the aforementioned populations, recognition, and awareness, especially with thorough investigation with computer tomography angiography (CTA) should be implemented, as it is the only possible way to visualize the possible contents of RTF.
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Affiliation(s)
- Jakub R Pękala
- International Evidence-Based Anatomy Working Group, Krakow, Poland
- The Brain and Spine Lab, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Jonasz Tempski
- International Evidence-Based Anatomy Working Group, Krakow, Poland
- The Brain and Spine Lab, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Eirik Krager
- International Evidence-Based Anatomy Working Group, Krakow, Poland
- The Brain and Spine Lab, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Jacob Johansen
- International Evidence-Based Anatomy Working Group, Krakow, Poland
- The Brain and Spine Lab, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Dominik P Łazarz
- International Evidence-Based Anatomy Working Group, Krakow, Poland
- The Brain and Spine Lab, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Jerzy A Walocha
- International Evidence-Based Anatomy Working Group, Krakow, Poland
- The Brain and Spine Lab, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
- University of Queensland, Brisbane, Australia
| | - Krzysztof A Tomaszewski
- International Evidence-Based Anatomy Working Group, Krakow, Poland
- The Brain and Spine Lab, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
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25
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Plutecki D, Kozioł T, Bonczar M, Ostrowski P, Skorupa A, Matejuk S, Walocha J, Pękala J, Musiał A, Pasternak A, Koziej M. Renal agenesis: A meta-analysis of its prevalence and clinical characteristics based on 15 641 184 patients. Nephrology (Carlton) 2023; 28:525-533. [PMID: 37254584 DOI: 10.1111/nep.14190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/17/2023] [Accepted: 05/20/2023] [Indexed: 06/01/2023]
Abstract
Our objective was to analyse the newest relevant data on worldwide prevalence and associated symptoms of renal agenesis (RA). This meta-analysis builds on previous systematic reviews to include bilateral RA, its symptoms and data on gender, unilateral RA and anomaly location prevalence. Review of available data included records in English and other languages from PubMed, Embase, ScienceDirect, Web of Science, SciELO, BIOSIS, Current Content Connect Korean Journal Database and Russian Citation Index and Google. A total of 15 641 184 patients were analysed in relation to the prevalence of RA. The pooled prevalence of RA was 0.03% (95% CI: 0.03%-0.04%). Based on 500 subjects, a pooled prevalence of 47.96% (95% CI: 31.55%-64.58%) for unilateral and 52.04% (95% CI: 35.42%-68.45%) for bilateral RA has been set. Our study presents the newest generalized findings on bilateral RA. There appears to be universal disease and symptom prevalence with minor differences between world regions, although quality of future observational research should include genomic data. This will provide even further insight into the prognosis of various renal anomalies and their etiologies.
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Affiliation(s)
- Dawid Plutecki
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Tomasz Kozioł
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Michał Bonczar
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Patryk Ostrowski
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Alicja Skorupa
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Szymon Matejuk
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Jakub Pękala
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Agata Musiał
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Artur Pasternak
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
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26
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Benes M, Kachlik D, Kopp L, Kunc V. Prevalence of the anterosuperior capsulolabral anatomical variations and their association with pathologies of the glenoid labrum: a systematic review and meta-analysis. Arch Orthop Trauma Surg 2023; 143:6295-6303. [PMID: 37351607 PMCID: PMC10491707 DOI: 10.1007/s00402-023-04932-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/23/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE Differentiating the anatomical variations of the anterosuperior portion of the glenoid labrum from pathologies is important to avoid unnecessary iatrogenic complications resulting from inaccurate diagnosis. Additionally, the presence of several variations was reported to be conductive to lesions involving the glenoid labrum. Thus, the aim of this study was to state the prevalence rates of the sublabral recess, sublabral foramen, and the Buford complex, and to verify their association with labral lesions. METHODS Systematic search of electronic databases was conducted to gain potentially eligible literature. Suitable studies were selected in a two-round screening, and relevant data were subsequently extracted. Calculation of the pooled prevalence estimates, including sub-analyses on cohort size, study type, and geographical variance, was conducted. Pooled analysis of risk ratios (RR) was used to assess the conductive nature of the discussed variants to superior labrum anterior to posterior (SLAP) lesions. RESULTS The screening resulted in selection of 20 studies investigating the morphological features of the glenoid labrum, consisting of 7601 upper limbs. On the bases of random-effects meta-analysis the sublabral recess, sublabral foramen and Buford complex occur with a pooled prevalence of 57.2% (95% CI 30.0-84.4%), 13.5% (95% CI 8.2-18.9%), and 3.0% (95% CI 1.5-4.5), respectively. Moreover, individuals with Buford complex have RR 2.4 (95% CI 1.3-4.7) of developing SLAP lesions, especially type II (95.5%; 95% CI 86.1-100%), whereas such risk for sublabral recess and sublabral foramen was not statistically significant. CONCLUSION Morphological variants of the glenoid labrum posing diagnostic confusion are frequently observed. Gradually, the Buford complex may be a predisposing factor for sustaining a SLAP lesion.
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Affiliation(s)
- Michal Benes
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Kachlik
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lubomir Kopp
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Clinic of Trauma Surgery, Masaryk Hospital, Usti nad Labem, Czech Republic
| | - Vojtech Kunc
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
- Clinic of Trauma Surgery, Masaryk Hospital, Usti nad Labem, Czech Republic.
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Asghar A, Narayan RK, Kumar P, Ravi KS, Tubbs RS, Patra A, Naaz S. Absence of the interthalamic adhesion (ITA) as a neuroanatomical association or risk factor for neuropsychiatric disorders: A systemic review and meta-analysis. Indian J Psychiatry 2023; 65:985-994. [PMID: 38108053 PMCID: PMC10725209 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_744_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 07/11/2023] [Accepted: 09/22/2023] [Indexed: 12/19/2023] Open
Abstract
Background This study aimed to provide an up-to-date account of the frequency of "the absence of interthalamic adhesion (AITA) as a risk factor or association" in healthy subjects and neuropsychiatric patients. Owing to the increased interest in the contribution of ITA to neurological function in previous literature, a meta-analysis of its frequency and sex dependency is required. Aim This study aimed to study whether the AITA is associated with neuropsychiatric disorders. Settings and Design This study is a meta-analysis and systemic review. Methods and Material Literature searches were conducted in PubMed, Web of Science, and Google Scholar using the keywords "interthalamic adhesion," "massa intermedia," "adhesio interthalamica," and "adhesion" along with the Boolean operators (OR, AND, and NOT). Three reviewers independently assessed the abstracts and full texts for validation based on the inclusion criteria. The meta-analysis was performed using Microsoft Excel 2019 for descriptive studies and RevMan 5.2 for comparative studies. Results The incidence of absent ITA was 15.3% in healthy subjects and 28.76% in neuropsychiatric subjects. The relative probability of AITA was 2.30 [95% confidence interval (CI), 1.96-2.70] in neuropsychiatric illness. Healthy men were 1.91 times more likely, and men with neuropsychiatric disorders were 1.82 times more likely to have absent ITA than women. Conclusions and Relevance In this study, a consistent association of AITA with psychiatric disorders was observed, rendering the condition to be treated as an associated risk factor affecting the function of the habenula nuclear complex via the stria medullaris thalami. A cohort or longitudinal study is needed to compare the incidence of psychiatric disorders in individuals with or without ITA and to calculate the attributed risk.
