Folia morphologica最新文献

Variations in the origin and branching pattern of the superior laryngeal artery are critically crucial for both anatomical understanding and clinical practice, especially for procedures involving the larynx. The superior laryngeal artery typically originates from the superior thyroid artery, a branch of the external carotid artery. However, alternative origins of this artery-such as from the external carotid artery, the common carotid artery, or other branches-have been documented in rare cases. Herein, we present a rare configuration of the external carotid artery branches identified on the left side of the neck of a 76-year-old male cadaver. A shared linguofacial trunk originated from the external carotid artery and then divided into the facial and lingual arteries. Afterward, the lingual artery gave rise to the superior laryngeal artery, which initially coursed horizontally before curving downward toward the larynx. Understanding such anatomical variations is essential for safe and effective surgical intervention and accurate diagnostic imaging, as these patterns can significantly impact surgical approaches in laryngeal procedures, neck reconstructive surgeries, and targeted intra-arterial chemotherapy for cancers affecting the larynx and hypopharynx.

Background: Thyroid diverticulum originates between the first and second pharyngeal pouches, and descends via the thyroglossal duct to the level of CV to TI vertebra. By the 6th week of gestation the thyroglossal duct starts to obliterate. Failure in its obliteration causes differentiation of the distal part into the pyramidal lobe (PL), while the cranial portion may alter into a fibromuscular remnant - levator glandulae thyreoideae (LGT).

Materials and methods: Morphological characteristics of PL and LGT were prospectively observed in 86 cadavers (66 male and 20 female).

Results: PL was observed in 59.3%, occurring more frequently in male cadavers (60.61%) compared to female cadavers (55%). PL was more frequent on the left side (50.98%) than on the right side (39.22%). Junctional PL was determined in 58.82%, isthmic PL in 27.45%, and lobar PL in 13.73%. The average height, width, and area of PL reached 23.81 mm, 13.13 mm, and 320.16 mm², respectively. The most frequent height-to-width ratio of PL was 1.3 : 1. LGT was observed in 47.67% of cadavers. LGT prevailed in male cadavers (48.48%) over female cadavers (45%). LGT occurred commonly on the left side (53.66%) than on the right side (31.71 %). Macroscopic evaluation demonstrated prevalence of fibrous LGTs (65.85%). Hyopyramidal type of LGT was observed in 70.73% of cadavers.

Conclusions: Knowledge gained from this study is applicable in the surgical field to reduce the risk of intraoperative and postoperative complications in thyroid surgery.

Background: Bifid mandibular condyle (BMC) is an extremely rare condition characterized by dublicity of the head of the mandibular condyle. Knowledge about the morphology of BMC may help to understand the development course of condyle and differential diagnosis of fractures or tumors in condylar area. The aim of this study was to examine temporomandibular joint (TMJ) hard tissue morphology of BMCs.

Materials and methods: 1900 cone beam computed tomography (CBCT) scans of the mandibular condylar heads examined for the presence of bifidity. When BMC were identified, morphological assessment and measurements of bone components of TMJ were done.

Results: 69 BMC were detected in 56 patients (3%). It was observed that 43 (76.8%) patients presented unilateral and 13 (23.2%) patients presented bilateral BMCs. 59.4% of condyles were mostly seen in mediolateral (ML) orientation and 40.6% of them were both ML and anteroposterior (AP) orientation. 46.4% of cases showed wide and shallow groove; 53.6% had deep and narrow groove on coronal images. 60 BMCs had osteoarthritic changes.

Conclusions: CBCT is an excellent imaging modality for accurate imaging of the bony components of TMJ. Due to the widespread use of CBCT, the prevalence of BMC is likely to be higher than has been previously reported and reported new cases in literature could be useful for dentists for improving their knowledge about this variation.

