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Cavalcanti M, Otero PE, Romano M, Medina-Serra R, Chiavaccini L, Vettorato E, Maxwell EA, Portela DA. Ultrasound-guided retromammillary injections in dogs: a feasibility, descriptive and anatomical study. Vet Anaesth Analg 2024; 51:695-701. [PMID: 39147678 DOI: 10.1016/j.vaa.2024.07.009] [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: 05/11/2024] [Revised: 07/22/2024] [Accepted: 07/22/2024] [Indexed: 08/17/2024]
Abstract
OBJECTIVE To evaluate the feasibility of an ultrasound-guided technique targeting the medial branches of the dorsal ramus of the spinal nerves (DRSN) by injecting a dye solution at the caudal aspect of the base of lumbar mammillary processes [i.e. the retromammillary (RM) space]. STUDY DESIGN Feasibility, descriptive, anatomical study. ANIMALS Eleven canine cadavers. METHODS Using anatomical dissections, the relationship between the mammillary processes and the branches of the DRSN of the thoracolumbar and lumbar spine was studied in two cadavers. Subsequently, ultrasound-guided RM injections were administered in nine cadavers, randomly assigned to low volume (LV; 0.01 mL kg-1) of a dye solution at multiple points from L3 to L6 on one side, and high volume (HV; 0.4 mL kg-1) at a single L4 point on the contralateral side. Gross anatomical dissections were immediately performed after the injections. The RM injections were feasible if ultrasonographic landmarks were identifiable in at least 80% of cases, and 80% of LV injections showed medial branch staining. A one-sample binomial test was used for testing feasibility. RESULTS The medial branches emerged shortly after the DRSN exited the intervertebral foramen and traveled towards the caudal aspect of the base of the mammillary process, which served as the target injection point. With LV, 36 out of 36 (100%) injected medial branches were stained, meeting the criteria of feasibility (p < 0.001). The median (range) number of stained medial branches per cadaver were 4 (4-4) and 2 (1-3), with LV and HV, respectively. Although no lateral branches were stained with LV, 1 (0-2) was stained with HV. Neither ventral branch staining nor epidural spread was noted in any cadaver. CONCLUSIONS AND CLINICAL RELEVANCE Ultrasound-guided RM injections are feasible and allow for selective staining of the medial branch of the DRSN in canine cadavers at the lumbar spine.
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Affiliation(s)
- Mariana Cavalcanti
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Pablo E Otero
- Department of Anesthesiology and Pain Management, Faculdad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Marta Romano
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Roger Medina-Serra
- North Downs Specialist Referrals, Brewerstreet Dairy Business Park, Bletchingley, UK
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Enzo Vettorato
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Elizabeth A Maxwell
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
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Malinowski K, Kim DW, Zabrzyński J, Walocha JA, Pękala PA. Evidence-based research in orthopaedics, sports medicine and rehabilitation-Why new studies should rely on earlier work. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 39431473 DOI: 10.1002/ksa.12474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2024]
Affiliation(s)
- Konrad Malinowski
- International Evidence-Based Anatomy Working Group, Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Artromedical Konrad Malinowski, Bełchatów, Poland
| | - Dong Woon Kim
- International Evidence-Based Anatomy Working Group, Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Jan Zabrzyński
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus university in Toruń, Bydgoszcz, Poland
| | - Jerzy A Walocha
- International Evidence-Based Anatomy Working Group, Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Przemysław A Pękala
- International Evidence-Based Anatomy Working Group, Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
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Plutecki D, Bonczar M, Wilk J, Necka S, Joniec M, Elsaftawy A, Matuszyk A, Walocha J, Koziej M, Ostrowski P. The Anatomy of the Thoracic Duct and Cisterna Chyli: A Meta-Analysis with Surgical Implications. J Clin Med 2024; 13:4285. [PMID: 39124550 PMCID: PMC11313251 DOI: 10.3390/jcm13154285] [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: 06/19/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 08/12/2024] Open
Abstract
Background: The thoracic duct (TD) and the cisterna chyli (CC) exhibit a high degree of variability in their topographical and morphometric properties. Materials and Methods: PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched to identify all studies that included information regarding the morphometric and topographical characteristics of the TD and CC. Results: The most frequent location of the TD termination was the left venous angle, with a pooled prevalence of 45.29% (95% CI: 25.51-65.81%). Moreover, the TD terminated most commonly as a single vessel (pooled prevalence = 78.41%; 95% CI: 70.91-85.09%). However, it divides into two or more terminating branches in approximately a quarter of the cases. The pooled prevalence of the CC was found to be 55.49% (95% CI: 26.79-82.53%). Conclusions: Our meta-analysis reveals significant variability in the anatomy of the TD and CC, particularly regarding TD termination patterns. Despite the predominance of single-vessel terminations, almost a quarter of cases exhibit branching, highlighting the complexity of the anatomy of the TD. These findings demonstrate the importance of detailed anatomical knowledge for surgeons to minimize the risk of accidental injury during head and neck, as well as thoracic surgeries. Our study provides essential insights that can enhance surgical safety and efficacy, ultimately improving patient outcomes.
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Affiliation(s)
- Dawid Plutecki
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Michał Bonczar
- Department of Anatomy, Jagiellonian University Medical College, 33-332 Kraków, Poland
- Youthoria—Youth Research Organization, 30-363 Kraków, Poland
| | - Jakub Wilk
- Department of Anatomy, Jagiellonian University Medical College, 33-332 Kraków, Poland
- Youthoria—Youth Research Organization, 30-363 Kraków, Poland
| | - Sandra Necka
- Department of Anatomy, Jagiellonian University Medical College, 33-332 Kraków, Poland
- Youthoria—Youth Research Organization, 30-363 Kraków, Poland
| | - Miłosz Joniec
- Department of Anatomy, Jagiellonian University Medical College, 33-332 Kraków, Poland
| | - Ahmed Elsaftawy
- Chiroplastica—Lower Silesian Centre of Hand and Aesthetic Surgery, 54-117 Wrocław, Poland
| | - Aleksandra Matuszyk
- Department of Anatomy, Jagiellonian University Medical College, 33-332 Kraków, Poland
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, 33-332 Kraków, Poland
- Youthoria—Youth Research Organization, 30-363 Kraków, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, 33-332 Kraków, Poland
- Youthoria—Youth Research Organization, 30-363 Kraków, Poland
| | - Patryk Ostrowski
- Department of Anatomy, Jagiellonian University Medical College, 33-332 Kraków, Poland
- Youthoria—Youth Research Organization, 30-363 Kraków, Poland
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Valenzuela-Fuenzalida JJ, Moyano-Valarezo L, Silva-Bravo V, Milos-Brandenberg D, Orellana-Donoso M, Nova-Baeza P, Suazo-Santibáñez A, Rodríguez-Luengo M, Oyanedel-Amaro G, Sanchis-Gimeno J, Gutiérrez Espinoza H. Association between the Anatomical Location of Glioblastoma and Its Evaluation with Clinical Considerations: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:3460. [PMID: 38929990 PMCID: PMC11204640 DOI: 10.3390/jcm13123460] [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: 05/07/2024] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Glioblastoma is a primary malignant brain tumor; it is aggressive with a high degree of malignancy and unfavorable prognosis and is the most common type of malignant brain tumor. Glioblastomas can be located in the brain, cerebellum, brainstem, and spinal cord, originating from glial cells, particularly astrocytes. Methods: The databases MEDLINE, Scopus, Web of Science, Google Scholar, and CINAHL were researched up to January 2024. Two authors independently performed the search, study selection, and data extraction. Methodological quality was evaluated with an assurance tool for anatomical studies (AQUA). The statistical mean, standard deviation, and difference of means calculated with the Student's t-test for presence between hemispheres and presence in the frontal and temporal lobes were analyzed. Results: A total of 123 studies met the established selection criteria, with a total of 6224 patients. In relation to the mean, GBM between hemispheres had a mean of 33.36 (SD 58.00) in the right hemisphere and a mean of 34.70 (SD 65.07) in the left hemisphere, due to the difference in averages between hemispheres. There were no statistically significant differences, p = 0.35. For the comparison between the presence of GBM in the frontal lobe and the temporal lobe, there was a mean in the frontal lobe of 23.23 (SD 40.03), while in the temporal lobe, the mean was 22.05 (SD 43.50), and for the difference in means between the frontal lobe and the temporal lobe, there was no statistically significant difference for the presence of GBM, p = 0.178. Conclusions: We believe that before a treatment, it will always be correct to know where the GBM is located and how it behaves clinically, in order to generate correct conservative or surgical treatment guidelines for each patient. We believe that more detailed studies are also needed to show why GBM is associated more with some regions than others, despite the brain structure being homologous to other regions in which GMB occurs less frequently, which is why knowing its predominant presence in brain regions is very important.
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Affiliation(s)
- Juan Jose Valenzuela-Fuenzalida
- Departamento de Ciencias Química y Biológicas, Facultad de Ciencias de la Salud, Universidad Bernardo O’Higgins, Santiago 8320000, Chile;
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
| | - Laura Moyano-Valarezo
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
| | - Vicente Silva-Bravo
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
| | - Daniel Milos-Brandenberg
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
- Escuela de Medicina, Facultad Ciencias de la Salud, Universidad del Alba, Santiago 8320000, Chile
| | - Mathias Orellana-Donoso
- Escuela de Medicina, Universidad Finis Terrae, Santiago 7501015, Chile;
- Department of Morphological Sciences, Faculty of Medicine and Science, Universidad San Sebastián, Santiago 8420524, Chile
| | - Pablo Nova-Baeza
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
| | | | - Macarena Rodríguez-Luengo
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8370146, Chile; (L.M.-V.); (V.S.-B.); (D.M.-B.); (P.N.-B.); (M.R.-L.)
| | - Gustavo Oyanedel-Amaro
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago 8910060, Chile;
| | - Juan Sanchis-Gimeno
- GIAVAL Research Group, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Valencia, 46001 Valencia, Spain;
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Pavlov R, Belbl M, Křeček J, Palouš D, Adla T, Kachlík D, Whitley A. A morphological study of the inferior phrenic arteries on multidetector computed tomography and angiography. Ann Anat 2024; 254:152258. [PMID: 38490465 DOI: 10.1016/j.aanat.2024.152258] [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: 12/22/2023] [Revised: 02/19/2024] [Accepted: 03/11/2024] [Indexed: 03/17/2024]
Abstract
INTRODUCTION The inferior phrenic artery is a paired artery with a variable origin and course, primarily supplying the diaphragm, but also the suprarenal glands, inferior vena cava, stomach, and oesophagus. The aim of this study is to investigate the origin and course of the inferior phrenic arteries on multidetector computed tomography and angiography. MATERIALS AND METHODS The anatomy of the inferior phrenic artery was analysed on 2449 multidetector computed tomography scans. Three-dimensional reconstructions were made of the main variations. Additionally, the course and branching pattern of the inferior phrenic artery were descriptively analysed in a cohort of 28 angiograms. RESULTS In 565 (23.1%) cases the inferior phrenic arteries arose as a common trunk and in 1884 (76.9%) cases as individual vessels. The most common origins of a common trunk were the coeliac trunk (n=303; 53.6%) and abdominal aorta (n=255; 45.1%). The most common origins of the right inferior phrenic artery were the coeliac trunk (n=965; 51.2%), abdominal aorta (n=562; 29.8%) and renal arteries (n=214; 11.4%). The most common origins of the left inferior phrenic artery were the coeliac trunk (n=1293; 68.6%) and abdominal aorta (n=403; 21.4%). CONCLUSION The inferior phrenic artery has a very variable anatomy. The most common origins of the inferior phrenic artery are the coeliac trunk and its branches, the abdominal aorta, and the renal arteries.