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Affiliation(s)
- Adil Asghar
- Department of Anatomy, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Ravi K. Narayan
- Department of Anatomy, ESIC Medical College and Hospital, Bihta, Patna, Bihar, India
| | - Pankaj Kumar
- Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Kumar S. Ravi
- Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - R. Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Neurosurgery, Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada
| | - Apurba Patra
- Department of Anatomy, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Shagufta Naaz
- Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, Bihar, India
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Suphamungmee W, Yurasakpong L, Poonudom K, Tubbs RS, Iwanaga J, Kruepunga N, Chaiyamoon A, Suwannakhan A. Radiological Study of Atlas Arch Defects with Meta-Analysis and a Proposed New Classification. Asian Spine J 2023; 17:975-984. [PMID: 37634902 PMCID: PMC10622819 DOI: 10.31616/asj.2023.0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/26/2023] [Accepted: 03/17/2023] [Indexed: 08/29/2023] Open
Abstract
This study consists of a retrospective cohort study, a systematic review, and a meta-analysis which were separately conducted. This study aimed to investigate the prevalence of atlas arch defects, generate an evidence-based synthesis, and propose a common classification system for the anterior and combined atlas arch defects. Atlas arch defects are well-corticated gaps in the anterior or posterior arch of the atlas. When both arches are involved, it is known as a combined arch defect. Awareness of these defects is essential for avoiding complications during surgical procedures on the upper spine. The prevalence of arch defects was investigated in an open-access OPC-Radiomics (Radiomic Biomarkers in Oropharyngeal Carcinoma) dataset comprising 606 head and neck computed tomography scans from oropharyngeal cancer patients. A systematic review and meta-analysis were performed to generate prevalence estimates of atlas arch defects and propose a classification system for the anterior and combined atlas arch defects. The posterior arch defect was found in 20 patients (3.3%) out of the 606 patients investigated. The anterior arch defect was not observed in any patient, while a combined arch defect was observed in one patient (0.2%). A meta-analysis of 13,539 participants from 14 studies, including the present study, yielded a pooled-posterior arch defect prevalence of 2.07% (95% confidence interval [CI], 1.22%-2.92%). The prevalences of anterior and combined arch defects were 0.00% (95% CI, 0.00%-0.10%) and 0.14% (95% CI, 0.04%-0.25%), respectively. The anterior and combined arch defects were classified into five subtypes based on their morphology and frequency. The present study showed that atlas arch defects were present in approximately 2% of the general population. For future studies, larger sample sizes should be used for studying arch defects to avoid the small-study effect and to predict the prevalence accurately.
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Affiliation(s)
- Worawit Suphamungmee
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok,
Thailand
| | - Laphatrada Yurasakpong
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok,
Thailand
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok,
Thailand
- In Silico and Clinical Anatomy Research Group (iSCAN), Department of Anatomy, Faculty of Science, Mahidol University, Bangkok,
Thailand
| | - Kanchanaphan Poonudom
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok,
Thailand
- In Silico and Clinical Anatomy Research Group (iSCAN), Department of Anatomy, Faculty of Science, Mahidol University, Bangkok,
Thailand
- Vejnitatphattana School, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok,
Thailand
| | - R. Shane Tubbs
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA,
USA
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA,
USA
- University of Queensland, Brisbane,
Australia
- Department of Neurosurgery and Ochsner Neurosciences Institute, Ochsner Health System, New Orleans, LA,
USA
- Department of Anatomical Sciences, St. George’s University, St. George’s,
Grenada
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA,
USA
- Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA,
USA
- Department of Neurology, Tulane University School of Medicine, New Orleans, LA,
USA
- Department of Anatomy, Kurume University School of Medicine, Fukuoka,
Japan
| | - Nutmethee Kruepunga
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok,
Thailand
- In Silico and Clinical Anatomy Research Group (iSCAN), Department of Anatomy, Faculty of Science, Mahidol University, Bangkok,
Thailand
| | - Arada Chaiyamoon
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok,
Thailand
| | - Athikhun Suwannakhan
- Department of Anatomy, Faculty of Science, Mahidol University, Bangkok,
Thailand
- In Silico and Clinical Anatomy Research Group (iSCAN), Department of Anatomy, Faculty of Science, Mahidol University, Bangkok,
Thailand
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Valenzuela-Fuenzalida JJ, Baez-Flores B, Sepúlveda RÁ, Medina CM, Pérez R, López E, Sanchis J, Orellana Donoso M, Silva JL, Rodriguez MC, Iwanaga J. Anatomical variations and abnormalities of the maxillary region and clinical implications: A systematic review and metaanalysis. Medicine (Baltimore) 2023; 102:e34510. [PMID: 37747000 PMCID: PMC10519516 DOI: 10.1097/md.0000000000034510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVE The objective of this review is to investigate and analyze the anatomical variations present in the maxillary sinus (MS), through the examination of the prevalence of these variations, as well as the corresponding prevalence of clinically significant pathologies and complications associated with them. METHODS The search process was carried out in the following databases; MEDLINE, SCIELO, WOS, CINHAL, SCOPUS, and GOOGLE SCHOLAR, using as search terms; "Maxillary bone," "Maxillary sinus," "Paranasal sinus," "Anatomical variations," "Sinusitis" and "Clinical anatomy." RESULTS A total of 26 articles and 12969 samples were included, from which 12,594 subjects had their sex recorded giving a total of 5802 males and 6792 females. The variants reported by the included were Haller cells, Concha Bullosa, Number of septa, Hypoplastic sinus, Agger Nasi, Thickening of the MS mucosa, Deviation of the nasal septum, Accessory ostium, and Onodi cells. Among the mentioned, the ones that presented the greatest number of studies (between 8 and 10 studies included) were: the Haller Cells, the Concha Bullosa, and the Number of septa, where prevalence was 0.30, 0.36, 0.39 respectively. These variations can lead to sinusitis, cause some types of tumors, or affect neighboring structures that could be compromised by this variation. CONCLUSION As a result, it is certainly complex to distinguish the presence of anatomical variations from pathological abnormalities. Therefore, knowledge of the different variations and their clinical relationships could be a useful asset for clinicians dedicated to this region.
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Affiliation(s)
- Juan José Valenzuela-Fuenzalida
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
- Departamento de Ciencias Química y Biológicas Facultad de Ciencias de la Salud, Universidad Bernardo O’Higgins, Santiago, Chile
| | - Belén Baez-Flores
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
| | | | - Claudia Moya Medina
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Rubén Pérez
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Esteban López
- Department of Morphology and Function, Faculty of Health and Social Sciences, Universidad de las Américas, Santiago, Chile
| | - Juan Sanchis
- Giaval Research Group, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Mathias Orellana Donoso
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
- Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Javiera Leyton Silva
- Departamento de Morfología, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile
| | | | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA
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M S, Bagewadi A, Lagali-Jirge V, S LK, Panwar A, Keluskar V. Reliability of gender determination from paranasal sinuses and its application in forensic identification-a systematic review and meta-analysis. Forensic Sci Med Pathol 2023; 19:409-439. [PMID: 36201147 DOI: 10.1007/s12024-022-00520-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 10/10/2022]
Abstract
This systematic review aims to determine whether linear or morphometric analysis of paranasal sinuses can be used for accurate determination of gender and to appraise which sinus can be evaluated for accurate gender determination.A comprehensive search of the specialized databases (PubMed/MEDLINE, Science Direct, Clinical Key, ProQuest, Google Scholar, Epistomonikos, LILACS, OpenGrey) and other institutional repositories was performed for including the studies which assessed paranasal sinuses for gender determination. Quality assessment was carried out with the AQUA tool. The meta-analysis was performed with the eligible study data at 95% CI and p ≤ 0.05 in the random-effects model.Forty-six studies evaluating frontal sinus (13), maxillary sinus (26), frontal and maxillary sinus (5), or three paranasal sinuses (2) were included. All the included studies assessed height, length, width, and volume, respectively, and other additional parameters (area, perimeter) if wherever applicable. Frontal sinus had significantly higher values for males compared to females except for left height (LH) and left volume (LV). Maxillary sinus measurements were significantly higher in males contrasted to females except for LH. Sub-group analyses revealed that analyses involving the population had statistically significant results for all the measured parameters for both the sinuses (p < 0.05 and p = 0.00, respectively).Measurements obtained from assessing sinuses reveal that there are variations in size, among populations in different geographic regions. Hence, more studies with improved sample sizes and standardized measurement protocols should be carried out on different populations to see the diversity and their reliability.