The puboprostatic ligament (PPL) and pubovesical ligament (PVL) are critical anatomical structures that play a significant role in maintaining urinary continence by supporting the urethra and bladder neck. Despite their well-documented functions, the impact of preserving or reconstructing these ligaments during surgical procedures, particularly radical prostatectomy, on continence outcomes remains underexplored. This systematic review synthesizes current evidence on the anatomy, function, and clinical implications of the PPL and PVL. A comprehensive literature search was conducted in PubMed following PRISMA guidelines, selecting studies related to the anatomical characteristics, functional roles, and clinical management of these ligaments. Anatomical studies consistently highlight the structural complexity and supportive roles of the PPL and PVL in maintaining urethral and bladder neck positioning, which are essential for continence. Functional studies on the other hand further explain their involvement in the urethral closure process while clinical evidence demonstrates that sparing or reconstructing these ligaments during radical prostatectomy significantly improves both early and long-term continence outcomes, suggesting that their preservation is crucial for enhancing postoperative continence recovery. The findings emphasize the importance of these ligaments in continence mechanisms and advocate for their consideration in future surgical innovations. Further research is needed to refine surgical techniques and to better understand the biomechanical properties of these ligaments to optimize patient outcomes.

Background: The genitofemoral nerve is the most variable nerve of the lumbar plexus, in terms of its course and bifurcation, thus it must be taken into consideration during extended pelvic lymph node dissection. Its borders, during robotic, laparoscopic or open radical prostatectomy for intermediate or high-grade prostate cancer, have long been defined and must be usually respected; the genitofemoral nerve represents the extended pelvic lymph-node dissection lateral boundary and may vary from case to case putting its integrity at risk.

Materials and methods: For the first time, here the authors report genitofemoral nerve branching pattern data obtained extended pelvic lymph node dissection during videolaparoscopic radical prostatectomyand propose a further sub-classification to identify the exact genitofemoral nerve bifurcation point in correlation with the injury risk.

Results: The surgical results show the prevalence of a genitofemoral nerve originating as a single trunk which divides into two branches and highlight how this condition occurs at external iliac artery upper third in more than 75% of cases. Furthermore, at the femoral canal inlet the genitofemoral nerve two branches were mainly seen lying laterally sided and below the external iliac artery, or in the middle of external iliac artery and external iliac vein.

Conclusions: Knowledge and recognition of the genitofemoral nerve course and bifurcation points deduced from the extended pelvic lymph node dissection and, in any case, applicable to all major pelvic surgery, can prove helpful in avoiding iatrogenic nerve injuries during extended pelvic lymph node dissection.

Background: The present meta-analysis aimed to analyze the morphological and morphometric aspects of temporal bone pneumatization based on the data in the available literature. It is hoped that our results may be useful for physicians, especially head and neck surgeons, performing procedures in the temporal bone region.

Materials and methods: A systematic search was conducted in which all articles regarding the temporal bone pneumatization were searched for. Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library were searched through. The overall search process was conducted in 3 stages.

Results: Overall, the analyses were based on the results of 3482 patients. The pooled mean surface area of the mastoid air cell system in adults was found to be 174.68 cm² (SE = 29.58). In children (14-18 years old) mean of the said parameter was found to be 114.36 cm² (SE = 44.21). The pooled mean volume of mastoid pneumatization in adults was found to be 7.74 cm³ (SE = 1.14). The pooled mean volume of the temporal bone pneumatization in adults was found to be 8.41 cm³ (SE = 0.58).

Conclusions: The present meta-analysis analyzed the characteristics of TBP. Our results show the mean values of the morphometric properties of the air cell system in humans. This information may be highly significant when performing numerous otolaryngological procedures, such as mastoidectomies or skull base operations in the area of the petrous apex. Furthermore, the present study results prove how the size of the air cells increases with age. It is hoped that our results may be useful for physicians operating on the temporal bone.

Background: Although the plantaris muscle (PM) is considered vestigial in humans, it plays a significant clinical role in procedures like grafting. Recent reports have suggested its potential involvement in mid-portion Achilles tendon tendinopathy. Therefore, this study aims to evaluate the morphological variations of the PM, focusing on its branching patterns at the level of insertion.

Materials and methods: Dissections were performed on 58 lower limbs obtained from 29 adult cadavers preserved in a 10% formalin solution. The morphology of the PM was assessed concerning its branching patterns at the insertion level and its relationship with the calcaneal tendon.

