Folia morphologica最新文献

Background: The arterial supply of the liver originates from the celiac trunk, which gives rise to the common hepatic artery. This artery subsequently bifurcates into the gastroduodenal artery and the proper hepatic artery, of which the latter further divides into the right and left hepatic arteries. This anatomical variability is described in order to highlight the high incidence of arterial hepatic vascular variations, to underline their clinical significance, and to classify the missing of proper hepatic artery within the framework of established hepatic arterial variation typologies.

Case report: The observed variation was identified during routine anatomical dissection of a 77-year-old female cadaver, who had voluntarily donated her body for scientific purposes as part of the Body Donation Program conducted by the Department of Anatomy of Wroclaw Medical University. Our case report presents an anatomical variant in which the proper hepatic artery is absent. Instead, the common hepatic artery gives rise to a common trunk that trifurcates into the right and left hepatic arteries, along with the gastroduodenal artery. Another part of this variation was that the right gastric artery originated from the left hepatic artery instead of the proper hepatic artery.

Conclusions: A thorough understanding of hepatic arterial anatomy is essential for a variety of surgical interventions, including liver transplantation, hepatic resection, cholecystectomy, and embolization of the right gastric artery. In cases of hepatocellular carcinoma, hepatic arteries may also serve as a route for intra-arterial chemotherapy. Therefore, precise knowledge of hepatic vascularization is of critical importance in the diagnosis and treatment of liver pathologies.

Background: A thorough understanding of paranasal sinus anatomy and its variations is essential for accurate diagnosis, effective treatment of sinus-related conditions, and safe surgical intervention. Preoperative assessment of sinus morphology plays a vital role in minimizing intraoperative risks and postoperative complications.

Materials and methods: During routine dissection of a 78-year-old female cadaver at the Department of Biomedical Sciences, Mercer University School of Medicine (Columbus, GA), an unique case of bilateral septa in both the sphenoid and maxillary sinuses was observed.

Results: Four accessory septa (AS) were identified in the sphenoid sinuses. On the left, one septum extended from the lateral wall to the internal carotid artery (ICA) prominence. The second one arose from the anterolateral wall. On the right, one septum was located on the inferior wall, and another on the posterosuperior wall, also attached to the ICA prominence. In the maxillary sinuses, vertical septa were present on both sides. On the left, a septum extended from the anterior wall to the infraorbital canal (IOC). On the right, a septum connected the anterior wall to the sinus roof.

Conclusions: With the increasing use of functional endoscopic sinus surgery and transsphenoidal approaches, it is important to recognize anatomical variations like AS. Septa that involve the ICA prominence or IOC present significant surgical risks. Preoperative imaging and careful surgical planning are essential to reduce complications and improve outcomes.

Background: The coccyx exhibits significant anatomical variation in its morphology, vertebral number, and joint fusion patterns. These variations can influence the development of coccygodynia, a common yet often underdiagnosed cause of chronic lower back pain. Understanding coccygeal anatomy is essential for accurate diagnosis and effective clinical management.

Materials and methods: A retrospective analysis was performed on 107 lumbosacral CT scans (63 males and 44 females; age range: 18-84 years). The study evaluated the number of coccygeal segments, coccyx type (as per established classification), presence of sacrococcygeal and intercoccygeal fusion, and the occurrence of coccygeal spicules.

Results: Type I coccyx was the most frequently observed (n = 43), followed by type II (n = 37), type III (n = 21), and type IV (n = 6). The majority of subjects had four coccygeal vertebrae (n = 53), followed by five (n = 39), three (n = 12), and two (n = 3). Sacrococcygeal fusion (partial or complete) was present in 47 subjects (43.66%), while 60 subjects (56.33%) showed no evidence of fusion. Intercoccygeal fusion affecting one or more segments was noted in 95 individuals, with only 12 showing no such fusion. Coccygeal spicules were identified in 10 subjects.

Conclusions: These findings underline the substantial morphological diversity of the coccyx and reaffirm the importance of high-resolution imaging in assessing coccygeal anomalies and planning interventions for conditions such as coccydynia.

Background: This review aims to provide a current, comprehensive, and evidence-based overview of the anatomy of the lesser occipital nerve.

Materials and methods: Major online databases (PubMed, Scopus, Embase, ScienceDirect, Web of Science) were searched to identify all studies reporting data on the anatomy of cutaneous branches of the cervical plexus. This review includes original studies containing morphometric and branching pattern data concerning LON. The risk of bias was assessed using the Anatomical Quality Assurance (AQUA) Tool. The authors strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines in this study. This review was registered in the PROSPERO database, ID CRD420251005988.

Results: A total of 13 articles (526 nerves) met all inclusion criteria. LON emerges at the posterior border of the sternocleidomastoid muscle (SCM). It courses superiorly on the occipital area. It can be located using the distance from the y-axis (a line going through the spinal processes of the cervical vertebrae or external occipital protuberance) and the x-axis (a line perpendicular to the y-axis). Several compression sites for LON have been identified and highlighted in the study.