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Affiliation(s)
- Sridhar M
- Department of Oral Medicine, Diagnosis and Radiology, KAHER'S KLE Vishwanath Katti Institute of Dental Sciences, JNMC Campus, Nehru Nagar, Karnataka, 590010, Belagavi, India.
| | - Anjana Bagewadi
- Department of Oral Medicine, Diagnosis and Radiology, KAHER'S KLE Vishwanath Katti Institute of Dental Sciences, JNMC Campus, Nehru Nagar, Karnataka, 590010, Belagavi, India
| | - Vasanti Lagali-Jirge
- Department of Oral Medicine, Diagnosis and Radiology, KAHER'S KLE Vishwanath Katti Institute of Dental Sciences, JNMC Campus, Nehru Nagar, Karnataka, 590010, Belagavi, India
| | - Lokesh Kumar S
- Department of Oral Medicine, Radiology and Special Care Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), 162, Poonamallee High Road, Chennai, 600077, India
| | - Arun Panwar
- Department of Oral Medicine, Diagnosis and Radiology, KAHER'S KLE Vishwanath Katti Institute of Dental Sciences, JNMC Campus, Nehru Nagar, Karnataka, 590010, Belagavi, India
| | - Vaishali Keluskar
- Department of Oral Medicine, Diagnosis and Radiology, KAHER'S KLE Vishwanath Katti Institute of Dental Sciences, JNMC Campus, Nehru Nagar, Karnataka, 590010, Belagavi, India
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Ostrowski P, Bonczar M, Iwanaga J, Michalczak M, Dziedzic M, Del Carmen Yika A, Gil A, Sporek M, Szczepanek E, Niemczyk K, Walocha J, Koziej M. The prevalence and anatomy of the pyramidal lobe of the thyroid gland: A meta-analysis with implications for thyroid surgery. Clin Anat 2023; 36:937-945. [PMID: 37245093 DOI: 10.1002/ca.24062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/28/2023] [Accepted: 05/06/2023] [Indexed: 05/29/2023]
Abstract
The pyramidal lobe (PL), also known as the third lobe of the thyroid gland or lobe of Lalouette is an embryological remnant of the caudal end of the thyroglossal tract. The following meta-analysis aims to provide a detailed analysis of the anatomical variations of the PL using the available data in the literature. Major online medical databases such as PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched in order to find all studies considering the prevalence and anatomy of the PL of the thyroid gland. Finally, a total of 24 studies that met the required criteria and contained complete and relevant data were included in the present meta-analysis. The pooled prevalence of the PL was found to be 42.82% (95% CI: 35.90%-49.89%). An analysis showed that the mean length was 23.09 mm (SE: 0.56). The mean width was found to be 10.59 mm (SE: 0.77). The pooled prevalence of the PL originating from the left lobe (LL) was established at 40.10% (95% CI: 28.83%-51.92%). In conclusion, we believe that this is the most accurate and up-to-date study regarding the complete surgical anatomy of the PL. The PL was prevalent in 42.82% of the cases, being slightly more prevalent in males (40.35%) than females (37.43%). The mean length and width of the PL were 23.09 mm and 10.59 mm, respectively. Our results should be taken into consideration when performing procedures on the thyroid gland, such as thyroidectomies. The presence of the PL can affect the completeness of this procedure and lead to postoperative complications.
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Affiliation(s)
- Patryk Ostrowski
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Michał Bonczar
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, USA
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mateusz Michalczak
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Martyna Dziedzic
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | | | - Anna Gil
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz Sporek
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Elżbieta Szczepanek
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Warsaw, Warsaw, Poland
- Doctoral School in Medical Sciences and Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
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Kuniewicz M, Ostrowski P, Bonczar M, Kwiecińska M, Możdżeń K, Murawska A, Dziedzic M, Żytkowski A, Goncerz G, Walocha J, Koziej M. The anatomy of the atrioventricular nodal artery: A meta-analysis with implications for cardiothoracic surgery and ablation procedures. Clin Anat 2023; 36:951-957. [PMID: 37245092 DOI: 10.1002/ca.24072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/29/2023]
Abstract
The objective of the present meta-analysis was to evaluate recent and applicable data regarding the location and variation of the atrioventricular nodal artery (AVNA) in relation to adjacent structures. In order to minimize postoperative risks and maintain physiological anastomosis for proper cardiac function, understanding such possible variations of vascularization of the AV node is of immense importance prior to cardiothoracic surgery as well as ablations. In order to perform this meta-analysis, a systematic search was conducted in which all articles regarding, or at least mentioning, the anatomy of the AVNA was searched. In general, the results were based on 3919 patients. AVNA was found to originate only from the RCA in 82.41% (95% CI: 79.46%-85.18%). The pooled prevalence of AVNA originating only from LCA was found to be 15.25% (95% CI: 12.71%-17.97%). The mean length of AVNA was found to be 22.64 mm (SE = 1.60). The mean maximal diameter of AVNA at its origin was found to be 1.40 mm (SE = 0.14). In conclusion, we believe that this is the most accurate and up-to-date study regarding the highly variable anatomy of the AVNA. The AVNA was found to originate most commonly from the RCA (82.41%). Furthermore, the AVNA was found to most commonly have no (52.46%) or only one branch (33.74%). It is hoped that the results of the present meta-analysis will be helpful for physicians performing cardiothoracic or ablation procedures.
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Affiliation(s)
- Marcin Kuniewicz
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Patryk Ostrowski
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Michał Bonczar
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Maria Kwiecińska
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Kamil Możdżeń
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Murawska
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Martyna Dziedzic
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Andrzej Żytkowski
- Faculty of Philology, Department of Polish Dialectology and Logopaedics, University of Lodz, Lodz, Poland
- Norbert Barlicki Memorial Teaching Hospital No. 1 of the Medical University of Lodz, Lodz, Poland
| | - Grzegorz Goncerz
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
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Iskra T, Stachera B, Możdżeń K, Murawska A, Ostrowski P, Bonczar M, Gregorczyk-Maga I, Walocha J, Koziej M, Wysiadecki G, Balawender K, Żytkowski A. Morphology of the Sella Turcica: A Meta-Analysis Based on the Results of 18,364 Patients. Brain Sci 2023; 13:1208. [PMID: 37626564 PMCID: PMC10452851 DOI: 10.3390/brainsci13081208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND This meta-analysis aimed to present data on the sella turcica (ST) morphology and variations. Furthermore, a detailed morphometric analysis of the ST was conducted. METHODS Major online databases such as PubMed, Scopus, Embase, Web of Science, and the Cochrane Library were searched through. The overall search process was conducted in three stages. RESULTS This meta-analysis was based on the results of 18,364 patients and demonstrates the most up-to-date and relevant data regarding the morphology of the ST in the available literature. Four classification methods of the ST shape can be distinguished, in which the most commonly occurring variants are the normal ST (55.56%), the U-shaped ST (73.58%), the circular type of ST (42.29%), and non-bridging ST (55.64%). The overall midpoint height of the ST was 6.59 mm (SE = 0.13). The overall length of the ST was 9.06 mm (SE = 0.15). The overall volume of the ST was 845.80 mm3 (SE = 288.92). Four main classification methods of ST morphology can be distinguished in the available literature. Various morphometric characteristics of the ST may be applied in clinical practice to evaluate its shape, dimensions, and normal or pathological variants.