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Affiliation(s)
- Roman Pavlov
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic
| | - Miroslav Belbl
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic
| | - Jan Křeček
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Cardiocenter, Third Faculty of Medicine, Charles University, Ruská 87, Praha 10 100 00, Czech Republic
| | - Daniel Palouš
- Department of Radiodiagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958, Praha 4 140 21, Czech Republic
| | - Theodor Adla
- Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Department of Radiodiagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958, Praha 4 140 21, Czech Republic
| | - David Kachlík
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic.
| | - Adam Whitley
- Department of Anatomy, Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, V Úvalu 84, Praha 5 150 06, Czech Republic; Department of General Surgery, Third Faculty of Medicine, Charles University and University Hospital Královské Vinohrady, Šrobárova 50, Praha 10 100 00, Czech Republic
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Mathieu T, Van Glabbeek F, Denteneer L, Van Winckel L, Schacht E, De Vlam B, Van Nassauw L. New Anatomical Concepts regarding Pubic-Related Groin Pain: A Dissection Study. Ann Anat 2024; 254:152238. [PMID: 38408529 DOI: 10.1016/j.aanat.2024.152238] [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: 04/13/2023] [Revised: 02/18/2024] [Accepted: 02/20/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVE Pubis-related groin pain remains a difficult topic in orthopedic and sports medicine. A better understanding of the anatomy of the adductors and the pubic ligaments is necessary. The aim of this study is to map all the musculotendinous attachments to the pubic ligaments and to investigate in detail all the possible inter-adductor fusions. METHODS The pubic symphyses were dissected in eight male and fourteen female embalmed cadavers (mean age 85 years), focusing on the fusion between the adductors, pubic ligaments, and musculotendinous attachments at the pubic ligaments. The 95% confidence intervals for the prevalence of the different conjoint tendons and tendon attachment to ligament were calculated. RESULTS The presence of three types of conjoint tendons was found: adductor brevis and gracilis (AB/G) 90.9 [72.2 - 97.5]%; adductor brevis and adductor longus (AB/AL) 50.0 [30.7 - 69.3]%; adductor longus and gracilis (AL/G) 50.0 [30.7 - 69.3]%. The AL, AB and G were in every cadaver attached to the anterior pubic ligament (APL). 64% of the AB and 100% of the G were attached to the inferior pubic ligament (IPL). CONCLUSION The proximal anatomy of the adductors is more complex than initially described. This study identified three possible conjoint tendons between the proximal adductors. The AB/G conjoint tendon was significantly more present than the AB/AL or AL/G conjoint tendon. The IPL has attachments only from the AB and G. Rectus Abdominis (RA) and AL were not attached to IPL. Mapping the musculotendinous attachments on the pubic ligaments creates more clarity on the pathophysiology of lesions in this area.
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Affiliation(s)
- Thomas Mathieu
- Department of ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Physical and Rehabilitative Medicine, Antwerp University Hospital, Edegem, Belgium.
| | - Francis Van Glabbeek
- Department of ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Orthopaedic Surgery and Traumatology, Antwerp University Hospital, Edegem, Belgium
| | - Lenie Denteneer
- Department of Rehabilitation Sciences & Physiotherapy, Research group MOVANT, University of Antwerp, Antwerp, Belgium; Education department, Horacio Oduber Hospital, Oranjestad, Aruba
| | - Levi Van Winckel
- Department of ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Emile Schacht
- Department of ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Benjamin De Vlam
- Department of ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Luc Van Nassauw
- Department of ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Bernardi S, Bianchi S, Gerardi D, Petrelli P, Rinaldi F, Piattelli M, Macchiarelli G, Varvara G. Anatomy of Maxillary Sinus: Focus on Vascularization and Underwood Septa via 3D Imaging. Tomography 2024; 10:444-458. [PMID: 38668392 PMCID: PMC11054790 DOI: 10.3390/tomography10040034] [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: 02/10/2024] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/29/2024] Open
Abstract
The study of the maxillary sinus anatomy should consider the presence of two features of clinical importance. The arterial supply course and the presence of the so-called Underwood septa are two important factors to consider when planning surgical treatment to reduce the risk of surgical complications such as excessive bleeding and Schneiderian membrane perforations. This study aimed to investigate the above-mentioned anatomical structures to improve the management of eventual vascular and surgical complications in this area. This study included a total of 200 cone-beam computed topographies (CBCTs) divided into two groups of 100 CBCTs to evaluate the arterial supply (AAa) course through the lateral sinus wall and Underwood's septa, respectively. The main parameters considered on 3D imaging were the presence of the AAa in the antral wall, the length of the arterial pathway, the height of the maxillary bone crest, the branch sizes of the artery in the first group, and the position of the septa, the length of the septa, and their gender associations in the second group. The CBCT analysis showed the presence of the arterial supply through the bone wall in 100% of the examined patients, with an average size of 1.07 mm. With regard to the septa, 19% of patients presented variations, and no gender difference was found to be statistically significant. The findings add to the current understanding of the clinical structure of the maxillary sinus, equipping medical professionals with vital details for surgical preparation and prevention of possible complications.
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Affiliation(s)
- Sara Bernardi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.B.); (D.G.); (G.M.)
| | - Serena Bianchi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.B.); (D.G.); (G.M.)
| | - Davide Gerardi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.B.); (D.G.); (G.M.)
| | - Pierpaolo Petrelli
- Department of Innovative Technologies in Medicine & Dentistry, Dental School, ‘G. D’Annunzio’ University of Chieti-Pescara, 66100 Chieti, Italy; (P.P.); (F.R.); (M.P.); (G.V.)
| | - Fabiola Rinaldi
- Department of Innovative Technologies in Medicine & Dentistry, Dental School, ‘G. D’Annunzio’ University of Chieti-Pescara, 66100 Chieti, Italy; (P.P.); (F.R.); (M.P.); (G.V.)
| | - Maurizio Piattelli
- Department of Innovative Technologies in Medicine & Dentistry, Dental School, ‘G. D’Annunzio’ University of Chieti-Pescara, 66100 Chieti, Italy; (P.P.); (F.R.); (M.P.); (G.V.)
| | - Guido Macchiarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.B.); (D.G.); (G.M.)
| | - Giuseppe Varvara
- Department of Innovative Technologies in Medicine & Dentistry, Dental School, ‘G. D’Annunzio’ University of Chieti-Pescara, 66100 Chieti, Italy; (P.P.); (F.R.); (M.P.); (G.V.)
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Smulders PS, Ten Hoope W, Baumann HM, Hermanides J, Hemke R, Beenen LFM, Oostra RJ, Marhofer P, Lirk P, Hollmann MW. Adductor canal block techniques do not lead to involvement of sciatic nerve branches: a radiological cadaveric study. Reg Anesth Pain Med 2024; 49:174-178. [PMID: 37399253 DOI: 10.1136/rapm-2022-104227] [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: 11/23/2022] [Accepted: 06/14/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION Low and high volume mid-thigh (ie, distal femoral triangle) and distal adductor canal block approaches are frequently applied for knee surgical procedures. Although these techniques aim to contain the injectate within the adductor canal, spillage into the popliteal fossa has been reported. While in theory this could improve analgesia, it might also result in motor blockade due to coverage of motor branches of the sciatic nerve. This radiological cadaveric study, therefore, investigated the incidence of coverage of sciatic nerve divisions after various adductor canal block techniques. METHODS Eighteen fresh, unfrozen and unembalmed human cadavers were randomized to receive ultrasound-guided distal femoral triangle or distal adductor canal injections, with 2 mL or 30 mL injectate volume, on both sides (36 blocks in total). The injectate was a 1:10 dilution of contrast medium in local anesthetic. Injectate spread was assessed using whole-body CT with reconstructions in axial, sagittal and coronal planes. RESULTS No coverage of the sciatic nerve or its main divisions was found. The contrast mixture spread to the popliteal fossa in three of 36 nerve blocks. Contrast reached the saphenous nerve after all injections, whereas the femoral nerve was always spared. CONCLUSIONS Adductor canal block techniques are unlikely, even when using larger volumes, to block the sciatic nerve, or its main branches. Furthermore, injectate reached the popliteal fossa in a small minority of cases, yet if a clinical analgesic effect is achieved by this mechanism is still unknown.
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Affiliation(s)
- Pascal Sh Smulders
- Department of Anesthesiology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Werner Ten Hoope
- Department of Anesthesiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Holger M Baumann
- Department of Anesthesiology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Jeroen Hermanides
- Department of Anesthesiology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Robert Hemke
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Ludo F M Beenen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Roelof-Jan Oostra
- Department of Medical Biology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Peter Marhofer
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Philipp Lirk
- Department of Anesthesiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Markus W Hollmann
- Department of Anesthesiology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
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Chaiyamoon A, Schneider K, Iwanaga J, Donofrio CA, Badaloni F, Fioravanti A, Tubbs RS. Anatomical study of the mastoid foramina and mastoid emissary veins: classification and application to localizing the sigmoid sinus. Neurosurg Rev 2023; 47:16. [PMID: 38110768 DOI: 10.1007/s10143-023-02229-4] [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: 08/24/2023] [Revised: 11/06/2023] [Accepted: 11/24/2023] [Indexed: 12/20/2023]
Abstract
The mastoid foramen (MF) is located on the mastoid process of the temporal bone, adjacent to the occipitomastoid suture or the parietomastoid suture, and contains the mastoid emissary vein (MEV). In retrosigmoid craniotomy, the MEV has been used to localize the position of the sigmoid sinus and, thus, the placement of the initial burr hole. Therefore, this study aimed to examine the exact location and variants of the MF and MEV to determine if their use in localizing the sigmoid sinus is reasonable. The sample in this study comprised 22 adult dried skulls (44 sides). MF were identified and classified into five types based on location, prevalence, whether they communicated with the sigmoid sinus and exact entrance into the groove of the sigmoid sinus. The diameters and relative locations of the MF in the skull were measured and recorded. Finally, the skulls were drilled to investigate the course of the MEV. Additionally, ten latex-injected sides from human cadavers were also dissected to follow the MEV, especially in cases with more than one vein. We found that type I MFs (single foramen) were the most prevalent (50%). These MFs were mainly located on the occipitomastoid suture; only one case on the right side was adjacent to the parietomastoid suture. Type II (paired foramina) was the second most prevalent (22.73%), followed by type III (13.64%), type 0 (9.09%), and type IV (4.55%). The diameter of the external opening in a connecting MF (2.43 ± 0.79) was twice that of a non-connecting MF (1.14 ± 0.56). Interestingly, on one side, two MFs on the external surface shared a single internal opening; the MEV bifurcated. MFs followed three different courses: ascending, almost horizontal, and descending. Regardless of how many external openings there were for the MF, these all ended at a single opening in the groove for the sigmoid sinus. For cadaveric specimens with multiple MEVs, all terminated in the sigmoid sinus as a single vein, with the more medial veins terminating more medially into the sinus. Based on our study, the MF/MEV can guide the surgeon and help localize the deeper-lying sigmoid sinus. Knowledge of this anatomical relationship could be an adjunct to neuronavigational technologies.
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Affiliation(s)
- Arada Chaiyamoon
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St., Suite 1300, New Orleans, LA, 70112, USA
| | | | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St., Suite 1300, New Orleans, LA, 70112, USA.
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.
| | - Carmine Antonio Donofrio
- Neurosurgery Department, ASST Cremona, Viale Concordia 1, 26100, Cremona, Italy
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, Faculty of Medicine, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Filippo Badaloni
- Department of Neurosurgery, IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Antonio Fioravanti
- Neurosurgery Department, ASST Cremona, Viale Concordia 1, 26100, Cremona, Italy
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St., Suite 1300, New Orleans, LA, 70112, USA
- Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
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Omotoso BR, Harrichandparsad R, Lazarus L. Prevalence of anatomical variations at the suboccipital (V3) segment of the vertebral artery: a systematic review. Neuroradiology 2023; 65:1677-1684. [PMID: 37878031 PMCID: PMC10654174 DOI: 10.1007/s00234-023-03223-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/12/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND AND OBJECTIVE A recent meta-analysis on the incidence of iatrogenic injury to the VA has revealed that patients with variant anatomy are more prone to iatrogenic injury. Therefore, this review is designed to investigate the incidence of variations in the suboccipital component of the vertebral artery in different population groups according to the available literature. METHODS This systematic review was conducted according to PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The review is based on a comprehensive and extensive search of PubMed, Google Scholar, and ResearchGate. The following search terms were used: "vertebral artery" AND "suboccipital segment" AND "anomalies/anatomical variations of the V3 segment." Reference lists of all extracted articles were also extensively searched for references to any further relevant publications. RESULTS A total of 17 papers met the inclusion criteria. The 17 studies corresponded to a total of 10,820 patients. A persistent first intersegmental artery was registered in 1.8% (197 out of 10,820) of the patients. Extradural PICA origin was observed in 1.6% (175 out of 10,820) of the patients. Fenestration was detected in 0.7% (72 out of 10,820) of the patients. CONCLUSION The authors summarize the incidence of vascular variation at the suboccipital segment of the VA in different population groups across the Asian, European, American, and African continents. Awareness of the extent of possible anatomical variation will help interpret radiographs, which will enhance the identification of vascular pathologies and reduce the risk of iatrogenic injury.
