Entrapment of the Subscapular Artery between the Radial Nerve and the Posterior Wall of the Axilla: An Anatomical Variation with Clinical Significance

OBJECTIVE

The subscapular artery vascularizes a substantial region of the thoracic wall, and the significance of its distribution is well depicted in the diversity of reconstructive procedures that rely on its blood supply. The aim of this study is to present an uncommon anatomical variation of the artery and discuss the clinical implications of its presence.

CASE REPORT

This case report depicts a rare variant of compression and the kinking of the subscapular artery by the radial nerve on the posterior wall of the axilla that was encountered during dissection of a male cadaver of Greek origin.

CONCLUSION

The use of autologous tissues in the reconstruction of defects and treatment of lymphedema is expanding, so the need to establish safer surgical dissections is also becoming more apparent. The case of entrapment of the subscapular artery by the radial nerve is extremely rare, however, utilizing tissues perfused by this artery for reconstructive purposes could potentially be futile and unsuccessful due to the inadequate blood supply or vessel thrombosis. Hence, the surgeon should adapt the treatment plan according to preoperative findings, as the presence of anatomical variants should always be suspected.

Remembering Karl Gustav Theodor Simon (1810-1857)

Karl Gustav Theodor Simon is considered as the founder of dermatopathology, because for the first time in modern times he beds the bases of the microscopical examination of the cutaneous diseases. He worked in Berlin as a private physician, general practitioner, especially for the poor patients, continuing his research in pathology and focusing on the cutaneous diseases, in which the use of the microscope had a central role. During his medical career, he achieved to be acknowledged as one of the most important figures in the treatment of cutaneous diseases and to be included among the best dermatologists and venerologists at the time worldwide.

An Ectopic External Jugular Vein Draining into the Axillary Vein: a Rare Anatomical Variation with Clinical Implications

OBJECTIVE

The external jugular vein drains a considerable part of the head and neck and constitutes a vessel implicated in various procedures in the cervical region. The aim of this study is to present an uncommon anatomical variation of the external jugular vein, and discuss the clinical implications of its presence.

CASE REPORT

We present a rare case of an ectopic external jugular vein terminating into the axillary vein, that we came across during routine dissection of a male cadaver of Greek origin.

CONCLUSION

The venous system of the external jugular vein is used during procedures for the treatment of various conditions such as cardiac arrhythmias, hydrocephalus and defects of the head and neck. Hence, encountering the unpredictable course of a variant draining into the axillary vein may complicate these interventions, leading to multiple manipulations and undesirable results. Surgeons should be aware of the alternate anatomy of the venous system of the cervical region, and mindful of the possibility of encountering them.

Warshaw Technique in Spleen-Preserving Pancreatectomy: A Case Series

We present three cases of spleen-preserving total pancreatectomy using the Warshaw technique for neoplasms of the pancreatic head. The first case involved a 5 cm mucinous pancreatic neoplasm invading the middle colic artery. The second case featured a patient with a BMI of 40 and adenocarcinoma of the pancreatic head. The third case involved a serous cystadenoma in the pancreatic head in a patient with a history of gastric surgery for a gastric ulcer, requiring surgical intervention due to weight loss and abdominal symptoms. These cases highlight the surgical nuances and benefits of the Warshaw technique, particularly its role in preserving splenic blood supply and reducing postoperative complications.

Quadrifurcation of the Facial Artery Near the Inferior Mandibular Border with a Bilateral Premasseteric Artery Component

During the dissection of the cervicofacial area in a donated male cadaver, an asymmetrical division of the facial artery (FA) and a premasseteric artery (PA) were identified. Specifically, on the left side, the FA stem is divided into four branches (quadrifurcation) 4.26 mm below the lower border of the mandible. In contrast, it is divided into two branches (bifurcation) on the right side. Whether symmetrical or asymmetrical, these variants can have significant implications for rhinoplastic, maxillofacial, or reconstructive surgery. This finding underscores the crucial role of surgeons in exercising caution and paying close attention during these procedures to avoid potential damage.

Nasal Septum Perforation Repair: Simplicity and low Morbidity Using the Temporalis Fascia and Silicone Films

Aim: We present a new, simple, and effective method for the closure of nasal septal perforations based on prolonged isolation of the surgical site. Nasal septal perforation usually results after rhinological surgical operations, primarily to correct septum deviation. When symptomatic, conservative and surgical treatments are required. Current techniques more often attempt direct mucosal closure by mobilizing local nasal mucosal flaps with or without interposed grafts. The reported success rates are sufficiently high approaching ≥ 90%. Method: Our current practice includes the insertion of a temporalis fascia graft between the septal mucosal flaps to cover the perforation, avoiding any effort to achieve mucosal closure. Instead of using sophisticated techniques and multiple synthetic grafts, we propose that the entire septum remains protected after perforation repair for 6 weeks between two thin silicone sheets which permit surgical site inspection and mucosal regrowth. We present our experience with 10 consecutive patients, two of whom had fairly large defects. Results: All cases, except one, had a successful outcome with complete closure of the defect after one year's follow up. No serious complications were reported and the silicone sheets were well tolerated by the patients. Conclusion: Our method is simple and consequently fast, resulting in high success rates, low morbidity, and high tolerance from the patients.

The Facial Artery as a Branch of the External Carotid Artery in Thomas Turner's (1793-1873) Treatise on the Arterial System (1825) and a Comparison with Modern Anatomy

The aim of the present paper is to contribute to the understanding of the history of the anatomical study of the facial artery. The facial artery plays a fundamental role in the study of the anatomy of the face, and in maxillofacial and vascular surgery. The debate on the understating of this vessel is essential in the educational process, with special focus on the historical development of topographical and descriptive ideas about it. The comparison between the study of facial artery in the work of Thomas Turner (1793-1873) and modern anatomical concepts serves as an excellent educational paradigm. The documentary research method was used this short historical survey. CONCLUSION: Thomas Turner laid the scientific foundation for the accurate anatomical study of the facial artery.