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Affiliation(s)
- Tomasz Iskra
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
| | - Bartłomiej Stachera
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
- Youthoria—Youth Research Organization, 33-332 Kraków, Poland
| | - Kamil Możdżeń
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
| | - Agnieszka Murawska
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
| | - Patryk Ostrowski
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
- Youthoria—Youth Research Organization, 33-332 Kraków, Poland
| | - Michał Bonczar
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
- Youthoria—Youth Research Organization, 33-332 Kraków, Poland
| | - Iwona Gregorczyk-Maga
- Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland;
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
- Youthoria—Youth Research Organization, 33-332 Kraków, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College Cracow, 33-332 Kraków, Poland; (T.I.); (B.S.); (K.M.); (A.M.); (P.O.); (M.B.); (J.W.); (M.K.)
- Youthoria—Youth Research Organization, 33-332 Kraków, Poland
| | - Grzegorz Wysiadecki
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, 90-752 Łódź, Poland
| | - Krzysztof Balawender
- Department of Normal and Clinical Anatomy, Institute of Medical Sciences, Medical College, Rzeszow University, 35-315 Rzeszów, Poland;
| | - Andrzej Żytkowski
- Norbert Barlicki Memorial Teaching Hospital No. 1, Medical University of Lodz, 90-001 Łódź, Poland;
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Abelleyra Lastoria DA, Kenny B, Dardak S, Brookes C, Hing CB. Is the patella apprehension test a valid diagnostic test for patellar instability? A systematic review. J Orthop 2023; 42:54-62. [PMID: 37483643 PMCID: PMC10362729 DOI: 10.1016/j.jor.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/03/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Patellar instability can arise from a traumatic event with anatomical predisposing factors increasing the risk of dislocation. Accurate diagnosis is required to initiate appropriate treatment. We aimed to evaluate the patella apprehension test (PAT) as a method to diagnose patellar instability. Methods The PRISMA diagnostic test accuracy checklist was followed. The review protocol was registered on PROSPERO with registration number CRD42022357898. Electronic databases, currently registered studies, conference proceedings and the reference lists of included studies were searched. A narrative synthesis evaluated the validity of the PAT as a method of diagnosing patellar instability. Results A total of 4867 records were screened in the initial search. Of these, 34 articles satisfied the inclusion criteria, assessing 1139 knees of 1046 patients. The PAT was found to have a high sensitivity and specificity. Its intra and inter-rater reliability was highly variable among studies. Studies reporting patellar instability correction following surgery also found a decrease in the number of patients exhibiting a positive PAT. Conclusion Current evidence suggests that the PAT has a high sensitivity and specificity. The intra- and inter-rater validities of the PAT are widely variable due to its subjective nature. Thus, though the PAT can be used to provide a provisional clinical diagnosis of patellar instability, formal functional assessment and imaging should be performed to confirm the diagnosis. Further research should explore the association between a positive PAT and anatomical parameters. In addition, studies comparing the accuracy of the PAT and radiological investigations should be performed.
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Affiliation(s)
| | - Bethany Kenny
- Department of Trauma and Orthopaedics, St George's University Hospitals NHS Foundation Trust, London, SW17 0RE, United Kingdom
| | - Sara Dardak
- Department of Trauma and Orthopaedics, St George's University Hospitals NHS Foundation Trust, London, SW17 0RE, United Kingdom
- Department of Trauma and Orthopaedics, Queen Elizabeth the Queen Mother Hospital, Margate, CT9 4AN, United Kingdom
| | - Charlotte Brookes
- Department of Trauma and Orthopaedics, St George's University Hospitals NHS Foundation Trust, London, SW17 0RE, United Kingdom
| | - Caroline Blanca Hing
- Department of Trauma and Orthopaedics, St George's University Hospitals NHS Foundation Trust, London, SW17 0RE, United Kingdom
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Paul S, Arora M, Das L, Raja BS, Kalia RB. Average Indian Glenoid Sizes Are Smaller than All Commercially Available Glenoid Components: A Systematic Review. Indian J Orthop 2023; 57:1008-1022. [PMID: 37384007 PMCID: PMC10293529 DOI: 10.1007/s43465-023-00885-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/26/2023] [Indexed: 06/30/2023]
Abstract
Background Despite the variability in glenoid sizes geographically, most of the currently available commercial glenoid component designs are based on the glenoid parameters of the Caucasian population which may not be suitable for the Indian population due to a mismatch between the prosthesis and native anatomy. The aim of the present study is to systematically review the literature to determine the average glenoid anthropometric parameters in the Indian population. Methods A comprehensive literature search was conducted using preferred reporting items for systematic reviews and meta-analyses guidelines in the PubMed, EMBASE, Google Scholar, and Cochrane Library databases from the date of inception to May 2021. Any observational study conducted on the Indian population measuring the glenoid diameters, glenoid index, version, inclination, or any other glenoid measurements were included in the review. Results A total of 38 studies were included in this review. The glenoid parameters were assessed on intact cadaveric scapulae in 33 studies, on 3DCT in three studies, and 2DCT in one study. The pooled average of glenoid dimensions are as the following- the superoinferior diameter or height was 34.65 mm, anteroposterior1 diameter or maximum width was 23.72 mm, anteroposterior2 diameter or maximum width of the upper part of the glenoid was 17.05 mm, the glenoid index was 67.88, and the glenoid version was 1.75-degree retroversion. Males were having a mean height of 3.65 mm and maximum width of 2.74 mm larger than the females. A subgroup analysis revealed no significant difference between different parts of India in glenoid parameters. Conclusion The glenoid dimensions in the Indian population are smaller compared to the average European and American populations. The average glenoid maximum width of the Indian population is 1.3 mm smaller than the minimum glenoid baseplate size available in reverse shoulder arthroplasty. Glenoid components specific to the Indian market need to be designed to reduce glenoid failure attributable to the above findings. Level of evidence III.
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Affiliation(s)
- Souvik Paul
- Department of Orthopaedics, AMRI Hospitals Mukundapur, Kolkata, India
| | - Manit Arora
- Fortis Hospitals Mohali, Mohali, Punjab India
| | - Lakhsmana Das
- Department of Orthopedics, All India Institute of Medical Sciences Bhatinda, Punjab, India
| | - Balgovind S. Raja
- Department of Orthopedics, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
| | - Roop Bhusan Kalia
- Department of Orthopedics, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
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Cirocchi R, Randolph J, Cheruiyot I, Davies RJ, Gioia S, Henry BM, Anania G, Donini A, Mingoli A, Sapienza P, Avenia S. Discontinuity of marginal artery at splenic flexure and rectosigmoid junction: A systematic review and meta-analysis. Colorectal Dis 2023. [PMID: 37317032 DOI: 10.1111/codi.16624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 02/08/2023] [Accepted: 04/02/2023] [Indexed: 06/16/2023]
Abstract
AIM The aim of this study was to provide comprehensive evidence-based assessment of the discontinuity of the marginal artery at the splenic flexure (SF) and the rectosigmoid junction (RSJ). METHOD A systematic review was conducted of literature published to 26 December 2022 in the electronic databases PubMed, SCOPUS and Web of Science to identify studies eligible for inclusion. Data were extracted and pooled into a meta-analysis using the Metafor package in R. The primary outcomes were the pooled PPEs of the marginal artery at the SF and the RSJ. The secondary outcome was the size of vascular anastomoses. RESULTS A total of 21 studies (n = 2,864 patients) were included. The marginal artery was present at the splenic flexure in 82% (95% CI: 62-95) of patients. Approximately 81% (95% CI: 63-94%) of patients had a large macroscopic anastomosis, while the remainder (19%) had small bridging ramifications forming the vessel. The marginal artery was present at the RSJ in 82% (95% CI: 70-91%) of patients. CONCLUSION The marginal artery may be absent at the SF and the RSJ in up to 18% of individuals, which may confer a higher risk of ischaemic colitis. As a result of high interstudy heterogeneity noted in our analysis, further well-powered studies to clarify the prevalence of the marginal artery at the SF and the RSJ, as well as its relationship with other complementary colonic collaterals (intermediate and central mesenteric), are warranted.