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Affiliation(s)
- Bukola R Omotoso
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa.
| | - Rohen Harrichandparsad
- Department of Neurosurgery, School of Clinical Medicine, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Lelika Lazarus
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa
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Koehler P, Otero PE, Chiavaccini L, Romano M, Stern AW, Cavalcanti M, Portela DA. A non-inferiority study comparing the ultrasound-guided parasacral with a novel greater ischiatic notch plane approach in canine cadavers. Vet Anaesth Analg 2023; 50:439-445. [PMID: 37331905 DOI: 10.1016/j.vaa.2023.05.003] [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: 02/08/2023] [Revised: 05/05/2023] [Accepted: 05/13/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE To describe the gross and ultrasound anatomy of the parasacral region and an ultrasound-guided greater ischiatic notch (GIN) plane approach aimed at staining the lumbosacral trunk (LST) in canine cadavers. To evaluate if the ultrasound-guided GIN plane approach is non-inferior to the previously described ultrasound-guided parasacral approach at staining the LST. STUDY DESIGN Prospective, randomized, non-inferiority experimental anatomic study. ANIMALS A total of 17 (23.9 ± 5.2 kg) mesocephalic canine cadavers. METHODS Anatomic and echographic landmarks, and the feasibility of performing a GIN plane technique were evaluated using two canine cadavers. The remaining 15 cadavers had each hemipelvis randomly assigned to be administered either parasacral or GIN plane injection of 0.15 mL kg-1 dye solution. The parasacral region was dissected after injections to assess the staining of LST, cranial gluteal nerve, pararectal fossa and pelvic cavity. The stained LST were removed and processed for histological evaluation of intraneural injections. A one-sided z-test for non-inferiority (non-inferiority margin -14%) was used to statistically evaluate the success of the GIN plane versus the parasacral approach. Data were considered statistically significant when p < 0.05. RESULTS The GIN plane and parasacral approach stained the LST in 100% and 93.3% of the injections, respectively. The success rate difference between treatments was 6.7% [95% confidence interval, -0.6 to 19.0%; p < 0.001 for non-inferiority]. The GIN plane and parasacral injections stained the LST for 32.7 ± 16.8 mm and 43.1 ± 24.3 mm, respectively (p = 0.18). No evidence of intraneural injection was found. CONCLUSIONS AND CLINICAL RELEVANCE The ultrasound-guided GIN plane technique resulted in nerve staining that was non-inferior to the parasacral technique and may be considered an alternative to the parasacral approach to block the LST in dogs.
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Affiliation(s)
- Perry Koehler
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Pablo E Otero
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Marta Romano
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Adam W Stern
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Mariana Cavalcanti
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
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Ten Hoope W, Smulders PSH, Baumann HM, Hermanides J, Beenen LFM, Oostra RJ, Marhofer P, Lirk P, Hollmann MW. A radiological cadaveric study of obturator nerve involvement and cranial injectate spread after different approaches to the fascia iliaca compartment block. Sci Rep 2023; 13:12070. [PMID: 37495606 PMCID: PMC10372149 DOI: 10.1038/s41598-023-39041-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 07/19/2023] [Indexed: 07/28/2023] Open
Abstract
Whether the fascia iliaca compartment block (FICB) involves the obturator nerve (ON) remains controversial. Involvement may require that the injectate spreads deep in the cranial direction, and might thus depend on the site of injection. Therefore, the effect of suprainguinal needle insertion with five centimeters of hydrodissection-mediated needle advancement (S-FICB-H) on ON involvement and cranial injectate spread was studied in this radiological cadaveric study. Results were compared with suprainguinal FICB without additional hydrodissection-mediated needle advancement (S-FICB), infrainguinal FICB (I-FICB), and femoral nerve block (FNB). Seventeen human cadavers were randomized to receive ultrasound-guided nerve block with a 40 mL solution of local anesthetic and contrast medium, on both sides. Injectate spread was objectified using computed tomography. The femoral and lateral femoral cutaneous nerves were consistently covered when S-FICB-H, S-FICB or FNB was applied, while the ON was involved in only one of the 34 nerve blocks. I-FICB failed to provide the same consistency of nerve involvement as S-FICB-H, S-FICB or FNB. Injectate reached most cranial in specimens treated with S-FICB-H. Our results demonstrate that even the technique with the most extensive cranial spread (S-FICB-H) does not lead to ON involvement and as such, the ON seems unrelated to FICB. Separate ON block should be considered when clinically indicated.
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Affiliation(s)
- Werner Ten Hoope
- Department of Anesthesiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Anesthesiology, Rijnstate Hospital, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands
| | - Pascal S H Smulders
- Department of Anesthesiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Holger M Baumann
- Department of Anesthesiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Jeroen Hermanides
- Department of Anesthesiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Ludo F M Beenen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Roelof-Jan Oostra
- Department of Medical Biology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Peter Marhofer
- Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Philipp Lirk
- Department of Anesthesiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
| | - Markus W Hollmann
- Department of Anesthesiology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Sarı E, Nteli Chatzioglou G, Aydın ÇY, Sarı F, Tokat T, Gürses İA. Publication rates of congress abstracts is associated with abstract quality: Evaluation of Turkish National Medical Education Congresses and Symposia between 2010 and 2014 using MERSQI. BMC MEDICAL EDUCATION 2023; 23:394. [PMID: 37254136 DOI: 10.1186/s12909-023-04383-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 05/22/2023] [Indexed: 06/01/2023]
Abstract
There are many parameters that could be used to evaluate the quality of scientific meetings such as publication rates of meeting abstracts as full-text articles after the meeting or scoring with validated quality scales/tools that evaluate individual papers, project proposals, or submitted abstracts. This study aimed to determine the full-text publication rates for abstracts presented at Turkish National Medical Education Congresses and Symposia and to assess the quality of given abstracts. Abstracts presented at national medical education congresses and symposia between 2010 and 2014 in Türkiye were evaluated. Initially, the abstracts were evaluated if they were published as full-text articles in international and national peer-reviewed journals following the meeting. Secondly, the quality of presented abstracts was assessed with the Medical Education Research Study Quality Instrument (MERSQI) scale. Overall publication rate for the abstracts was 11.3%. The publication rate of oral and poster presentations were 26.6% and 8.1%, respectively. Oral presentations had a statistically higher publication rate than poster presentations (p = .000). The mean MERSQI score for abstracts was 7.73 ± 2.59. The oral presentations had higher MERSQI mean scores than poster presentations (8.28 ± 2.46 vs. 7.61 ± 2.6; p = .032). Similarly, published abstracts had a significantly higher score compared to unpublished abstracts (10.07 ± 2.74 vs. 7.43 ± 2.41; p = .000). Interestingly, there was no statistical difference between the mean MERSQI scores of the published oral and poster presentations (9.33 ± 2.45 vs. 10.61 ± 2.72; p = .101). This study showed that the main factor for a meeting abstract to be published as a full-text article is the scientific quality of the study. The quality of presentations at annual medical education meetings in Türkiye were low compared with international meetings which did not improve over five years. An institutional policy that would set quality standards for medical education research and increase the awareness of researchers on the topic might help improve the design, execution, and reporting of such studies in Türkiye. The MERSQI could be a valuable tool to monitor the quality of submitted abstracts and to increase the awareness of novice researchers on high quality research.
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Affiliation(s)
- Elif Sarı
- Department of Ear Nose Throat, School of Medicine, Istanbul Aydın University, Istanbul, Turkey
| | - Gkionoul Nteli Chatzioglou
- Department of Anatomy, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey.
- Department of Anatomy, Faculty of Medicine, Istanbul Health and Technology University, Istanbul, Turkey.
| | - Çiğdem Yılmaz Aydın
- Department of Public Health, Muğla Provincial Health Directorate, Muğla, Turkey
| | - Ferhat Sarı
- Department of Pediatric Intensive Care, School of Medicine, Istanbul Aydın University, Istanbul, Turkey
| | - Taşkın Tokat
- Sakarya University, Education and Research Hospital, Sakarya, Turkey
| | - İlke Ali Gürses
- Department of Anatomy, School of Medicine, Koç University, İstanbul, Turkey
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Prill R, Królikowska A, de Girolamo L, Becker R, Karlsson J. Checklists, risk of bias tools, and reporting guidelines for research in orthopedics, sports medicine, and rehabilitation. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07442-8. [PMID: 37145131 DOI: 10.1007/s00167-023-07442-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/24/2023] [Indexed: 05/06/2023]
Affiliation(s)
- Robert Prill
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H, Germany.
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H, Germany.
| | - Aleksandra Królikowska
- Ergonomics and Biomedical Monitoring Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Laura de Girolamo
- Orthopaedic Biotechnology Laboratory, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Roland Becker
- Center of Orthopaedics and Traumatology, University Hospital Brandenburg/Havel, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a.d.H, Germany
| | - Jon Karlsson
- Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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15
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Belbl M, Kachlik D, Benes M, Kunc V, Kunc V. Variations of the lumbrical muscles of the hand: Systematic review and meta-analysis. Ann Anat 2023; 247:152065. [PMID: 36754240 DOI: 10.1016/j.aanat.2023.152065] [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: 04/17/2022] [Revised: 12/20/2022] [Accepted: 01/23/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE Lumbrical muscles of the upper limb belong to the middle group of intrinsic hand muscles. Their anatomical variability has been extensively studied with heterogeneous findings. Therefore, the aim of this study is to provide a systematic review and a meta-analysis of the lumbrical muscles variations in the human hand. METHODS For this purpose, four major electronic databases were searched to identify eligible studies. Then, all relevant data were extracted, and statistical analysis performed. A new classification of lumbrical muscles variations is proposed to summarize and clearly define all described findings. We included 26 studies, making a total sample of 1340 dissected hands. FINDINGS The most common variations for each muscle were an accessory belly for the first lumbrical muscle, a variable origin for the second lumbrical muscle, a variable innervation for the third lumbrical muscle and a variable insertion for the fourth lumbrical muscle with the prevalence 3.8%; 7.7%; 12% and 5.8%, respectively. CONCLUSIONS We believe that results of our statistical analysis are suitable for both hand surgeons and other medical professionals dealing with hand injuries or functional problems in their daily routine.
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Affiliation(s)
- Miroslav Belbl
- 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; Department of Health Care Studies, College of Polytechnics, Jihlava, Czech Republic
| | - Michal Benes
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vladimir Kunc
- Department of Computer Science, Czech Technical University, Prague, Czech Republic
| | - Vojtech Kunc
- Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Clinic of Trauma Surgery, Masaryk Hospital, Usti and Labem, Czech Republic.
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Portela DA, Cavalcanti M, Teixeira JG, Gandy KY, Zamora G, Stern AW, Jones R, Fuensalida SE, Chiavaccini L, Romano M, Otero PE. Lumbosacral plexus block using a combination of ultrasound-guided lateral pre-iliac and parasacral approaches in cats. Vet Anaesth Analg 2023; 50:188-196. [PMID: 36775670 DOI: 10.1016/j.vaa.2023.01.003] [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: 10/28/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To describe an ultrasound-guided lateral pre-iliac (LPI) and parasacral (PS) approach in feline cadavers (phase I) and compare the perioperative analgesic use and complications in cats administered LPI and PS blocks (group PNB) or epidural anesthesia (group EPI) for pelvic limb surgery (phase II). STUDY DESIGN Experimental uncontrolled, anatomic and retrospective cohort study. ANIMALS A group of eight feline cadavers and 52 medical records. METHODS Bilateral LPI and PS approaches with 0.1 mL kg-1 of dye to stain the femoral and obturator nerves and the lumbosacral trunk, respectively, were performed on each cadaver. Nerve staining effect was evaluated upon dissections (phase I). Perioperative analgesics use, and complication rates were retrospectively compared between groups PNB and EPI (phase II). Continuous data were compared using the Mann-Whitney U test and the prevalence of events with Fisher's exact test. Differences were considered significant when p < 0.05. RESULTS Dissections revealed that the LPI approach stained 94% and 75% of the femoral and obturator nerves, respectively. The PS approach stained 100% of the lumbosacral trunks. Cats enrolled in group PNB (n = 23) were administered lower doses of intraoperative opioids than those in group EPI (n = 25) (p = 0.006). Intraoperative rescue analgesia was required in 60% and 17.4% of cats enrolled in groups EPI and PNB, respectively (p = 0.003). Group PNB required more intraoperative anticholinergics than group EPI (p = 0.02). There were no differences in postoperative pain scores, analgesic use and complication rates. CONCLUSIONS AND CLINICAL RELEVANCE The ultrasound-guided LPI and PS approach stained the femoral/obturator nerves and the lumbosacral trunk, respectively, in feline cadavers. Furthermore, PNB was associated with lower intraoperative opioid use and similar postoperative pain and analgesic use compared with epidural anesthesia in a cohort of cats undergoing surgery of the pelvic limb.