Results: The PM was present in 52 out of 58 cases (89.65%). In majority of these cases (37 limbs, 63.79%), there was no splitting of the plantaris tendon (PT) at the level of the extensor expansion (ExP). Bifurcation occurred in 10 cases (19.23%), trifurcation in 4 cases (7.69%), and in one instance, the tendon divided into four slips. In 11 cases (22.4%), the insertion blended with the Achilles tendon (Type VII), which may increase the risk of Achilles tendinopathy.

Conclusions: The study indicates the existence of new types of PM tendon insertions that could potentially influence the development of Achilles tendinopathy. Variations in the anatomical morphology of the PM tendon may lead to potential conflicts with the Achilles tendon and the tibialis posterior tendon, thereby increasing the risk of tendinopathy.

During the dissection of an 82-year-old male specimen, we found an atypical variant of the aortic arch with 5 branches instead of the usual 3. The additional arteries were identified as the IMA thyroid artery (the artery of Neubauer) and the left vertebral artery, which arose directly from the aortic arch. The IMA artery was located between the origin of the brachiocephalic trunk and the left common carotid artery. The left vertebral artery was situated between the origin of the left common carotid artery and the left subclavian artery. No other variations in the origins of major vessels in the thoracic region, head, and neck were observed. The frequency of the left vertebral artery arising directly from the aortic arch is estimated to be 3-8%, and when combined with the IMA artery arising directly from the aortic arch, which occurs in less than 1% of cases, the variant described appears to be extremely rare. In this paper, we present the exact measurements of the arteries we found, their topography relative to other significant anatomical structures, and the potential clinical significance of these variations. The work is accompanied by diagrams and photographs.

Recently, special scientific efforts have been directed to investigate the role of small non-coding RNA (miRs) in different renal diseases. Extracellular vesicles (EVs) are small secretory vesicles released from almost all mammalian cells. EVs-miRs cargo plays a significant role in regulating various aspects of the biological machinery of the recipient cells. EVs-miRs may play an essential role in promoting cellular regenerative functions. miRs contained within the EVs fractions are capable of preserving their function throughout their journey from the cell of origin to the host cells. The current review discusses the role of EVs-miRs in different renal diseases as a novel approach for managing particular renal injuries. We tried to simplify the possible modulatory impact of miRs at the ultrastructural cellular pathological signaling, demonstrating the hazardous and the beneficial subtypes based on the previous research work. Further investigations are still needed in this regard, as miRs may have dual effects, as EVs-miR-23a could attenuate renal fibrosis through activation of Akt and inhibition of FoxO1 signaling. Whereas, EVs-miR-23a was upregulated by the hypoxia-inducible factor (HIF-1a) in the hypoxic TECs and activated macrophages to accelerate the renal inflammatory cytokine storm and promote interstitial fibrosis.

Background: The nasopalatine canal (NPC), or incisive canal, is an interosseous conduit in the premaxilla, located just behind the maxillary central incisors. Its variations must be carefully considered in dental and oral surgical procedures, especially with the higher aesthetic considerations in the premaxilla. This study aims to assess the morphology of NPC and its variations across different populations while proposing a new classification system for naming and describing the NPC.

Materials and methods: Followingthe PRISMA guidelines, the Population, Intervention, Comparison, Outcome format was applied to formulate the intensive question. An electronic literature search was conducted in Google Scholar by using the subsequent databases: Clarivate Analytics' or ISI Web of Science, Elsevier's Scopus, and PubMed (MEDLINE). No restriction was placed on studies after the2013 publication year. The keywords used were NPC morphology, incisive canal morphology, incisive foramen, NPC foramen, NPC shape, incisive canal shape,incisive canal,and NPC.Outstanding full-text studies were assessed according to inclusion and exclusion criteria, and appropriate reports were nominated. The collected data were analyzed and subjected to risk of bias and quality assessment.

Results: Ten full-length papers with a total of 1697 participants are included.Among them, the cylindrical shape, slant-straight course, and single canal are the most commonly observed in both sagittal and coronal views.

Conclusions: This review highlights the significant variability in the anatomical morphology of NPC across different populations, presenting challenges in establishing a standardized classification system. In order, the current study introduces a new, adaptable naming system to be utilized in education, research, and by clinicians during the description of the NPC anatomy.