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Affiliation(s)
- Roberto Cirocchi
- Department of Medicine and Surgery, University of Perugia, Piazza dell' Universitá, Perugia, Italy
| | - Justus Randolph
- Georgia Baptist College of Nursing, Mercer University, Atlanta, USA
| | - Isaac Cheruiyot
- Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
- International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - R Justin Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- University of Cambridge, Cambridge, UK
| | - Sara Gioia
- Section of Legal Medicine, Hospital of Terni, Terni, Italy
| | | | - Gabriele Anania
- Department of Medical Science, Sant'Anna Hospital, University of Ferrara, Ferrara, Italy
| | - Annibale Donini
- Department of Medicine and Surgery, University of Perugia, Piazza dell' Universitá, Perugia, Italy
| | - Andrea Mingoli
- Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy
| | - Paolo Sapienza
- Department of Surgery "Pietro Valdoni", "Sapienza" University of Rome, Rome, Italy
| | - Stefano Avenia
- Department of Medicine and Surgery, University of Perugia, Piazza dell' Universitá, Perugia, Italy
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Abelleyra Lastoria DA, Benny CK, Hing CB. Predisposing factors for Hoffa's fat pad syndrome: a systematic review. Knee Surg Relat Res 2023; 35:17. [PMID: 37296488 PMCID: PMC10251569 DOI: 10.1186/s43019-023-00192-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Hoffa's fat pad syndrome has been defined as impingement of Hoffa's fat pad, leading to oedema and fibrosis. The primary aim of this systematic review was to identify morphological differences in Hoffa's fat pad between patients with and without Hoffa's fat pad syndrome, evaluating them as risk factors predisposing to its development. The secondary aim was to summarize and evaluate current evidence pertaining to the management of Hoffa's fat pad syndrome. MATERIALS AND METHODS The protocol for this review was prospectively registered (PROSPERO registration: CRD42022357036). Electronic databases, currently registered studies, conference proceedings and the reference lists of included studies were searched. All studies evaluating differences in Hoffa's fat pad anatomy under imaging between patients with and without Hoffa's fat pad syndrome were included, as well as those exploring epidemiological factors predisposing to its development (ethnicity, employment status, sex, age and BMI), and studies reporting on the effect of treatment on Hoffa's fat pad morphology. RESULTS A total of 3871 records were screened. Twenty one articles satisfied the inclusion criteria, evaluating 3603 knees of 3518 patients. Patella alta, increased tibial tubercle-tibial groove distance, and increased trochlear angle were found to predispose the development of Hoffa's fat pad syndrome. Trochlear inclination, sulcus angle, patient age and BMI were not associated with this condition. The link between Hoffa's fat pad syndrome and ethnicity, employment, patellar alignment, Hoffa's fat pad composition, physical activity and other pathological processes cannot be established due to lack of evidence. No studies reporting on treatment for Hoffa's fat pad syndrome were identified. Though weight loss and gene therapy may provide symptomatic relief, further research is required to corroborate these claims. CONCLUSION Current evidence suggests that high patellar height, TT-TG distance, and trochlear angle predispose the development of Hoffa's fat pad syndrome. In addition, trochlear inclination, sulcus angle, patient age and BMI do not seem to be associated with this condition. Further research should explore the link between Hoffa's fat pad syndrome and sport as well as other conditions pertaining to the knee. In addition, further study evaluating treatment approaches for Hoffa's fat pad syndrome is required.
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Affiliation(s)
| | | | - Caroline Blanca Hing
- Department of Trauma and Orthopaedics, St George's University Hospitals NHS Foundation Trust, London, UK
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Al-Rammahi HM, Chai WL, Nabhan MS, Ahmed HMA. Root and canal anatomy of mandibular first molars using micro-computed tomography: a systematic review. BMC Oral Health 2023; 23:339. [PMID: 37248469 DOI: 10.1186/s12903-023-03036-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/12/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND A thorough understanding of root and canal anatomy is crucial for successful root canal treatment outcomes. This systematic review aims to explore the published micro-CT studies investigated the anatomy of root and canal system in permanent mandibular first molars. METHOD An electronic search was performed on Web of science, PubMed, and Scopus. Micro-CT journal studies investigated the root and canal anatomy of permanent double-rooted mandibular first molars were included. Data on study characteristics, objectives of interest, specifications of the studies, and micro-CT specifications were extracted. Risk of bias assessment (ROB) of the included studies was performed using Anatomical Quality Assessment (AQUA) tool. The extracted data were presented in tables and figures to present and synthesise the results. A meta-analysis was performed for the studies related to the prevalence of Vertucci's canal configurations, middle mesial canal (MMC) configurations, and Fan's isthmus types. RESULTS Amongst 1358 identified studies, thirty met the inclusion criteria. In terms of the objectives, the selected studies showed high anatomical variability in mandibular first molars. Twenty-two (73%), 25 (83%), and 12 (40%) of the studies reported the population/ethnicity, micro-CT specifications, and ethical approval, respectively. 28 (93%) studies did not disclose the method of sample size estimation. In only 6 (20%) of the studies, the authors had calibrated the assessment approaches. Mostly, a potential ROB was reported in domain 1 (objective(s) and subject characteristics) and domain 3 (methodology characterization). Whilst, low risk was reported in domains 2 (study design), 4 (descriptive anatomy), and 5 (reporting of results). The overall ROB was reported to be ''moderate'' in the vast majority of the studies (27/30). Meta-analysis results showed high levels of heterogeneity among the studies related to MMCs (I2 = 86%) and Fan's isthmus (I2 = 87%). As for the root canal configuration, pooled prevalence showed that Vertucci type IV and type I were the most prevalent in mesial and distal root canals, respectively. CONCLUSION Based on moderate risk of bias level of evidence, micro-CT studies have shown wide range of qualitative and quantitative data presentations of the roots and canals in mandibular first molars. Protocol and registration. The protocol of this systematic review was prospectively registered in the Open Science Framework database ( https://osf.io ) on 2022-06-20 with the registration number 10.17605/OSF.IO/EZP7K.
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Affiliation(s)
- Hasan M Al-Rammahi
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Conservative Dentistry, Faculty of Dentistry, University of Babylon, AL Hillah city, Iraq
| | - Wen Lin Chai
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Mohamed Shady Nabhan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Hany M A Ahmed
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Wong MJ, Rajarathinam M. Ultrasound-guided axial facet joint interventions for chronic spinal pain: A narrative review. Can J Pain 2023; 7:2193617. [PMID: 37214187 PMCID: PMC10193888 DOI: 10.1080/24740527.2023.2193617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 05/24/2023]
Abstract
Background Axial facet joint interventions (e.g., medial branch block and radiofrequency ablation, facet joint intra-articular injection) are commonly performed for managing chronic spinal pain. Although traditionally performed with fluoroscopy or computed tomography (CT) guidance, ultrasound-guided techniques have also been developed for these interventions. Aims The aim of this study is to present contemporary ultrasound-guided techniques for facet joint interventions and synthesize data addressing their accuracy, safety, and efficacy. Methods The PubMed, MEDLINE, CINAHL, Embase, and Cochrane Central Register of Controlled Trials databases were systematically searched for studies of ultrasound-guided facet joint interventions with human subjects from November 1, 1992, to November 1, 2022. Additional sources were drawn from reference lists and citations of relevant studies. Results We found 48 studies assessing ultrasound-guided facet joint interventions. Ultrasound guidance for injection of the cervical facet joints and their innervating nerves had favorable accuracy (78%-100%), with lower procedural time compared to fluoroscopy or CT guidance and comparable pain relief. Accuracy with ultrasound-guided lumbar facet joint intra-articular injection (86%-100%) was more reliable than medial branch block (72%-97%); analgesia was comparable to fluoroscopy and CT guidance. In general, these procedures were more challenging for patients with obesity, and deeper structures were more difficult to accurately target (e.g., lower cervical levels, L5 dorsal ramus). Conclusions Ultrasound-guided facet joint interventions continue to evolve. Some technically challenging interventions may be impractical for widespread usage or require further technical refinement. The utility of ultrasound guidance with obesity and abnormal anatomy may be reduced.