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Affiliation(s)
- Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| | - Mariana Cavalcanti
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Jorge G Teixeira
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Keith Y Gandy
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Gustavo Zamora
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Adam W Stern
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Rachel Jones
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Santiago E Fuensalida
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Ludovica Chiavaccini
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Marta Romano
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Pablo E Otero
- Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
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Domański J, Domagala Z, Simmons JE, Wanat M. Terra Incognita in anatomical museology – A literature review from the perspective of evidence-based care. Ann Anat 2023; 245:152013. [DOI: 10.1016/j.aanat.2022.152013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/09/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
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18
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Hoey C, Wang A, Raymond RJ, Ulagenthian A, Okholm Kryger K. Foot morphological variations between different ethnicities and sex: a systematic review. FOOTWEAR SCIENCE 2022. [DOI: 10.1080/19424280.2022.2148294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Caoimhe Hoey
- Faculty of Orthopaedics, Bon Secours Hospital Galway, Galway, Ireland
| | - Albert Wang
- William Harvey Research Institute, Bart’s and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Ashwin Ulagenthian
- The Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Katrine Okholm Kryger
- The Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
- Faculty of Sport, Health and Applied Science, St Mary’s University, London, UK
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Arbogast KB, Caccese JB, Buckley TA, McIntosh AS, Henderson K, Stemper BD, Solomon G, Broglio SP, Funk JR, Crandall JR. Consensus Head Acceleration Measurement Practices (CHAMP): Origins, Methods, Transparency and Disclosure. Ann Biomed Eng 2022; 50:1317-1345. [PMID: 35920964 PMCID: PMC9652170 DOI: 10.1007/s10439-022-03025-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022]
Abstract
The use of head kinematic measurement devices has recently proliferated owing to technology advances that make such measurement more feasible. In parallel, demand to understand the biomechanics of head impacts and injury in sports and the military has increased as the burden of such loading on the brain has received focused attention. As a result, the field has matured to the point of needing methodological guidelines to improve the rigor and consistency of research and reduce the risk of scientific bias. To this end, a diverse group of scientists undertook a comprehensive effort to define current best practices in head kinematic measurement, culminating in a series of manuscripts outlining consensus methodologies and companion summary statements. Summary statements were discussed, revised, and voted upon at the Consensus Head Acceleration Measurement Practices (CHAMP) Conference in March 2022. This manuscript summarizes the motivation and methods of the consensus process and introduces recommended reporting checklists to be used to increase transparency and rigor of future experimental design and publication of work in this field. The checklists provide an accessible means for researchers to apply the best practices summarized in the companion manuscripts when reporting studies utilizing head kinematic measurement in sport and military settings.
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Affiliation(s)
- Kristy B Arbogast
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, 2716 South St., PA, 19146, Philadelphia, USA. .,Department of Pediatrics, University of Pennsylvania, PA, Philadelphia, USA.
| | - Jaclyn B Caccese
- The Ohio State University Chronic Brain Injury Program, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Thomas A Buckley
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, USA
| | - Andrew S McIntosh
- McIntosh Consultancy and Research, Sydney, NSW, Australia.,Monash University Accident Research Centre, Monash University, Melbourne, VIC, Australia.,School of Engineering, Edith Cowan University, Perth, WA, Australia
| | | | - Brian D Stemper
- Joint Department of Biomedical Engineering, Medical College of Wisconsin & Marquette University, Milwaukee, WI, USA.,Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.,Neuroscience Research, Zablocki Veterans Affairs Medical Center, Milwaukee, WI, USA
| | - Gary Solomon
- National Football League Player Health and Safety, New York, NY, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
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20
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Erector spinae plane block at the thoracolumbar spine: a canine cadaveric study. Vet Anaesth Analg 2022; 49:656-663. [DOI: 10.1016/j.vaa.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
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21
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Costa Almeida L, de Souza Figueiredo YJ, Pinheiro Zylberman A, Garção DC. Ascent of the conus medullaris in human foetuses: a systematic review and meta-analysis. Sci Rep 2022; 12:12659. [PMID: 35879383 PMCID: PMC9314333 DOI: 10.1038/s41598-022-15130-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 06/20/2022] [Indexed: 11/08/2022] Open
Abstract
The aim of the present systematic review and meta-analysis was to identify when the ascent of the conus medullaris occurs in human foetuses considering differences in evaluation methods and sample characteristics. Five databases were searched for relevant articles using different combinations of keywords. Article selection and data extraction were performed independently by two reviewers. Disagreements were resolved by a third reviewer. The variables were distributed into four groups according to the gestational age of the specimens: I (13-18 weeks); II (19-25 weeks); III (26-32 weeks); IV (33 weeks to the probable date of birth). Eighteen articles were included. The majority used imaging exams as the evaluation method. Cadaveric dissections were reported in the remaining articles. Only morphological studies were included in the meta-analysis. Significant ascent occurs between groups I and III as well as groups II and IV. Despite the considerable heterogeneity among the studies included in the present review, the findings enabled the determination that the conus medullaris reaches its normal birth level by the 26th week. Further analyses should be performed based on nationality and ethnicity to diminish the heterogeneity of the data.
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Affiliation(s)
- Lucas Costa Almeida
- Department of Morphology, Center for Biological and Health Sciences, Federal University of Sergipe, Av. Marechal Rondon, s/n - Jardim Rosa Elze, São Cristóvão, SE, 49100-000, Brazil
| | - Yasmin Juliany de Souza Figueiredo
- Department of Morphology, Center for Biological and Health Sciences, Federal University of Sergipe, Av. Marechal Rondon, s/n - Jardim Rosa Elze, São Cristóvão, SE, 49100-000, Brazil
| | - André Pinheiro Zylberman
- Department of Morphology, Center for Biological and Health Sciences, Federal University of Sergipe, Av. Marechal Rondon, s/n - Jardim Rosa Elze, São Cristóvão, SE, 49100-000, Brazil
| | - Diogo Costa Garção
- Department of Morphology, Center for Biological and Health Sciences, Federal University of Sergipe, Av. Marechal Rondon, s/n - Jardim Rosa Elze, São Cristóvão, SE, 49100-000, Brazil.
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22
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A systematic review: normative reference values of the median nerve cross-sectional area using ultrasonography in healthy individuals. Sci Rep 2022; 12:9217. [PMID: 35654926 PMCID: PMC9163181 DOI: 10.1038/s41598-022-13058-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/19/2022] [Indexed: 11/30/2022] Open
Abstract
Median nerve cross-sectional area (CSA) was used for screening and diagnosis of neuropathy, but few studies have suggested reference range. Hence, this systematic review was performed to evaluate a normative values of median nerve CSA at various landmarks of upper limb based on ultrasonography. PubMed and Web of science were used to search relevant articles from 2000 to 2020. Forty-one eligible articles (2504 nerves) were included to access median nerve CSA at different landmarks (mid-arm, elbow, mid-forearm, carpal tunnel (CT) inlet and CT outlet). Data was also stratified based on age, sex, ethnicity, geographical location, and method of measurement. Random effects model was used to calculate pooled weighted mean (95% confidence interval (CI), [upper bound, lower bound]) at mid-arm, elbow, mid-forearm, CT inlet and outlet which found to be 8.81 mm2, CI [8.10, 9.52]; 8.57 mm2 [8.00, 9.14]; 7.07 mm2 [6.41, 7.73]; 8.74 mm2 [8.45, 9.03] and 9.02 mm2 [8.08, 9.95] respectively. Median nerve CSA varies with age, geographical location, and sex at all landmarks. A low (I2 < 25%) to considerable heterogeneity (I2 > 75%) was observed, indicating the variation among the included studies. These findings show that median nerve CSA is varying not only along its course but also in other sub-variables.
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23
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Smith WL, Pękala PA, Iwanaga J, Loukas M, Dumont AS, Walocha J, Tubbs RS. The Forgotten Intermediate Condylar Canal: Anatomic Study with Application to Skull Base Surgery. World Neurosurg 2022; 161:e75-e79. [PMID: 35033691 DOI: 10.1016/j.wneu.2022.01.028] [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: 11/10/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The intermediate condylar canal, which lies lateral to the occipital condyles and medial to the jugular foramen, is rarely mentioned in textbooks, even those devoted to the skull base. Therefore the present anatomic study was performed to better elucidate these structures. METHODS We studied 100 adult skulls (200 sides) to better understand the prevalence and anatomy of the intermediate condylar canal. RESULTS An intermediate canal was found on 6 of 200 sides (3%). On average, these canals traveled 7.1 mm lateral to the occipital condyle and had a mean of 2.2 mm posteromedial to the jugular foramen. Anteriorly, these canals opened into the external surface of the hypoglossal canal and, when present, were just medial to a paracondylar process for which there was a strong positive correlation. The length of the canals ranged from 5 to 7.8 mm. In all, there were 3 partial canals and 3 complete canals. One left canal communicated anteriorly at the confluence of the inferior opening of a septated (bifurcated) hypoglossal canal and an unnamed foramen medial to the jugular foramen. These canals were distinct from posterior condylar canals when the latter was present. CONCLUSIONS Knowledge of the anatomic variants at the base of the skull may help minimize complications during surgical procedures that employ a paracondylar or transcondylar approach or approaches to the jugular foramen.
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Affiliation(s)
- William L Smith
- Tulane University, School of Medicine, New Orleans, Louisiana, USA
| | - Przemysław A Pękala
- The Brain and Spine Lab, Department of Anatomy, Jagiellonian University, Krakow, Poland
| | - Joe Iwanaga
- 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.
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Jerzy Walocha
- The Brain and Spine Lab, Department of Anatomy, Jagiellonian University, 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 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; Department of Anatomical Sciences, St. George's University, St. George's, Grenada; University of Queensland, Brisbane, Australia
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24
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Yu A, Dupont G, Pękala PA, Wysiadecki G, Iwanaga J, Dumont AS, Walocha JA, Tubbs RS. Duplication and Fenestration of the Inferior Petrosal Sinus: Cadaveric Study with Application to Imaging, Skull Base Surgery, and Neurointerventional Procedures. World Neurosurg 2022; 164:e59-e66. [PMID: 35342025 DOI: 10.1016/j.wneu.2022.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/05/2022] [Accepted: 03/07/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Reports of a duplicated or fenestrated inferior petrosal sinus (IPS) are scarce or not found in the literature, respectively. To our knowledge, there are no cadaveric reports of the latter. METHODS This study used 20 adult cadaveric heads (40 sides). After removal of the brain, the IPS was dissected using a surgical microscope. Specimens with duplication or fenestration of the IPS anywhere along its course were photographed and measured. RESULTS On 2 (5%) left sides, a fenestration was identified in the IPS. One of these was found to have 2 fenestrations. The mean length and width of the 3 fenestrations were 2.3 mm and 0.95 mm, respectively. The 3 fenestrations were located at the middle to terminal parts of the IPS. On 2 (5%) left sides and 1 (2.5%) right side, the IPS was duplicated over a part of its course. The mean length and width of the duplicated parts of the IPS were 25.9 mm and 3.1 mm, respectively. No statistical significance was found for fenestrations or duplications comparing males versus females, but fenestrations were statistically significant (P < 0.05) for occurring on left sides. CONCLUSIONS Unfamiliarity with a duplicated or fenestrated IPS could increase risk of iatrogenic injury and misinterpretation of imaging. Further radiological imaging studies are required to substantiate more accurately the mechanisms by which a duplicated or fenestrated IPS affects clinical outcomes. Nonetheless, anatomical awareness of such lesser known variations of the IPS is crucial for promoting safe and effective interventional approaches at the skull base.
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Affiliation(s)
- Aaron Yu
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Graham Dupont
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Przemysław A Pękala
- Brain and Spine Laboratory, Department of Anatomy, Jagiellonian University, Krakow, Poland
| | - Grzegorz Wysiadecki
- Department of Normal and Clinical Anatomy, Medical University of Lodz, Lodz, Poland
| | - Joe Iwanaga
- 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.
