Folia morphologica最新文献

Background: Most of the anatomical variants in the anterior compartment of the leg is related with morphology of tendons and insertion points. The variants related with muscle bellies and their relations with surrounding structures are much less profusely described. We present a case of a unique fusion between the extensor hallucis longus and the extensor digitorum longus.

Materials and methods: During a routine dissection of a female cadaver, an anomalous fusion between the extensor digitorum longus and the extensor hallucis longus was encountered. The finding was subsequently measured and photographed.

Results: Both muscles had a common attachment to the fibula. This fusion extended distally beyond their common origin. The anatomy of the tendons, their insertions and relation to the fibularis tertius and tibialis anterior muscles was typical.

Conclusions: Many variants of the extensor hallucis longus and the extensor digitorum longus have been previously described however, most of them refer to their tendons. It is important to be aware of morphological variability of the muscles, even if they are not common finding. We hypothesize that this variant may predispose to more severe injuries and increased pain sensations.

Background: Numerous anatomical variations have been documented in muscles from various human body regions. Here, we describe an exceptionally uncommon instance of a psoas major muscle exhibiting a multiheaded configuration with diverse morphology.

Materials and methods: During a routine dissection of the posterior abdominal wall, an abnormal muscle was observed. The muscle was identified, photographed, and subjected to further measurement.

Conclusions: Atypical morphology of commonly occurring anatomical structures may lead to numerous clinical consequences, therefore knowledge regarding morphological variability seems crucial and worth documenting.

Introduction: Digastric muscle (DM) constitutes a fundamental component of the suprahyoid region, where it contributes to the indirect depression of the mandible and plays an essential role in deglutition and phonation. The objective of the present study is to systematically evaluate the morphometry and anatomical characteristics of DM through a comprehensive meta-analysis of studies reporting extractable data pertaining to this muscle.

Materials and methods: Major online medical databases such as PubMed, Embase, Scopus, ScienceDirect, Web of Science, SciELO, BIOSIS, Current Content Connect and Korean Journal Database were searched to gather all relevant studies regarding the anatomical characteristics of DM.

Results: The results of the present meta-analysis comprised 52 studies. The overall frequency of DM variation in the general population is 17.51% (95% CI: 13.70-22.12%) occurring more often in men 10.78% (95% CI: 5.58-19.81%) than in women 7.19% (95% CI: 3.83-13.12%). Based on the De-Ary-Pires classification, the most prevalent morphological pattern of the DM was consistently identified as Type I. The pooled mean length of DM was calculated at 42.41 mm (95% CI: 33.32-51.49).

Conclusions: This study represents the most extensive and up-to-date evaluation of DM morphometry and anatomy to date. Its findings provide an important reference for clinicians, particularly surgeons performing procedures in the head and neck region.

Background: The aim of this study was to evaluate the diameters of selected skull‑base neurovascular canals in patients with medication‑related osteonecrosis of the jaw (MRONJ) compared to a healthy control group.

Materials and methods: Cone‑beam computed tomography (CBCT) images from 43 patients with MRONJ and 41 healthy controls were retrospectively analyzed. The maximal diameters (in millimeters) of the foramen rotundum, pterygoid canal, foramen ovale, foramen spinosum, and foramen jugulare were measured bilaterally. Independent‑samples t tests were used for statistical comparisons, with p < 0.05 considered significant.

Results: In the MRONJ group, the maximal diameters of the foramen rotundum, pterygoid canal, and foramen jugulare were significantly smaller than those of the control group (p < 0.05). No significant differences were observed between groups for the diameters of the foramen ovale and foramen spinosum (p > 0.05).

Conclusions: Patients with MRONJ exhibit marked narrowing of the foramen rotundum, pterygoid canal, and foramen jugulare, whereas the dimensions of the foramen ovale and foramen spinosum remain unaffected. These findings suggest that MRONJ may induce morphometric alterations in certain skull‑base neurovascular canals.

Background: Anatomical variants such as the precondylar tubercle (PCT) and third occipital condyle (TOC) are rare bony projections located at the anterior margin of the foramen magnum. Though often asymptomatic, they can have clinical relevance in radiological and surgical contexts. Despite growing interest in these traits, their presence in European skeletal collections remains poorly documented.