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Affiliation(s)
- Michael J. Wong
- Department of Anesthesia & Perioperative Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Manikandan Rajarathinam
- Department of Anesthesia & Perioperative Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Lastoria DAA, Benny CK. Variations in the origin of the infrapyloric artery: A systematic review and meta-analysis. Ann Anat 2023; 249:152109. [PMID: 37207852 DOI: 10.1016/j.aanat.2023.152109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND The infrapyloric artery (IPA) supplies the pylorus and the large curvature of the antrum. Its common origin points include the gastroduodenal artery (GDA) and right gastroepiploic artery (RGEA). The prevalence of variations in IPA origins can be of interest to gastric cancer surgeons who wish to increase their understanding of this vessel. The primary aim of this study was to perform a systematic review and meta-analysis on the origin of the IPA. The secondary aims were to assess imaging identification accuracy, to identify IPA morphological features, and to explore the relationship of IPA origin and clinicopathological characteristics. METHODS Electronic databases, currently registered studies, conference proceedings and the reference lists of included studies were searched through March 2023. There were no constraints based on language, publication status, or patient demographics. Database search, data extraction and risk of bias assessment were performed independently by two reviewers. The point of origin of the IPA was the primary outcome. Secondary outcomes were imaging identification accuracy, relationship between IPA origin and clinicopathological characteristics, and IPA morphological features. A random-effects meta-analysis of the prevalence of different IPA origins was conducted. Secondary outcomes were narratively synthesized given the heterogeneity of studies reporting on these. RESULTS A total of 7279 records were screened in the initial search. Seven studies were included in the meta-analysis, assessing 998 patients. The IPA arose most frequently from the anterior superior pancreaticoduodenal artery (ASPDA), with a pooled prevalence of 40.4% (95% CI 17.1 - 55.8%), followed by the RGEA with a pooled prevalence of 27.6% (95% CI 8.7 - 43.7%), and the GDA with a pooled prevalence of 23.7% (95% CI 6.4 - 39.7%). Cases of multiple IPAs had a pooled prevalence of 4.9% (95% CI 0 - 14.3%). The IPA was absent in 2.6% (95% CI 0 - 10.3%) of cases and arose from the posterior superior pancreaticoduodenal artery (PSPDA) in the remaining 0.8% (95% CI 0 - 6.1%). Distance between the pylorus and the proximal branch of the IPA and distance from the pylorus to the first gastric branch of the RGEA when the IPA originated from the ASPDA and RGEA were longer than when the IPA originated from the GDA. The IPA is a small vessel (<1mm), and its origin is not related to clinicopathological characteristics including patient sex, age, and tumor stage and location. CONCLUSIONS Surgeons must be aware of the most common origin points of the IPA. Recommendations for future study include the stratification of IPA origin according to demographic characteristics, and further investigation into IPA morphological parameters such as tortuosity, course and relation to adjacent lymph nodes, aiding the creation of a standardized classification system pertaining to the anatomy of this vessel.
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Garção DC, de Souza Paiva MS, Corcinio KS. Anatomical patterns of the sural nerve: a meta-analysis with clinical and surgical considerations. Surg Radiol Anat 2023; 45:681-691. [PMID: 37115291 DOI: 10.1007/s00276-023-03152-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND The sural nerve (SN) supplies the posterolateral aspect of the leg and the lateral aspects of the ankle and foot and descends through the gastrocnemius muscle along the lower third of leg. Because in-depth knowledge about SN anatomy is essential for clinical and surgical approaches, our study aims to review SN anatomical patterns. METHODS We searched the PubMed, Lilacs, Web of Science, and SpringerLink databases to find relevant articles for meta-analysis. We assessed the quality of the studies using the Anatomical Quality Assessment tool. We used proportion meta-analysis to analyze the SN morphological variables and simple mean meta-analysis to analyze the SN morphometric variables (nerve length and distance to anatomical landmarks). RESULTS Thirty-six studies comprised this meta-analysis. Overall, Type 2A (63.68% [95% CI 42.36-82.64]), Type 1A (51.17% [95% CI 33.16-69.04]) and Type 1B (32.19% [95% CI 17.83-48.38]) were the most common SN formation patterns. The lower third of leg (42.40% [95% CI 32.24-52.86]) and middle third of leg (40.00% [95% CI 25.21-53.48]) were the most common SN formation sites. The pooled SN length from nerve formation to the lateral malleolus was 144.54 mm (95% CI 123.23-169.53) in adults, whereas the SN length was 25.10 mm (95% CI 23.20-27.16) in fetuses in the second trimester of gestation and 34.88 mm (95% CI 32.86-37.02) in fetuses in the third trimester of gestation. CONCLUSIONS The most prevalent SN formation pattern was the union of the medial sural cutaneous nerve with the lateral sural cutaneous nerve. We found differences regarding geographical subgroup and subject age. The most common SN formation sites were the lower and middle thirds of the leg.
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Affiliation(s)
- Diogo Costa Garção
- Department of Morphology, Federal University of Sergipe, São Cristóvão, Brazil.
- Neurosciences Study Group, Federal University of Sergipe, São Cristóvão, Brazil.
| | - Maria Stephany de Souza Paiva
- Neurosciences Study Group, Federal University of Sergipe, São Cristóvão, Brazil
- Department of Nursing, Federal University of Sergipe, Aracaju, Brazil
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Valenzuela-Fuenzalida JJ, Baeza-Garrido V, Navia-Ramírez MF, Cariseo-Ávila C, Bruna-Mejías A, Becerra-Farfan Á, Lopez E, Orellana Donoso M, Loyola-Sepulveda W. Systematic Review and Meta-Analysis: Recurrent Laryngeal Nerve Variants and Their Implication in Surgery and Neck Pathologies, Using the Anatomical Quality Assurance (AQUA) Checklist. Life (Basel) 2023; 13:life13051077. [PMID: 37240722 DOI: 10.3390/life13051077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION The recurrent laryngeal nerve (RLN) is the structure responsible for sensory and motor innervation of the larynx, and it has been shown that its lesion due to a lack of surgical rigor led to alterations such as respiratory obstruction due to vocal cords paralysis and permanent phonation impairment. The objectives of this review were to know the variants of the RLN and its clinical relevance in the neck region. METHODS This review considered specific scientific articles that were written in Spanish or English and published between 1960 and 2022. A systematic search was carried out in the electronic databases MEDLINE, WOS, CINAHL, SCOPUS, SCIELO, and Latin American and Caribbean Center for Information on Health Sciences to compile the available literature on the subject to be treated and was enrolled in PROSPERO. The included articles were studies that had a sample of RLN dissections or imaging, intervention group to look for RLN variants, or the comparison of the non-recurrent laryngeal nerve (NRLN) variants, and finally, its clinical correlations. Review articles and letters to the editor were excluded. All included articles were evaluated through quality assessment and risk of bias analysis using the methodological quality assurance tool for anatomical studies (AQUA). The extracted data in the meta-analysis were interpreted to calculate the prevalence of the RLN variants and their comparison and the relationship between the RLN and NRLN. The heterogeneity degree between included studies was assessed. RESULTS The included studies that showed variants of the RLN included in this review were 41, a total of 29,218. For the statistical analysis of the prevalence of the RLN variant, a forest plot was performed with 15 studies that met the condition of having a prevalence of less than 100%. As a result, the prevalence was shown to be 12% (95% CI, SD 0.11 to 0.14). Limitations that were present in this review were the publication bias of the included studies, the probability of not having carried out the most sensitive and specific search, and finally, the authors' personal inclinations in selecting the articles. DISCUSSION This meta-analysis can be considered based on an update of the prevalence of RLN variants, in addition to considering that the results show some clinical correlations such as intra-surgical complications and with some pathologies and aspects function of the vocal cords, which could be a guideline in management prior to surgery or of interest for the diagnostic.