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Jerzy A Walocha
- Department of Anatomy, Jagiellonian University, 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 Structural and 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 Anatomical Sciences, St. George's University, Grenada, West Indies; Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA; University of Queensland, Brisbane, Queensland, Australia
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25
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Pearcy Q, Tomlinson J, Niestrawska JA, Möbius D, Zhang M, Zwirner J. Systematic review and meta-analysis of the biomechanical properties of the human dura mater applicable in computational human head models. Biomech Model Mechanobiol 2022; 21:755-770. [PMID: 35266061 PMCID: PMC9132839 DOI: 10.1007/s10237-022-01566-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 02/13/2022] [Indexed: 11/28/2022]
Abstract
Accurate biomechanical properties of the human dura mater are required for computational models and to fabricate artificial substitutes for transplantation and surgical training purposes. Here, a systematic literature review was performed to summarize the biomechanical properties of the human dura mater that are reported in the literature. Furthermore, anthropometric data, information regarding the mechanically tested samples, and specifications with respect to the used mechanical testing setup were extracted. A meta-analysis was performed to obtain the pooled mean estimate for the elastic modulus, ultimate tensile strength, and strain at maximum force. A total of 17 studies were deemed eligible, which focused on human cranial and spinal dura mater in 13 and 4 cases, respectively. Pooled mean estimates for the elastic modulus (n = 448), the ultimate tensile strength (n = 448), and the strain at maximum force (n = 431) of 68.1 MPa, 7.3 MPa and 14.4% were observed for native cranial dura mater. Gaps in the literature related to the extracted data were identified and future directions for mechanical characterizations of human dura mater were formulated. The main conclusion is that the most commonly used elastic modulus value of 31.5 MPa for the simulation of the human cranial dura mater in computational head models is likely an underestimation and an oversimplification given the morphological diversity of the tissue in different brain regions. Based on the here provided meta-analysis, a stiffer linear elastic modulus of 68 MPa was observed instead. However, further experimental data are essential to confirm its validity.
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Affiliation(s)
- Quinton Pearcy
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Joanna Tomlinson
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Justyna A Niestrawska
- Division of Macroscopic and Clinical Anatomy, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Dustin Möbius
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ming Zhang
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Johann Zwirner
- Department of Anatomy, University of Otago, Dunedin, New Zealand. .,Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. .,Institute of Legal Medicine, University of Leipzig, Leipzig, Germany.
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26
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Anatomical features of the iliocapsularis muscle: a dissection study. Surg Radiol Anat 2022; 44:599-608. [PMID: 35218407 PMCID: PMC8881757 DOI: 10.1007/s00276-022-02905-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/13/2022] [Indexed: 11/25/2022]
Abstract
Purpose Iliocapsularis (IC) overlies the anteromedial hip capsule and is an important landmark in anterior approaches to hip arthroplasty. Previously believed to be part of iliacus, few publications describe the prevalence, attachments, fibre direction, blood supply, innervation, and size of IC. This study was aimed to determine these anatomical features using embalmed bodies and whether they vary between sides, sex, and age. Methods Thirty-eight formalin-fixed adult bodies were dissected and the prevalence, presence of a connective tissue raphe, attachments, fibre direction, blood supply, and innervation, were documented. Length and width were measured, and significant differences were investigated with t tests. Results Iliocapsularis was present in all bodies examined, originating from the inferior border of the anterior inferior iliac spine, and inserting 20 mm distal to the lesser trochanter in 54 muscles (71%). Iliocapsularis was supplied by a thin branch from the femoral nerve and by branches of the lateral circumflex femoral and deep femoral arteries and veins. Muscle fibre direction was from superolateral to inferomedial. Mean length was 116.8 ± 11.2 mm and width was 12.8 ± 3.1 mm, with no significant differences between sides, sex, and age. Conclusion This was the first study to document the venous drainage and compare the dimensions with sides, sex, and age, using adult bodies. However, the true function of IC is still unknown. Iliocapsularis is a constant muscle, distinct from iliacus, which is relevant to orthopaedic surgeons and physical rehabilitation specialists, particularly for postoperative patient care. Supplementary Information The online version contains supplementary material available at 10.1007/s00276-022-02905-y.
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27
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Puladi B, Vogt F, Dinekov M, Köhler C. Variants of arterial supply to the inferior (diaphragmatic) surface of the ventricles of the heart and the influence on age at death. Clin Anat 2022; 35:404-411. [PMID: 35112400 DOI: 10.1002/ca.23846] [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: 11/30/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/08/2022]
Abstract
Coronary artery systems of the inferior wall of the ventricles vary considerably. Schlesinger's concept distinguishes dominance of the right or left coronary artery or balanced type. Left coronary artery dominance has been reported to be associated with increased mortality. Early angiography studies have shown that the anterior interventricular artery (AIVA), a branch of the left coronary artery, often continues on the inferior surface of the heart and may replace the inferior interventricular artery. Others considered an AIVA on the inferior surface of the heart a rare variant. A long AIVA is a strong predictor of death in acute anterior wall myocardial infarction. We determined coronary artery variance at the inferior surface of the ventricles in 134 dissected human hearts and analyzed a possible association between coronary artery variance and age at death. The AIVA extended to the inferior side in 64.9% of the hearts, but rarely reached the basal half of the inferior interventricular groove. Most frequently (53.03%), it extended into the apical two-fifths of the length of the inferior ventricular walls. An AIVA extending to the apical 40% of the length of the inferior ventricular walls may therefore be considered a common variant. In 20.1% of the hearts, a right inferior diagonal artery was also found. Statistical analysis neither revealed an association between mean AIVA length at the inferior ventricular surface and type of coronary artery dominance nor an association between AIVA length at the inferior ventricular surface or coronary artery dominance type and age at death.
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Affiliation(s)
- Behrus Puladi
- University of Cologne, Germany, Faculty of Medicine and University Hospital Cologne, Center Anatomy, Department II
| | - Felix Vogt
- Medical Clinic I, University Hospital RWTH Aachen, Aachen, Germany
| | - Maja Dinekov
- University of Cologne, Germany, Faculty of Medicine and University Hospital Cologne, Center Anatomy, Department II
| | - Christoph Köhler
- University of Cologne, Germany, Faculty of Medicine and University Hospital Cologne, Center Anatomy, Department II
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28
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Wahl L, Iwanaga J, Chabot AB, Dumont AS, Tubbs RS. Hypoplasia of the Tentorium Cerebelli: Case Report and Review of the Literature. Kurume Med J 2022; 67:49-52. [PMID: 35095020 DOI: 10.2739/kurumemedj.ms671009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The second largest intracranial specialization of the dura mater, the tentorium cerebelli, is a transverse fold that partially separates the cerebellum and cerebral hemispheres. During routine dissection of the posterior cranial fossa, a left-sided hypoplastic region of the tentorium cerebelli was observed. This fenestration was seen at the posterior portion of the tentorium as a posteromedial strip of tissue rising vertically to interface with the falx cerebri. Although isolated cases of tentorial hypoplasia have been reported in, for example, cases of Chiari II malformation, we believe isolated fenestration of this membrane is very rare, especially in the absence of the Chiari II malformation. The current case adds to the sparse literature on isolated tentorial defects and might be of interest to neurosurgeons or clinicians who review intracranial imaging.
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Affiliation(s)
- Lauren Wahl
- Department of Cell and Developmental Biology, University of Colorado
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine
| | - A Bert Chabot
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine.,Department of Structural & Cellular Biology, Tulane University School of Medicine.,Department of Anatomical Sciences, St. George's University.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System
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29
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D'Antoni AV, Tubbs RS, Patti AC, Higgins QM, Tiburzi H, Battaglia F. The Critical Appraisal Tool for Anatomical Meta-analysis (CATAM): A framework for critically appraising anatomical meta-analyses. Clin Anat 2022; 35:323-331. [PMID: 35015336 DOI: 10.1002/ca.23833] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/06/2022] [Indexed: 11/06/2022]
Abstract
The hallmark of evidence-based medicine is the meta-analysis (MA). For much of its rich history, the field of anatomy has been dominated by descriptive, cadaveric studies. In the last two decades, quantitative measurements and statistical analyses have frequently accompanied such studies. These studies have directly led to the publication of anatomical MAs, which have ushered in the exciting field of evidence-based anatomy. Although critical appraisal tools exist for clinical MAs, none of them are specifically tailored for anatomical MAs. Therefore, the purpose of this paper is to provide a framework by which clinical anatomists and others can critically appraise anatomical MAs using the Critical Appraisal Tool for Anatomical Meta-analysis (CATAM). Using a running example from a recently published MA, we show how to use the CATAM rubric in a step-by-step fashion. Each scored section of the CATAM rubric is summated into a total score (maximum 50 points). This score is then referenced to a conversion chart, which assigns a qualitative value to the MA in a range from "very good" to "poor." Future studies can investigate the interrater reliability of the instrument, and possibly subject the CATAM rubric to a Delphi panel. As anatomical MAs become more commonplace at surgical grand rounds and journal clubs in academic medical centers throughout the world, we hope that the CATAM rubric can help facilitate meaningful discussions about the quality and clinical relevance of anatomical MAs. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Anthony V D'Antoni
- Physician Assistant Program, Wagner College, Staten Island, New York, USA.,Division of Anatomy, Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - 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 and 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
| | | | | | | | - Fortunato Battaglia
- Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
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30
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Mathkour M, Werner C, Berry JF, Wysiadecki G, Walocha J, Iwanaga J, Dumont AS, Tubbs RS. Hakuba's triangle: a cadaveric study detailing its anatomy and neurovascular contents with vascular and skull base implications. Neurosurg Rev 2022; 45:2087-2093. [PMID: 34993690 DOI: 10.1007/s10143-021-01707-x] [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: 06/29/2021] [Revised: 10/20/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
Hakuba's triangle is a superior cavernous sinus triangle that allows for wide and relatively safe exposure of vascular and neoplastic lesions. This study provides cadaveric measurements of the borders of Hakuba's triangle and describes its neurovascular contents in order to enrich the available literature. The anatomical borders of the Hakuba's triangle (lateral, medial, and posterior borders) were defined based on Hakuba's description and identified. Then the triangle was dissected to reveal its morphology and relationship with adjacent neurovascular structures in Embalmed Caucasian cadaveric specimens. The oculomotor nerve occupied roughly one-third of the area of the triangle and the nerve was more or less parallel to its medial border. The mean lengths of the lateral border, posterior border, and medial border were 17 mm ± 0.5 mm, 12.2 mm ± 0.4 mm, and 10.6 mm ± 0.4 mm, respectively. The mean area of Hakuba's triangle was 63.9 mm2 ± 4.4 mm2. In this study, we provided cadaveric measurements of the borders of Hakuba's triangle along with descriptions of its neurovascular contents.
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Affiliation(s)
- Mansour Mathkour
- Tulane University & Ochsner Clinic Neurosurgery Program, Tulane University School of Medicine, New Orleans, LA, USA.,Neurosurgery Division, Surgery Department, Jazan University School of Medicine, Jazan, Kingdom of Saudi Arabia
| | - Cassidy Werner
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA
| | - John F Berry
- Tulane University & Ochsner Clinic Neurosurgery Program, Tulane University School of Medicine, New Orleans, LA, USA
| | - Grzegorz Wysiadecki
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA. .,Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA.
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA.,Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,University of Queensland, Brisbane, Australia
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31
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Ottone NE, Sandoval C, Cid-Gutierrez P, Vásquez-Balboa ML, Tubbs RS, Fuentes R. Systematic review and meta-analysis of the anatomy of the maxillary artery using the Anatomical Quality Assurance (AQUA) checklist. Surg Radiol Anat 2021; 43:1875-1886. [PMID: 34480213 DOI: 10.1007/s00276-021-02825-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/26/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The maxillary artery (MA) is one of the terminal branches of the external carotid artery (ECA) and through its branches, it is responsible for vascularizing several organs and muscles of the head and neck, including their surrounding soft tissues, the oral and sinonasal cavities, dura mater, and various cranial nerves. The aim of this study was to conduct a systematic review and meta-analysis of maxillary artery anatomy according to the Anatomical Quality Assurance (AQUA) checklist. METHODS We conducted a systematic search through PubMed, EMBASE, Scopus, ScienceDirect, Web of Science, SciELO, Springerlink, WILEY and BIREME databases. We applied the Anatomical Quality Assurance (AQUA) checklist for analysis the methodological quality of the articles. RESULTS From a total of 11,759 articles found in the first search, and after applying the inclusion/exclusion criteria, in addition to eliminating duplicate articles, a final number of 24 articles were identified. The information on the maxillary artery was analyzed from each study regarding its course in relation to the lateral pterygoid muscle, the intra- and extraluminal diameters of the maxillary artery and its branches, and the types of branching of the maxillary artery in the pterygopalatine fossa. CONCLUSION From this study, it was possible to conclude the importance of anatomical knowledge of the maxillary artery, for its application in the clinical study of the head and neck, as well as the need to apply the AQUA checklist in the development of systematic anatomical reviews to ensure accurate reliability and a better assessment of the effect of anatomical publications.