Materials and methods: This study examined 126 crania from the historical collection curated at the Museum of Anthropology "Giuseppe Sergi" (MGS), Sapienza University of Rome. Biological profiles were reassessed using standard anthropological methods for sex determination and age estimation. Macroscopic evaluation focused on the presence of PCT and TOC, as well as associated traits such as bipartite hypoglossal canals.

Results and discussion: Eight crania presented PCTs; of these, two also exhibited TOC. In the latter specimens, the absence of postmortem damage allowed confident exclusion of fusion with the atlas or axis, suggesting an incidental occurrence and likely asymptomatic condition. Two specimens with PCT also displayed bipartite hypoglossal canals. Although the sample does not represent a population in the proper sense, these findings align with previously reported frequencies in modern collections and highlight potential developmental origins shared between PCT and TOC.

Conclusions: The identification of PCT and TOC in a curated historical sample contributes to the documentation of rare morphological variants at the craniovertebral junction. These results underscore the relevance of skeletal collections in descriptive anatomy and support future multidisciplinary research integrating clinical, developmental, and evolutionary perspectives.

Background: The common hepatic artery (CHA) is a major vessel supplying the liver, stomach, pancreas, and duodenum. While typically arising from the celiac trunk, its origin, course, and morphometry exhibit considerable variability, which may complicate hepatobiliary and pancreatic surgery, liver transplantation, and interventional procedures. This study aimed to comprehensively assess the anatomy and morphometry of the CHA using computed tomography angiography (CTA), with attention to clinically relevant variations.

Materials and methods: A retrospective analysis was performed on 73 consecutive patients (41 females, 32 males). Each CHA was reconstructed in three dimensions using dedicated software, and its origin, length, diameter, cross-sectional area, and departure angle were measured at standardized points.

Results: The CHA most commonly originated from the celiac trunk (93.2%), with aberrant origins from the superior mesenteric artery (5.5%) and aorta (1.4%). The median distance from the celiac trunk to CHA origin was 35.73 mm, and the median CHA diameter at its origin was 5.55 mm. Proximal to the bifurcation into the proper hepatic and gastroduodenal arteries, the median CHA diameter and cross-sectional area were 5.54 mm and 23.48 mm², respectively.

Conclusions: Although the CHA typically arises from the celiac trunk, clinically significant variants, including superior mesenteric artery, and aorta-derived CHAs, necessitate preoperative recognition to avoid vascular injury during pancreaticoduodenectomy or hepatic resection. The morphometric data presented provide valuable guidance for endovascular procedures, catheter and graft selection, and arterial reconstruction planning, underscoring the importance of routine preoperative vascular mapping with CTA in hepatobiliary and pancreatic surgery.

Background: The obturator artery (OA) and obturator vein (OV) often exhibit anatomical variations, particularly in their origins. Corona mortis (CMOR) is a well-known type of anatomical variation; however, few studies have reported the distribution of OA after it passes through the obturator canal (OC). This case reports an abnormal OA and OVs that formed a CMOR without passing through the OC.

Materials and methods: Variations were observed in an 81-year-old Japanese man during a gross-anatomical dissection course for students at Tokai University of Medicine in 2023.

Results: The left OA branched from the external iliac artery via the inferior epigastric artery, coursing toward the OC with the obturator nerve (ON); however, only the ON emerged from the canal. The left OV originated in the public and internal obturator regions as OV1 and OV2, each exiting the OC separately. Furthermore, OV1 and OV2 branched and converged with the external iliac vein to form OV3 and OV4. The muscles normally supplied by OA were instead distributed by branches of the left medial circumflex femoral artery (MCFA) and femoral artery.

Conclusions: This is the first report of the OA and OVs not passing through the OC. Understanding the course of these vessels is essential for procedures such as pelvic lymph node dissection and endovascular aneurysm repair involving unilateral internal iliac artery interruption. The branches of the MCFA and femoral artery observed in this case may contribute to further studies on the vascular anatomy of the pelvic system.

Background: The great auricular nerve (GAN) is the largest cutaneous branch of the cervical plexus, playing a crucial role in head and neck surgeries, including aesthetic procedures, migraine treatment, and parotid gland interventions. Despite its clinical importance, anatomical descriptions of GAN remain inconsistent across studies.