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Affiliation(s)
- Juan José Valenzuela-Fuenzalida
- Department of Morphology and Function, Faculty of Health Sciences, Universidad de las Américas, Santiago 8370040, Chile
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370186, Chile
| | - Vicente Baeza-Garrido
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370186, Chile
| | | | - Carolina Cariseo-Ávila
- Departamento de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370186, Chile
| | - Alejandro Bruna-Mejías
- Departamento de Ciencias y Geografía, Facultad de Ciencias Naturales y Exactas, Universidad de Playa Ancha, Valparaíso 2360072, Chile
| | - Álvaro Becerra-Farfan
- Departamento de Ciencias Química y Biológicas, Facultad de Ciencias de la Salud, Universidad Bernardo O'Higgins, Santiago 8370874, Chile
| | - Esteban Lopez
- Department of Morphology and Function, Faculty of Health Sciences, Universidad de las Américas, Santiago 8370040, Chile
| | | | - Walter Loyola-Sepulveda
- Kinesiology School, Faculty of Health Sciences, Universidad de las Américas, Santiago 8370040, Chile
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Tzortzis AS, Antonopoulos I, Pechlivanidou E, Chrysikos D, Pappas N, Troupis T. Anatomical variations of the superior thyroid artery: A systematic review. Morphologie 2023:S1286-0115(23)00028-0. [PMID: 37061377 DOI: 10.1016/j.morpho.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND The superior thyroid artery (STA) is one of the main arteries that provide blood supply to the thyroid gland. It has a plethora of anatomical variations, and knowledge of its anatomy is necessary in procedures in this area. The aim of this review is to summarize and describe human studies (cadaveric and angiographic) that investigate the anatomical variations related to the STA. MATERIAL AND METHODS A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. A literature search in PubMed, and Embase databases was carried out. Original studies that investigated the origin of the STA and reported data on the variant arterial anatomy were considered, including only cadaveric and angiographic studies. RESULTS A total of 34 studies (4048 heminecks in total; heminecks in each study: min: 25-max: 1280) were finally included. All studies provide details about sex [men/women ratio median (IQR): 2(1-5)] but none about age and 10 (29%) about nationality. STA morphological characteristics described in the included studies are origin, length, number of branches, distance from the carotid bifurcation and the vessel's diameter. CONCLUSIONS The STA's anatomical features are subject to a non-negligible degree of variability. Our results should improve the awareness of anatomical variations of the STA, and eventually have an impact on the interventions regarding the visceral compartment of the neck in clinical practice.
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Affiliation(s)
- A S Tzortzis
- Department of anatomy, school of medicine, faculty of health sciences, national and Kapodistrian university of Athens, 75, Mikras Asias street, Goudi, 11527 Athens, Greece
| | - I Antonopoulos
- Department of anatomy, school of medicine, faculty of health sciences, national and Kapodistrian university of Athens, 75, Mikras Asias street, Goudi, 11527 Athens, Greece
| | - E Pechlivanidou
- Department of hygiene, epidemiology and medical statistics, medical school, National and Kapodistrian university of Athens, Athens, Greece
| | - D Chrysikos
- Department of anatomy, school of medicine, faculty of health sciences, national and Kapodistrian university of Athens, 75, Mikras Asias street, Goudi, 11527 Athens, Greece
| | - N Pappas
- Department of anatomy, school of medicine, faculty of health sciences, national and Kapodistrian university of Athens, 75, Mikras Asias street, Goudi, 11527 Athens, Greece
| | - T Troupis
- Department of anatomy, school of medicine, faculty of health sciences, national and Kapodistrian university of Athens, 75, Mikras Asias street, Goudi, 11527 Athens, Greece.
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Abelleyra Lastoria DA, Smith R, Raison N. Variations in the origin of the right gastric artery: a systematic review and meta-analysis. Surg Radiol Anat 2023; 45:709-720. [PMID: 37022462 DOI: 10.1007/s00276-023-03138-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/22/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE The right gastric artery (RGA) supplies the lesser curvature of the stomach. The prevalence of variations in RGA origins can be of interests to students, surgeons, and radiologists who wish to increase their understanding of this vessel. The aim of this study was to perform a systematic review and meta-analysis on the origin of the RGA. METHODS The PRISMA 2020 checklist was followed. Electronic databases, currently registered studies, conference proceedings and the reference lists of included studies were searched. There were no constraints based on language or publication status. Database search, data extraction and risk of bias assessment were performed independently by two authors. A random-effects meta-analysis of the prevalence of different RGA origins was conducted. RESULTS A total of 9084 records were screened in the initial search. Fifteen studies were included, assessing 1971 right gastric arteries. The RGA arose most frequently from the Proper Hepatic Artery (PHA), with a pooled prevalence of 53.6% (95% CI 44.5-60.8%), followed by the Left Hepatic Artery (LHA) with a pooled prevalence of 25.9% (95% CI 18.6-32.8%), and the Gastroduodenal Artery (GDA) with a pooled prevalence of 8.89% (95% CI 4.62-13.9%). Less common origins were the Common Hepatic Artery (CHA) (6.86%, 95% CI 3.15-11.5%), the Right Hepatic Artery (RHA) (3.43%, 95% CI 0.93-7.04%), and Middle Hepatic Artery (MHA) (1.31%, 95% CI 0-3.44%). CONCLUSIONS This meta-analysis provides an accurate estimate of the prevalence of different RGA origins. Anatomical knowledge combined with pre-operative planning and imaging can prevent iatrogenic injury during surgery.
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Affiliation(s)
| | - Robert Smith
- St George's, University of London, London, SW17 0RE, UK
| | - Nicholas Raison
- Simulation Unit, MRC Centre for Transplantation, King's College London, Great Maze Pond, London, SE1 9RT, UK
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Mann MR, Plutecki D, Janda P, Pękala J, Malinowski K, Walocha J, Ghosh SK, Balawender K, Pękala P. The subscapularis muscle: A meta-analysis of its variations, prevalence, and anatomy. Clin Anat 2023; 36:527-541. [PMID: 36597929 DOI: 10.1002/ca.24008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 01/05/2023]
Abstract
BACKGROUND The subscapularis (SSC) is the largest rotator cuff muscle and is involved in the medial rotation, abduction, adduction, and anterior stabilization of the shoulder. It is anatomically variable, as is the morphology and prevalence of the accessory SSC (aSSC), a rare muscle slip attached to the SSC. There is no current review investigating the prevalence and morphometrics of the SSC and aSSC. PURPOSE To investigate the prevalence of the morphological variants of the SSC and aSSC via meta-analysis and review the relevant literature involving cadaveric, magnetic resonance imaging, and ultrasonographic studies. STUDY DESIGN Meta-analysis. MATERIALS AND METHODS Literature data reporting the prevalence rates and morphometrics of the SSC and aSSC and their variants were pooled. Literature searches and data analyses were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Anatomical Quality Assurance guidelines. RESULTS Forty-six studies, totaling 2166 shoulders, were assessed. The SSC showed an overall length, thickness, cross-sectional area, and volume of 152.2 mm (95% confidence interval, CI, 103.8-200.5 mm), 5.6 mm (95% CI, 4.6-6.6 mm), 18.1 cm2 (95% CI, 14.2-22.0 cm2 ), and 126.9 cm3 (95% CI, 87.2-166.5 cm3 ), respectively. The SSC displayed substantial variations in its origin and insertion points and in the composition of its tendon. The aSSC had an overall pooled prevalence of 24.6% (95% CI, 0.0%-76.9%). CONCLUSIONS The SSC and aSSC have been implicated in multiple shoulder pathologies, including muscle and tendon ruptures and neurovascular compromise. A better understanding of SSC and aSSC variants when diagnosing and treating their related pathologies will reduce patient morbidity and improve treatment regimens.