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Affiliation(s)
- Nicolás E Ottone
- Laboratory of Plastination and Anatomical Techniques, Centre for Research in Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile. .,Department of Integral Adults Odontology, Dental School, Universidad de La Frontera, Temuco, Chile. .,Center of Excellence in Morphological and Surgical Studies (CEMyQ), School of Medicine, Universidad de La Frontera, Temuco, Chile.
| | - Cristian Sandoval
- Escuela de Tecnología Médica, Facultad de Salud, Universidad Santo Tomás, Los Carreras 753, Osorno, Chile.,Departamento de Ciencias Preclínicas, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | | | | | - 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.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Ramón Fuentes
- Laboratory of Plastination and Anatomical Techniques, Centre for Research in Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile.,Department of Integral Adults Odontology, Dental School, Universidad de La Frontera, Temuco, Chile
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Ishak B, von Glinski A, Dupont G, Lachkar S, Yilmaz E, Iwanaga J, Unterberg A, Oskouian R, Tubbs RS, Chapman JR. Update on the Biomechanics of the Craniocervical Junction, Part II: Alar Ligament. Global Spine J 2021; 11:1064-1069. [PMID: 32691628 PMCID: PMC8351059 DOI: 10.1177/2192568220941452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
STUDY DESIGN In vitro biomechanical study. OBJECTIVE The strength of the alar ligament has been described inconsistently, possibly because of the nonphysiological biomechanical testing models, and the inability to test the ligament with both attachments simultaneously. The purpose of this biomechanical model was to reevaluate the alar ligament's tensile strength with both bony attachments, while also keeping the transverse ligament intact, all in a more physiological biomechanical model that mimics the mechanism of traumatic injury closely. METHODS Eleven fresh-frozen occipito-atlanto-axial (C0-C1-C2) specimens were harvested from individuals whose mean age at death was 77.4 years (range 46-97 years). Only the alar and transverse ligaments were preserved, and the bony C0-C1-C2 complex was left intact. Axial tension was exerted on the dens to displace it posteriorly, while the occipito-axial complex was fixed anteriorly. A device that applies controlled increasing force was used to test the tensile strength (M2-200, Mark-10 Corporation). RESULTS The mean force required for the alar ligament to fail was 394 ± 52 N (range 317-503 N). However, both the right and left alar ligaments ruptured simultaneously in 10 specimens. The ligament failed most often at the dens (n = 10), followed by occipital condyle rupture (n = 1). The transverse ligament remained intact in all specimens. CONCLUSIONS When both the right and left alar ligament were included, the total alar ligament failure occurred at an average force of 394 N. The alar ligament failed before the transverse ligament.
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Affiliation(s)
- Basem Ishak
- Seattle Science Foundation, Seattle, WA, USA,Swedish Neuroscience Institute, Seattle, WA, USA,Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany,Basem Ishak, Department of Neurosurgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
| | - Alexander von Glinski
- Seattle Science Foundation, Seattle, WA, USA,Swedish Neuroscience Institute, Seattle, WA, USA,BG University Hospital Bochum, Bochum, Germany
| | | | | | - Emre Yilmaz
- Seattle Science Foundation, Seattle, WA, USA,Swedish Neuroscience Institute, Seattle, WA, USA,BG University Hospital Bochum, Bochum, Germany
| | - Joe Iwanaga
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Andreas Unterberg
- Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Rod Oskouian
- Seattle Science Foundation, Seattle, WA, USA,Swedish Neuroscience Institute, Seattle, WA, USA
| | - R. Shane Tubbs
- Tulane University School of Medicine, New Orleans, LA, USA,St. George’s University, Grenada, West Indies
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Keet KA, Baatjes KJ, Venter RG, Wessels Q, Correia JC. Development of a Virtual Journal Club in Anatomy: a Responsive Pandemic Pedagogy. MEDICAL SCIENCE EDUCATOR 2021; 31:1411-1418. [PMID: 34094692 PMCID: PMC8169400 DOI: 10.1007/s40670-021-01325-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 05/30/2023]
Abstract
The COVID-19 pandemic forced changes to online teaching worldwide. The Clinical Anatomy journal club (JC) is key in the Bachelor of Science Honours (BScHons) programme and aims to improve scientific appraisal and communication abilities in anatomical research. An online JC through synchronous contact between members was deemed fitting as it could bridge the newly enforced geographical limitations due to the national lockdown in South Africa. Although common in clinical specialties, there are no published reports of anatomy themed online JCs. This project aimed to develop, implement, and appraise a synchronous virtual JC for Clinical Anatomy during the COVID-19 South African lockdown. A qualitative exploratory study design within an interpretive/constructivist paradigm was followed and aimed to explore students' perceptions of a virtual anatomy JC during the lockdown. The study was conducted at a South African institution, within the BScHons programme, and all enrolled students were invited to participate. Upon receipt of informed consent, an anonymous questionnaire was administered via Moodle for the BScHons students. The responses were analysed by thematic analysis, codes were developed, and themes were generated. Two main themes were generated from the results: the first related to the virtual format of the JC and the second focused on the content and topics covered during the JC sessions. The Clinical Anatomy staff and students adapted rapidly to the virtual JC and formed a community of practice. The benefits of teaching and learning within JC were maintained during the virtual format. It is envisioned that the JC will continue in a hybrid format (face-to-face and virtual) in future academic years. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-021-01325-8.
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Affiliation(s)
- Kerri A. Keet
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7550 South Africa
| | - Karin J. Baatjes
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7550 South Africa
- Division of Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7550 South Africa
| | - Rudolph G. Venter
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7550 South Africa
- Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7550 South Africa
| | - Quenton Wessels
- Department of Anatomy, School of Medicine, University of Namibia, Windhoek, Namibia 10026
| | - Janine C. Correia
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7550 South Africa
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Dupont G, Iwanaga J, Tubbs RS. Variant Innervation of the Medial Pterygoid Muscle from the Lingual Nerve. Kurume Med J 2021; 66:135-138. [PMID: 34135200 DOI: 10.2739/kurumemedj.ms662005] [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] [Indexed: 06/12/2023]
Abstract
During a routine dissection of the infratemporal fossa and lateral face, a branch of the left lingual nerve was observed entering the medial pterygoid muscle. Normally, the nerve to the medial pterygoid is a direct branch from the mandibular nerve, with no communications with the lingual nerve. There are many reports involving variations of the mandibular nerve; however, few reports describe lingual nerve variations involving the medial pterygoid muscle. Reconstructive surgeries for cosmesis and trauma, tumor excision, and impacted third molar removal may all damage the lingual nerve and might, as seen in the present case, affect the medial pterygoid muscle. Given the presumed rarity of this variation, we discuss the possible embryological origins as well as the surgical conflicts that may arise with this type of variation.
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Affiliation(s)
| | | | - R Shane Tubbs
- Seattle Science Foundation
- Department of Anatomical Sciences, St. George's University, University Centre
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Arráez-Aybar LA, García-Mata R, Murillo-González JA, de-la-Cuadra-Blanco C, Gómez-Martínez A, Bueno-López JL. Physicians' viewpoints on faculty anatomists and dissection of human bodies in the undergraduate medical studies. Ann Anat 2021; 238:151786. [PMID: 34153435 DOI: 10.1016/j.aanat.2021.151786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/17/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Studies abound regarding the views of faculty anatomists and medical students on the importance of anatomy and the dissection of human bodies, but very little is known about the views of practicing physicians. METHODS A survey was distributed among physicians and surgeons practicing in Spain in order to find out their views on the practice and consequences of human dissection by undergraduate students of medicine. The most relevant definition to qualify faculty anatomists of medical schools was also requested. Responses were repeatedly clustered into characteristic subgroups for analysis. RESULTS In total, 536 physicians and surgeons belonging to 36 different specialties in seven Spanish hospitals responded to the survey. The results highlighted two main facts. Firstly, faculty anatomists were perceived as teachers, above any other professional identity (namely: physician, biologist or scientist); nonetheless, the ascription of identities varied between specialties (p=0.009); and it also depended on whether the respondents had dissected in their undergraduate degree (p=0.03) and on the respondent's gender (p=0.03). Secondly, physicians and surgeons confirmed that dissecting human cadavers serves the undergraduate student not only for acquiring anatomical knowledge, but also essential skills and attitudes, including professionalism. CONCLUSIONS The results strongly suggest that dissection practice should be reinforced and enriched in undergraduate medical school. As this is important in itself, the results of the study could also help with the development of strategies to alleviate the current shortage of adequately trained anatomists for medical degrees.
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Affiliation(s)
- Luis-A Arráez-Aybar
- Department of Anatomy & Embryology, Faculty of Medicine, Complutense University of Madrid (CUM), Madrid, Spain.
| | | | - Jorge-A Murillo-González
- Department of Anatomy & Embryology, Faculty of Medicine, Complutense University of Madrid (CUM), Madrid, Spain
| | - Crótida de-la-Cuadra-Blanco
- Department of Anatomy & Embryology, Faculty of Medicine, Complutense University of Madrid (CUM), Madrid, Spain
| | - Ana Gómez-Martínez
- Department of Surgery, Thoracic Surgery Service, Hospital Clínico "San Carlos", Madrid, Spain
| | - José Luis Bueno-López
- Department of Neurosciences, School of Medicine and Nursing, The University of the Basque Country (UPV/EHU), Leioa (Biscay), Spain
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Faustino LD, Ferreira LM, Ramirez OM, Nahas FX. Components separation technique of the abdominal wall: Which muscle release produces the greatest reduction in tension on the mideline? J Plast Reconstr Aesthet Surg 2021; 74:3361-3370. [PMID: 34229956 DOI: 10.1016/j.bjps.2021.05.015] [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: 10/08/2020] [Revised: 03/24/2021] [Accepted: 05/24/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The components separation technique (CS) is used for the reconstruction of complex abdominal wall defects. Release and undermining of the rectus abdominis muscle (RAM) and external oblique muscle (EOM) decrease tension on the abdominal midline, reducing recurrence of ventral hernia, but causes major changes in the physiology of abdominal wall. The purpose of the study was to determine which muscle release and undermining produces the lowest tension on the midline. METHODS Twenty fresh cadavers were dissected and the anterior and posterior layers of the rectus sheath were isolated in the midline. The forces necessary to advance the layers of the rectus sheath to the mid abdomen were measured bilaterally at two points located 3 cm above and 2 cm below the umbilicus, and at 3 different stages: before any muscle release; after release and undermining of the right RAM and left EOM; and after release and undermining of the left RAM and right EOM. Comparisons of tensile forces were conducted separately for the different muscles involved, layers of the rectus sheath, measurement points, and stages of separation. RESULTS Tension on the abdominal midline after the release and undermining of both the RAM and EOM was reduced by 56% (p <0.05), 42% after the release and undermining of the EOM alone (p <0.05), and 35% after release and undermining of the RAM alone (p <0.05). CONCLUSION Release and undermining of the EOM by CS led to lower tension on the abdominal midline compared to that associated with the release of the RAM alone.