Materials and methods: This systematic review aims to provide a comprehensive, evidence-based analysis of GAN anatomy. A systematic search was conducted across major electronic databases to identify original studies reporting morphometric and branching data on GAN. Studies that were review articles, case reports, letters to the editor, conference abstracts, or performed on animals were excluded. The methodological quality of the included studies was assessed using the Anatomical Quality Assurance (AQUA) Tool developed by the Evidence-Based Anatomy Working Group.

Results: This review was registered in the PROSPERO database, ID CRD420251005988. This part of the review included 21 studies, encompassing 745 dissected GANs (512 cadaveric and 233 intraoperative observations). During its course, GAN divides into multiple branches supplying the mastoid region, posterior two-thirds of the auricle, lobule, parotid gland, and overlying skin. Several anatomical landmarks were identified for GAN localization, and their distances to notable parts of GAN anatomy were recorded and analyzed.

Discussion and conclusions: This review provides the most comprehensive synthesis of GAN anatomy to date. Given its high clinical relevance, especially in surgical procedures and nerve grafting, precise anatomical knowledge is essential to minimize iatrogenic injuries. However, due to variability in study methodologies and reporting quality, further high-quality anatomical studies are needed to refine surgical guidelines.

Background: The inferior mesenteric artery (IMA) serves as the primary blood supply for the hindgut, extending from the distal transverse colon to the rectum. Variations in the anatomy of the IMA are well-documented, and numerous classification systems have been developed to describe these anatomical differences. These variations can involve differences in the origin, course, and branching patterns of the IMA. The present study aimed to analyze the anatomy of the IMA with respect to the available classification systems in the literature.

Materials and methods: Results from 74 consecutive patients who underwent abdominal computed tomography angiography (CTA) were evaluated.

Results: The most common vertebral level of departure of the IMA was found to be the body of the L3 vertebra. The most common IMA type according to the Zhang classification was found to be Type IA, which occurred in 25 of the studied patients (35.71%). The most common IMA type according to the Zebrowski classification was found to be Type B (n = 26; 41.27%), followed by Types C and H (n = 14; 22.22%). The most common order of departure of the branches of the IMA was found to be the left colic artery (LCA) followed by the common departure of the sigmoid trunk and superior rectal artery (SRA). The median diameter of the IMA at its origin was found to be 3.49 mm (LQ = 3.09; HQ = 3.70) in females and 3.74 mm (LQ = 3.44; HQ = 4.05) in males (p = 0.01).

Conclusions: The results of the present study demonstrate that the most comprehensive but also specific classification system of the IMA was the McSweeney classification. It is hoped that the results of the present study may be useful to physicians performing various gastrointestinal and endovascular procedures, such as laparoscopic ligation of the IMA or embolization procedures.

Background: The brachioradialis muscle (BRM), among the extensor muscles of the forearm, is positioned most laterally and marks the beginning of the lateral extensor group of the forearm.

Materials and methods: The study was based on 100 human fetuses of both sexes (47♂ and 53♀), aged between 20 and 34 weeks of gestation. The fetuses, preserved in 10% buffered formalin solution, underwent conventional anatomical dissection to expose the lateral group of forearm extensors. Photographic documentation of the muscles in situ was analyzed using an optimized digital imaging system and subjected to statistical evaluation (including Student's t-test and nonlinear estimation).

Results: For most of the parameters examined, no statistically significant differences were identified with respect to sex or laterality. The greatest variability was observed in muscle surface area and tendon width at mid-length. Derivatives of linear parameters were calculated to determine the rate of increase of these functions, confirming a faster growth rate in the proximal portion of the muscle compared with the distal portion of the BRM. These results corresponded with developmental patterns previously reported for upper limb musculature.

Conclusions: 1) The variability of the brachioradialis muscle (BRM) in the human fetus is minimal. 2) The BRM shows no sex- or side related (laterality) except for the morphometric parameters with the greatest overall variability (i.e., the largest mean-median differences and highest SDs) which are: tendon width at mid-length and muscle surface area. 3) BRM development follows a proximal-distal growth pattern, similar to other upper-limb muscles.