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Affiliation(s)
- Mitchell R Mann
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Dawid Plutecki
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Patryk Janda
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Jakub Pękala
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Konrad Malinowski
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Sanjib Kumar Ghosh
- Department of Anatomy, All India Institute of Medical Sciences, Patna, India
| | - Krzysztof Balawender
- Department of Morphological Sciences, College of Medical Sciences, Institute of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Przemysław Pękala
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
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An evaluation of mandibular canal variations: a systematic review and meta-analysis. Anat Sci Int 2023; 98:176-184. [PMID: 36038792 DOI: 10.1007/s12565-022-00682-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/22/2022] [Indexed: 02/07/2023]
Abstract
The inferior alveolar nerve and vessels are carried via the mandibular canal, which extends bilaterally from the inferior alveolar foramen to the mental foramen. Bifid and trifid mandibular canals result from abnormal fusions of nerve canals. The purpose of this study was to provide an up-to-date and comprehensive analysis of the prevalence of mandibular canal variations among healthy adults, and to identify any potential ethnic, sex, or laterality predilections. The prevalence of the bifid mandibular canal was 18.87% and that of the trifid canal 1.3%. Unilateral variants were three times commoner than bilateral. Each mandibular half had four canals emanating from separate openings on the lingual surface of the mandibular ramus. Retromolar and forward canals were the predominant subtypes, followed by dental; buccolingual were the least frequent. The mean length and diameter of the bifid mandibular canal were 13.62 mm and 1.63 mm, respectively. The possibility of a bifid mandibular canal is a crucial consideration in dental medicine. Because anatomical variations of the mandibular canal are fairly common, awareness of them is essential for anatomy teachers and for surgeons who operate in the oromaxillofacial region.
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Sakaran R, Alias A, Woon CK, Ku Mohd Noor KM, Zaidun NH, Zulkiflee NDI, Lin NW, Chung E. Sex estimation on thoracic vertebrae: A systematic review. TRANSLATIONAL RESEARCH IN ANATOMY 2023. [DOI: 10.1016/j.tria.2023.100243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Ejlersen M. The human clavicle's nutrient foramen's prevalence, number, location, and direction: A systematic review and meta-analysis. Surgeon 2023; 21:e48-e61. [PMID: 35606260 DOI: 10.1016/j.surge.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 03/08/2022] [Accepted: 04/03/2022] [Indexed: 02/01/2023]
Abstract
INTRODUCTION The clavicle's nutrient foramen is a surrogate marker for its nutrient artery. Knowing its location may be useful for interpreting fractures and to avoid iatrogenic lesions. The aim of this review was to determine the prevalence, number, location, and direction of the nutrient foramen. METHODS Embase, Medline, PubMed, Scopus, and Web of Science were searched and supplemented by Google Scholar, hand-searching major anatomical journals, and the reference list of included studies (updated March 08, 2022). Titles and abstracts were screened for eligibility, and observational studies with quantitative data were included based on full text evaluation. Internal validity was assessed using the anatomical quality assessment tool. Pooled prevalence proportions were derived using a random effects DerSimonian-Laird model using the Freeman-Tukey double arcsine transformation with Miller's inverse back-transformation. RESULTS From 18,889 unique reports, 33 studies with 3760 clavicles and 3358 foramina were included. All studies suffered from untransparent reporting. The prevalence of the nutrient foramen was 97.75%, 95% confidence interval 94.70%-99.60%. It was mainly found as a single foramen on the middle third segment's posterior surface with acromial (lateral) obliquity. Results were stable over time, robust to sensitivity analyses, albeit limited by unexplained heterogeneity and asymmetry. CONCLUSION This review may aid in interpreting fractures passing through a high-risk area (mean foraminal index range 36.31-61.03%) for lesions to the nutrient artery. Practical implications are a need to update current inaccurate textbook descriptions and further advocate evidence-based anatomy to improve conduct and reporting of anatomical research.
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Affiliation(s)
- Morten Ejlersen
- Faculty of Health Sciences, University of Southern Denmark, J.B. Winsløws Vej 19.3, Odense, 5000, Denmark.
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The effect of quadriceps anatomical factors on patellar stability: A systematic review. Knee 2023; 41:29-37. [PMID: 36610240 DOI: 10.1016/j.knee.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/21/2022] [Accepted: 12/14/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE The aim of this systematic review was to analyse the effect of quadriceps anatomical factors on patellar stability. METHODS The protocol for this review was registered on PROSPERO with registration number CRD42022334265. A systematic PRISMA compliant database search was conducted. Electronic databases (MEDLINE, Global Health, MIDIRS, Embase, PsycARTICLES and APA PsycInfo), currently registered studies, conference proceedings and the reference lists of included studies were searched. A narrative synthesis provided a summary of current evidence pertaining to the effect of quadriceps anatomical factors on patellar stability. RESULTS A total of 9168 records were screened in the initial search. Of these, 20 articles satisfied the inclusion criteria, assessing 754 knees of 689 patients, and 69 cadaveric knees. Vastus medialis obliquus strength (VMO) affected patellar stability up to 15° of knee flexion, whereas medial retinaculum integrity did so up to 30° of knee flexion. Studies disagreed as to whether this applied to the rest of knee flexion. There is conflicting evidence regarding the effect of VMO elevation, cross-sectional area and angulation on patellar stability. The lateral retinaculum contributed to patellar stability throughout the entirety of knee flexion. Quadriceps angle altered patellar orientation during knee flexion, but not extension. CONCLUSION Whilst vastus medialis obliquus strength was found to be a determinant of patellar stability, there is conflicting evidence regarding the effect of VMO morphological parameters on patellar stability. The lateral retinaculum provided stability throughout the entirety of knee flexion, and the medial retinaculum did so up to 30° of flexion.
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The Morphology of the Pituitary Gland: A Meta-Analysis with Implications for Diagnostic Imaging. Brain Sci 2023; 13:brainsci13010089. [PMID: 36672070 PMCID: PMC9856875 DOI: 10.3390/brainsci13010089] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023] Open
Abstract
The objective of this meta-analysis was to present transparent data on the morphology of the pituitary gland (PG) using the available data in the literature. The main online medical databases, such as PubMed, Embase, Scopus, and Web of Science, were searched to gather all relevant studies regarding PG morphology. The mean overall volume of the PG was found to be 597.23 mm3 (SE = 28.81). The mean overall height of the PG was established to be 5.64 mm (SE = 0.11). The mean overall length of the PG was found to be 9.98 mm (SE = 0.26). In the present study, the PG's overall morphology and morphometric features were analyzed. Our results showed that, on average, females from Asia have the highest volume of PG (706.69 mm3), and males from Europe have the lowest (456.42 mm3). These values are crucial to be aware of because they represent the normal average properties of the PG, which may be used as reference points when trying to diagnose potential pathologies of this gland. Furthermore, the present study's results prove how the PG's size decreases with age. The results of the present study may be helpful for physicians, especially surgeons, performing procedures on the PG.
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