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Affiliation(s)
- Leandro Dario Faustino
- Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Lydia Masako Ferreira
- Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Oscar M Ramirez
- Division of Plastic Surgery, Cleveland Clinic, Fort Lauderdale, FL, United States
| | - Fábio Xerfan Nahas
- Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
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Els K, Warton C, Gunston G, Henry BM, Keet K. Structural variations in the sulco-gyral pattern of the orbitofrontal cortex. TRANSLATIONAL RESEARCH IN ANATOMY 2021. [DOI: 10.1016/j.tria.2021.100121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Anatomy of the sural nerve complex: Unaccounted anatomic variations and morphometric data. Ann Anat 2021; 238:151742. [PMID: 33932499 DOI: 10.1016/j.aanat.2021.151742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/19/2021] [Accepted: 04/05/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND The sural nerve (SN) is a cutaneous sensory nerve innervating the posterolateral leg. The SN is formed from a highly variable set of contributing nerves called the sural nerve complex (SNC). The SNC is made up of the lateral sural cutaneous nerve, medial sural cutaneous nerve, sural communicating branch, and SN. The SN is frequently cited as the most common donor nerve graft and is commonly injured in procedures of the lower extremity. Recent meta-analysis standardized six morphologies of the SNC and established a required reporting criterion for the group of nerves forming the SN. Due to the inconsistencies in previous literature, this study will group observed SNC's by one of these six SNC morphologies to assess and validate the meta-analysis grouping criteria. This study will also collect the same morphometric data previously outlined in order to grow the number of samples that are reported in a standardized fashion. METHODS 100 formalin and 4 Theil preserved cadavers (n = 208) lower limbs were bilaterally dissected at Kansas City University and Creighton University School of Dentistry to observe the SNC in its entirety on the posterolateral leg. Anatomic data was captured utilizing the standardized morphologies types 1-6 with two sub-typing. Nerves that were found to be outside of this categorization were placed in an unassigned grouping. RESULTS The most prevalent SNCs were type 1 at 41.35% (n = 86) and type 3 nerves at 34.62% (n = 72). Type 2 was found 8.65% (n = 18), type 4 and 5 were found each at 0.48% (n = 1). Type 6 was not observed. When comparing the present studies frequency of nerve types 1-6 to the meta-analysis a sub-grouping of "North American" cadaveric studies a X2 = .903 p = .030 was found. Two distinct and previously unassigned formations of the SNC were 10.58% (n = 20) and 3.85% (n = 8) of data. These two SNC are termed type 7 & 8, these represent two formations of SN that are outside of what was previously reported. 15.87% (n = 33) did not match visual descriptions based on nerve origin of a type 1 SNC but met written definitions. These were termed type 1A1 and type 1A2. The SNC was asymmetrical in 57.69% (n = 120). The pooled mean length of the SN was 32.97 ± 14.12 cm (31.05-34.88), mean diameter was 2.31 ± 0.83 mm (2.20-2.42, and the distance of the posterior border of the lateral malleolus to the SN was found to be 1.72 ± 0.70 cm (1.63-1.80). CONCLUSION Anatomic variation in the SNC is highly variable, yet is consistent with previously observed literature. This study demonstrates two unaccounted formations of the SNC as well as two additional subcategories of SNC that were not included in the previous meta-analysis. These four variants warrant inclusion as standard formations of the SNC due to the high prevalence observed in this study as well as historical consistency observed in previous literature and case reports. These two SNC formations increase the risk of iatrogenic injury during surgical interventions of the lower extremity. Morphometric data describing the spatial relationship of this nerve complex on the posterolateral leg is consistent with previously reported data and aids in generating a large data set for future studies to characterize spatial properties of this nerve complex.
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Critical structures in the needle path of the costoclavicular brachial plexus block: a cadaver study. Can J Anaesth 2021; 68:1156-1164. [PMID: 33880729 DOI: 10.1007/s12630-021-01990-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/09/2021] [Accepted: 03/14/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The costoclavicular block is a relatively novel alternative to the infraclavicular block. We aimed to determine the anatomical structures vulnerable to needle injury during a costoclavicular block. METHODS The needle path consistent with a costoclavicular block approach was performed bilaterally on four lightly embalmed cadavers using ultrasound guidance. Careful dissection was performed with 18-G Tuohy needles in situ and photographs were taken. RESULTS The needle penetrated the deltoid in six of eight cases and the pectoralis minor in three of eight cases. The subclavius tendon or its fascia were punctured in two of eight cases. The lateral cord was in contact with the needle in six procedures and punctured in three. The posterior cord was contacted in two instances, and the medial cord in one. In a single dissection, the needle was in contact with the medial antebrachial cutaneous nerve. The needle was close to the medial brachial cutaneous nerve in one case and close to the pectoral nerves in two of eight cases. While the cephalic vein and thoracoacromial artery were consistently nearby, there were no cases of vascular puncture. CONCLUSION We found that the needle path may be close to the medial antebrachial cutaneous nerve, medial brachial cutaneous nerve, and pectoral nerves but did not traverse any critical structures aside from the lateral cord. This suggests relative safety when compared with other approaches to the infraclavicular brachial plexus. Structures dans la trajectoire de l'aiguille du bloc de plexus brachial costoclaviculaire : une étude cadavérique.
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Ishak B, Dupont G, Lachkar S, Yilmaz E, Glinski AV, Altafulla J, Kikuta S, Iwanaga J, Chapman JR, Oskouian R, Tubbs RS. Update on the Biomechanics of the Craniocervical Junction-Part I: Transverse Atlantal Ligament in the Elderly. Global Spine J 2021; 11:180-186. [PMID: 32875854 PMCID: PMC7882814 DOI: 10.1177/2192568219896544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
STUDY DESIGN In vitro biomechanical study. OBJECTIVE The transverse ligament is the strongest ligament of the craniocervical junction and plays a critical role in atlanto-axial stability. The goal of this cadaveric study, and the subsequent study (part II), was to reevaluate the force required for the transverse ligament and alar ligament to fail in a more physiological biomechanical model in elderly specimens. METHODS Twelve C1-2 specimens were harvested from fresh-frozen Caucasian cadavers with a mean age at death of 81 years (range 68-89 years). Only the transverse ligament was preserved, and the bony C1-2 complex was left intact. The dens was pulled away from the anterior arch of C1 using a strength test machine that applies controlled increasing force. After testing, the axis was split in half to check for hidden pathologies and osteoporosis. The differences in the failure force between sex and age groups (group 1: <80 years, group 2: >80 years) were compared. RESULTS The mean force required for the transverse ligament to fail was 236.2 ± 66 N (range 132-326 N). All but 2 specimens had significant osteoporotic loss of trabecular bone. No significant differences between sex and age groups were found. CONCLUSIONS The transverse ligament's failure in elderly specimens occurred at an average force of 236 N, which was lower than that reported in the previous literature. The ligament's failure force in younger patients differs and may be similar to the findings published to date.
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Affiliation(s)
- Basem Ishak
- Seattle Science Foundation, Seattle, WA, USA,Swedish Neuroscience Institute, Seattle, WA, USA,Heidelberg University Hospital, Heidelberg, Germany,Basem Ishak, Swedish Neuroscience Institute, Seattle, WA 98122, USA.
| | | | | | - Emre Yilmaz
- Seattle Science Foundation, Seattle, WA, USA,Swedish Neuroscience Institute, Seattle, WA, USA
| | | | | | | | - Joe Iwanaga
- Seattle Science Foundation, Seattle, WA, USA
| | | | - Rod Oskouian
- Seattle Science Foundation, Seattle, WA, USA,Swedish Neuroscience Institute, Seattle, WA, USA
| | - R. Shane Tubbs
- Seattle Science Foundation, Seattle, WA, USA,St. George’s University, Grenada, West Indies
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Altafulla JJ, Prickett J, Iwanaga J, Dumont AS, Tubbs RS. Intraluminal anatomy of the transverse sinus: implications for endovascular therapy. Anat Cell Biol 2020; 53:393-397. [PMID: 32647072 PMCID: PMC7769094 DOI: 10.5115/acb.20.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/01/2020] [Accepted: 04/27/2020] [Indexed: 11/27/2022] Open
Abstract
Trabeculae or septations in the transverse sinus can have potentially life-threatening clinical significance. The current study demonstrates trabecula/septum patterning within the transverse sinus with measurements and distribution data supplemented by imaging, and describes the possible etiology of idiopathic intracranial hypertension and turbulent blood flow in the transverse sinus. Twenty-four sides from 12 cadaveric heads, all fresh-frozen, were used (five males, seven females; age at death 65–91 years, mean 79.1 years). The length and diameter of the transverse sinus were measured along with the number and locations of septations/trabeculae and their tensile strength. The mean length of the transverse sinus was 68.43 mm on the right side and 74.31 mm on the left. A total of 42 septations were found in the 24 transverse sinuses. The number of septations per side ranged from zero to four with a mean of 1.75. The septations were located in the proximal 1/3 in 54.8% (23/42), the middle 1/3 in 21.4% (9/42), and the distal 1/3 in 23.8% (10/42). The work presented here furthers our understanding of transverse sinus anatomy, including its detailed internal architecture. The measurements can provide a technical guide for neurosurgeons and influence instrument selection when a large thrombus forms or anchors in one of these trabeculae or septa and necessitates treatment.
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Affiliation(s)
- Juan J Altafulla
- Department of Neurosurgery, Hospital Santo Tomas, Panamá, Panama, USA
| | | | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
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Brzegowy K, Solewski B, Zarzecki MP, Musiał A, Kasprzycki T, Popiela T, Walocha JA. The Anatomy of the Convergence of Major Deep Cerebral Veins in the Pineal Region: A Computed Tomography Angiography Study. World Neurosurg 2020; 147:e334-e342. [PMID: 33346053 DOI: 10.1016/j.wneu.2020.12.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND The anatomy of the veins in the pineal region is one of the most complex areas in the brain because all major deep cerebral veins converge there: the internal cerebral veins (ICVs), the great cerebral vein of Galen (GV), the basal veins (BVs), and the internal occipital veins (IOVs). The aim of this study was to comprehensively describe the anatomy of the veins in the pineal region using computed tomography angiography. METHODS Head computed tomography angiography scans of 250 adult Polish patients were evaluated. We assessed the location of the junction of 2 ICVs and the presence of a narrowing of the GV and arachnoid granulation at the GV-straight sinus junction. We evaluated the presence, appearance, and termination of the BV, and the presence and termination of the IOV. RESULTS The study showed that 2 ICVs usually converged posterior to the splenium of the corpus callosum (62.4%). Narrowing of the BV was observed in 51.2% of patients, and the arachnoid granulation was found in 25.2%. The 3 segments of the BV were well visualized in 66% of the studied hemispheres. The BV flowed into the GV in 34.8% of the hemispheres. The IOV was present in 90.2% of the hemispheres and terminated medially in 84.5%. CONCLUSIONS Because an injury to major deep cerebral veins may result in severe postoperative neurologic deficits, it is essential for neurosurgeons to be familiar with both normal and variant patterns of veins in the pineal region.
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Affiliation(s)
- Karolina Brzegowy
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.
| | - Bernard Solewski
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Michał P Zarzecki
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Agata Musiał
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Kasprzycki
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Tadeusz Popiela
- Department of Radiology, Jagiellonian University Medical College, Krakow, Poland
| | - Jerzy A Walocha
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
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Bruce L, Gunston G, Myburgh A, Keet K, Augoustides JG, Pulton DA, Thalappillil R, Rong LQ, Garner C, Fernando RJ. The Anatomy of the Eustachian Valve-Navigating the Implications for Right-Sided Surgical and Transcatheter Cardiac Interventions. J Cardiothorac Vasc Anesth 2020; 35:1215-1224. [PMID: 33455884 DOI: 10.1053/j.jvca.2020.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Louren Bruce
- Division of Clinical Anatomy and Biological Anthropology, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Geney Gunston
- Division of Clinical Anatomy and Biological Anthropology, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Adriaan Myburgh
- Department of Anesthesia and Perioperative Medicine, Groote Schuur Hospital, Cape Town, South Africa
| | - Kerri Keet
- Division of Clinical Anatomy, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - John G Augoustides
- Cardiovascular and Thoracic Division, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
| | - Danielle A Pulton
- Cardiovascular and Thoracic Division, Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Lisa Q Rong
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY
| | - Chandrika Garner
- Cardiothoracic Section, Department of Anesthesiology, School of Medicine, Wake Forest University, Winston Salem, NC
| | - Rohesh J Fernando
- Cardiothoracic Section, Department of Anesthesiology, School of Medicine, Wake Forest University, Winston Salem, NC
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Brzegowy K, Kowalska N, Solewski B, Musiał A, Kasprzycki T, Herman-Sucharska I, Walocha JA. Prevalence and anatomical characteristics of developmental venous anomalies: an MRI study. Neuroradiology 2020; 63:1001-1008. [PMID: 33230619 DOI: 10.1007/s00234-020-02612-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/17/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Developmental venous anomalies (DVAs) are extreme anatomical venous variations formed by multiple radiating medullary veins, which converge centripetally into a single collecting vein. Their coexistence with symptomatic cavernous malformations (CMs) has been reported in the literature. The aim of this study was to assess the characteristics of DVAs using MRI. METHODS A total of 6948 head MRIs of adult Caucasian patients were retrospectively analyzed to determine the number and locations of DVAs. We collected the data on the termination of the collecting vein, the prevalence of DVA-related CMs, and MRI FLAIR signal-hyperintensity corresponding to the location of the DVA. RESULTS At least one DVA was identified in 7.46% of the patients. The prevalence decreased with age, with a Pearson correlation coefficient of - 0.7328. A total of 599 DVAs were identified. Multiple DVAs were found in 10.92% of the patients with DVAs. The DVAs were identified more often in the supratentorial region (73.12%, p < 0.0001), and the most common location was the frontal lobe (35.23%). The collecting vein usually drained into the superficial cerebral veins (68.78%). CMs were observed in 4.14% of the patients with DVAs, and the prevalence showed a positive correlation with age. Signal-intensity abnormalities were identified in the vicinity of 5.18% DVAs. CONCLUSION Knowledge about characteristics of DVAs and associated anomalies is essential for neuroradiologists and neurosurgeons. The large number of currently available diagnostic studies enables us to assess anatomical variants on a great number of subjects.
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Affiliation(s)
- Karolina Brzegowy
- Department of Anatomy, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
| | - Natalia Kowalska
- Department of Anatomy, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Bernard Solewski
- Department of Anatomy, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Agata Musiał
- Department of Anatomy, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Kasprzycki
- Department of Anatomy, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Izabela Herman-Sucharska
- Department of Radiology, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.,Voxel Diagnostic Medical Center, Krakow, Poland
| | - Jerzy A Walocha
- Department of Anatomy, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
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García Corredor N, Forero Porras PL, Ballesteros Acuña LE. Morphological evaluation of the distal medial striate artery. A study with cadaveric material. Colomb Med (Cali) 2020; 51:e204440. [PMID: 33402753 PMCID: PMC7744106 DOI: 10.25100/cm.v51i3.4440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/09/2020] [Accepted: 09/26/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the morphology of the distal medial striated artery, taking into account biometric variables useful for clinical and surgical management. METHODS A descriptive transversal study was performed with a sample of brains, who underwent autopsy at the Institute of Legal Medicine and Forensic Sciences of Bucaramanga-Colombia, which were evaluated using the perfusion technique of vascular structures with polyester resin. RESULTS The distal medial striated artery was presented in 1.4% and 4.2% duplicated in the right and left hemispheres respectively. Agenesis was presented in 2.8% in the left hemisphere. Its origin was 44.6% of the anterior cerebral artery junction site with the anterior communicating artery and was observed in 6 cases (4.2%) presented with a common trunk with the orbitofrontal artery. The main qualitative finding was the sinuous trajectory that was observed in 57.7% on the right side and 45.1% in the left hemisphere. Also, an important alteration found at the biometric analysis was hypoplasia that could be related to the decreased blood supply to the basal nuclei. The diameter was 0.5 ± 0.2 mm and its total length was 20.3 ± 4.1 mm. CONCLUSIONS The topographical knowledge of this structure determines the vulnerability of its morphology because it can complicate surgical procedures performed in the anterior segment of the arterial circle of the brain. Besides, the observed collateral circulation contributes to the blood supply and the perfect functionality of the subcortical nervous structures.
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Affiliation(s)
- Natalia García Corredor
- Universidad Industrial de Santander, Facultad de Salud, Maestría en Ciencias Básicas Biomédicas Bucaramanga, Colombia
| | - Pedro Luis Forero Porras
- Universidad Industrial de Santander, Facultad de Salud, Departamento de Patología, Bucaramanga, Colombia
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Iwanaga J, Singh V, Ohtsuka A, Hwang Y, Kim HJ, Moryś J, Ravi KS, Ribatti D, Trainor PA, Sañudo JR, Apaydin N, Şengül G, Albertine KH, Walocha JA, Loukas M, Duparc F, Paulsen F, Del Sol M, Adds P, Hegazy A, Tubbs RS. Acknowledging the use of human cadaveric tissues in research papers: Recommendations from anatomical journal editors. Clin Anat 2020; 34:2-4. [PMID: 32808702 DOI: 10.1002/ca.23671] [Citation(s) in RCA: 294] [Impact Index Per Article: 73.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 08/09/2020] [Indexed: 11/11/2022]
Abstract
Research within the anatomical sciences often relies on human cadaveric tissues. Without the good will of these donors who allow us to use their bodies to push forward our anatomical knowledge, most human anatomical research would come to a standstill. However, many research papers omit an acknowledgement to the donor cadavers or, as no current standardized versions exist, use language that is extremely varied. To remedy this problem, 20 editors-in-chiefs from 17 anatomical journals joined together to put together official recommendations that can be used by authors when acknowledging the donor cadavers used in their studies. The goal of these recommendations is to standardize the writing approach by which donors are acknowledged in anatomical studies that use human cadaveric tissues. Such sections in anatomical papers will not only rightfully thank those who made the donation but might also encourage, motivate, and inspire future individuals to make such gifts for the betterment of the anatomical sciences and patient care.
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Affiliation(s)
- Joe Iwanaga
- 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.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Vishram Singh
- Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, India
| | - Aiji Ohtsuka
- Department of Human Morphology, Okayama University Medical School, Okayama, Japan
| | - Youngil Hwang
- Department of Anatomy and Cell Biology, Seoul National University College of Medicine, South Korea
| | - Hee-Jin Kim
- Division in Anatomy and Development Biology, Department of Oral Biology, Yonsei University College of Dentistry, Seoul, South Korea
| | - Janusz Moryś
- Department of Anatomy and Neurobiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Kumar Satish Ravi
- Department of Anatomy, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
| | - Domenico Ribatti
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, Bari, Italy
| | - Paul A Trainor
- Stowers Institute for Medical Research, Kansas City, Missouri, USA.,Department of Anatomy and Cell Biology, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - José Ramón Sañudo
- Departamento de Anatomía y Embriología Humanas, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Nihal Apaydin
- Department of Anatomy, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gülgün Şengül
- Department of Anatomy, Ege University Faculty School of Medicine, Bornova, Izmir, Turkey
| | - Kurt H Albertine
- Departments of Pediatrics, Medicine, and Neurobiology and Anatomy, University of Utah, School of Medicine, Salt Lake City, Utah, USA
| | - Jerzy A Walocha
- Department of Anatomy, Jagiellonian University, Medical College, Kraków, Poland
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies.,Department of Anatomy, Medical School Varmia and Mazuria, Olsztyn, Poland
| | - Fabrice Duparc
- Laboratory of Anatomy, Faculty of Medicine, Rouen-Normandy University, Rouen, France
| | - Friedrich Paulsen
- Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Department of Operative Surgery and Topographic Anatomy, Sechenov University, Moscow, Russia
| | - Mariano Del Sol
- Center of Excellence in Morphological and Surgical Studies, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Philip Adds
- Department of Anatomy, St George's, University of London, London, UK
| | - Ahmed Hegazy
- Anatomy and Embryology, Faculty of Medicine, Benha University, Egypt, Anatomy Department, Faculty of Medicine, Northern Border University (NBU), Saudi Arabia
| | - 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 Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA
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Crampon F, Prum G, Trost O, Grignon B, Duparc F. Does the quality of the presentation influence the outcome of a submitted manuscript? A plea for including "How to submit" in medical education. Surg Radiol Anat 2020; 43:579-583. [PMID: 32845395 DOI: 10.1007/s00276-020-02561-0] [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: 08/07/2020] [Accepted: 08/19/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Our goal was to study the influence of the author's compliance with the Instructions for Authors for a submitted manuscript to a journal, on the final outcome of the submission. MATERIAL AND METHODS 1200 consecutive submissions to the journal Surgical and Radiologic Anatomy have been evaluated and divided into four groups: A: Accepted, R: Rejected, I + : Instructions for Authors followed, I - : Instructions for Authors not followed. The quantity of manuscripts in the groups was measured and compared through statistical tests. We tried to determine if a specific category of authors was more likely to incorrectly follow the Instructions for Authors by verifying the lists of authors and the tables of contributions of co-authors. 322 (26.83%) manuscripts were accepted, 248 were I + , 74 were I - ; 878 (73.16%) were rejected, 526 were I + ; 352 were I - . RESULTS The comparisons of the observed values and percentages showed significant differences between the groups. We could not identify a specific type of author associated with non-compliance with the Instructions for Authors. CONCLUSION Most of the guidelines that have been published concern the preparation of the scientific contents of the manuscript (How to write), but the submission process (How to submit) has rarely been explained. We suggest including the rules of submitting a manuscript in graduate and post-graduate medical education.
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Affiliation(s)
- Frédéric Crampon
- Laboratory of Anatomy, Faculty of Medicine-Pharmacy, Rouen-Normandie University, 22 Boulevard Gambetta, 76183, Rouen, France
| | - Grégoire Prum
- Laboratory of Anatomy, Faculty of Medicine-Pharmacy, Rouen-Normandie University, 22 Boulevard Gambetta, 76183, Rouen, France
| | - Olivier Trost
- Laboratory of Anatomy, Faculty of Medicine-Pharmacy, Rouen-Normandie University, 22 Boulevard Gambetta, 76183, Rouen, France
| | - Bruno Grignon
- Department of Anatomy, University of Lorraine, Avenue de la Forêt de Haye, 54505, Vandoeuvre-les-Nancy, France
| | - Fabrice Duparc
- Laboratory of Anatomy, Faculty of Medicine-Pharmacy, Rouen-Normandie University, 22 Boulevard Gambetta, 76183, Rouen, France.
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The sulcus of the caudate process (Rouviere's sulcus): anatomy and clinical applications-a review of current literature. Surg Radiol Anat 2020; 42:1441-1446. [PMID: 32681224 DOI: 10.1007/s00276-020-02529-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/04/2020] [Indexed: 02/03/2023]
Abstract
The sulcus of the caudate process is a horizontal groove on the inferior face of the liver. Its prevalence has not previously been determined. Because of its location, it represents a helpful extra-biliary landmark that could be used in biliary surgery to decrease bile duct injury. The goal of this study is to determine the prevalence of Rouviere's sulcus and describe its anatomy and relevant surgical applications. We conducted a literature review on the various characteristics of the sulcus, selecting anatomical clinical studies and dissections. We performed 10 cadaveric dissections in the Laboratory of Anatomy at Purpan University to determine the contents. We selected 12 anatomical studies, conducted between 1924 and January 1st, 2020, which included 2394 patients. The prevalence of the sulcus is 78.24% ± 9.1. Classification of Singh was used to describe anatomical characteristics. Type I ("deep sulcus") was identified in 50.4% ± 9.8 of cases, mostly consisting of Type Ia (open). Type II ("slit-like") was estimated to account for 13.3% ± 13.2, whereas Type III ("scar") described 12.3% ± 8.0. Average dimensions were estimated for length (26 mm ± 5.7), width (6.5 mm ± 1.5), and depth (7.9 mm ± 1.75). The content of the sulcus consists of the right portal vein and its division, the right hepatic artery, along with the right hepatic bile duct. The sulcus determines the orientation of the common bile duct. The sulcus of the caudate process is a reliable extra-biliary landmark, which presents a useful tool for reducing bile duct injuries during hepatobiliary surgery.
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The falciform ligament: Anatomical study with microsurgical implications. Clin Neurol Neurosurg 2020; 195:106049. [PMID: 32652394 DOI: 10.1016/j.clineuro.2020.106049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The current study aims to increase awareness of the falciform ligament and its anatomical and surgical relationships, for the benefit of the neurosurgeon. PATINENTS AND METHODS Twenty-four sides from twelve Caucasian cadaveric heads (all fresh-frozen) were used in this study. The length and thickness of the falciform ligament were recorded. The relationship of the falciform ligament to the optic nerve was also observed and documented. Finally, the force needed to avulse the falciform ligament was recorded. RESULTS In all specimens, the ligament was identified as a continuation of the outer dural layer, forming a roof at the entrance of the optic canal. The mean medial-to-lateral length, anteroposterior length, and thickness of the falciform ligament were 7.97 mm, 2.12 mm, and 0.26 mm, respectively. The mean distance from the medial attachment of the ligament to the midline was 5.54 mm. For the undersurface of the falciform ligament, the optic nerve occupied the middle third in 50.0 %, the lateral third in 44.4 %, and the medial third in 5.6 % of sides. The mean optic nerve diameter at the entrance of the optic canal was 4.20 mm. The mean failure force was 2.47 N. CONCLUSION The anatomical measurements and relationships provided in this description of the falciform ligament serve as a tool for surgery selection and planning, as well as an aid to improving microsurgical techniques, with the final goal being better patient outcomes.
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