Discussion and conclusions: This is the most comprehensive review of the anatomy of the lesser occipital nerve to date. Because the included studies were of variable quality and had inconsistent methodology, further research is necessary. This study identified standardised landmarks for describing LON anatomy: EOP, MP, SCM border, external auditory canal and the superior nuchal line. Significant progress has been made in identifying the most optimal surgical approaches to regions concerning LON anatomy.

Background: This study aimed to describe the anatomical features and variations of the abdominal aorta and its major visceral branches - the celiac trunk, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA) - using 128-slice computed to-mography (CT) imaging.

Materials and methods: A descriptive, retrospective study was conducted on 193 adult Vietnamese patients who underwent contrast-enhanced 128-slice abdominal CT scans at Tam Anh General Hospital between December 2023 and December 2024. Origins, diameters, branching angles, and anatomical variants were recorded and an-alyzed using MIP and 3D VR reconstructions. Variations were classified using Uflack-er's (celiac trunk) and Kornafel's (SMA) systems.

Results: The most common origin levels were T12-L1 for the celiac trunk (33.7%), L1 for the SMA (36.3%), and L3 for the IMA (30.6%). Classical branching patterns were present in 68.0% for the celiac trunk, 96.3% for the SMA, and 97.4% for the IMA. Several uncommon variants, such as hepatosplenic trunks and IMA origin from the SMA, were identified.

Conclusions: 128-slice CT provides high-resolution imaging to reliably assess vascular anatomy. Significant anatomical variation exists in the abdominal aorta and its branches, under-lining the importance of individualized preoperative evaluation.

Background: The ovarian veins (OVs) are paired vessels that drain deoxygenated blood from the ovaries, fallopian tubes, and adjacent pelvic structures. The objective of this study is to systematically synthesize cadaveric and imaging-based data to describe the anatomy, variations, and clinical relevance of the OVs.

Materials and methods: To conduct this meta-analysis, a systematic literature search was carried out to identify all studies concerning the anatomy of the ovarian vein. Searches were performed in major medical databases, including PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library.

Results: A total of 35 studies were included in this meta-analysis. The overall mean diameter of the OV was estimated at 4.88 mm (SE = 0.24). The diameter of the right OV reached 4.44 mm (SE = 0.28), while the left OV measured 4.99 mm (SE = 0.34). The pooled prevalence of valves in the ovarian veins was calculated at 91.93% (95% CI: 83.32-97.79%). Competent valves were found in 72.16% of cases (95% CI: 58.72-83.89%), while incompetent valves were present in 27.84% (95% CI: 16.11-41.28%). On the right side, a double OV was present in 1.00% of specimens (95% CI: 0.00-3.08%). On the left, this variation occurred slightly more frequently, with a pooled prevalence of 2.08% (95% CI: 0.43-4.72%).

Conclusions: This meta-analysis highlights critical anatomical and clinical features of the ovarian veins. The left OV is wider and more frequently incompetent than the right, supporting the left-sided predominance of pelvic congestion syndrome. Drainage patterns confirm classical anatomy - right OV to inferior vena cava, left OV to left renal vein - but rare variants must be considered during interventions. OV duplication, though rare, poses a risk of incomplete embolization if unrecognized. These findings underscore the need for side-specific imaging and thorough anatomical evaluation to improve diagnosis, embolization outcomes, and surgical planning in pelvic venous disorders.

Background: This study aimed to evaluate the effects of congenital tooth agenesis (hypodontia) on craniofacial morphology and facial symmetry using cephalometric (CEPH) and posteroanterior (PA) canting analyses.

Materials and methods: This retrospective cross-sectional study included 141 individuals, comprising 101 patients with congenital tooth agenesis and 40 controls, all of whom had pre-treatment CEPH and PA radiographs. The data were obtained retrospectively from the digital archive of orthodontic patients between 2014 and 2024, enhancing the comprehensiveness of the findings. Subjects were classified based on the localization of missing teeth (maxilla, mandible, or both) and the affected facial side (right or left). Craniofacial morphology was assessed using cephalometric parameters via WebCeph software, while facial asymmetry in the transverse plane was evaluated using PA canting angles.

Results: SNA, SNB, and ANB angles, as well as anterior facial height, showed statistically significant differences according to the jaw in which the missing teeth were located (p < 0.05). Individuals with maxillary agenesis exhibited lower SNA values, while those with mandibular agenesis had higher ANB values. No statistically significant differences were observed among groups in terms of canting direction or degree (p > 0.05). Canting angles ranged from 0.56° to 1.84°, remaining below the threshold of esthetic detectability.

Conclusions: Congenital tooth agenesis can cause measurable changes in craniofacial morphology, particularly in the sagittal plane. However, the laterality of agenesis (right or left) did not significantly affect PA canting characteristics. These results suggest that the craniofacial impact of hypodontia varies according to the pattern of missing teeth and individual anatomical factors.

Background: In the present study, we aimed to determine the prevalence and morphometric characteristics of the psoas minor (PM) muscle in human fetuses.

Materials and methods: A total of 67 formalin-fixed fetuses of both sexes (31 male, 36 female), aged 16-28 weeks of gestation, were examined using anatomical dissection and digital image analysis (NIS Elements AR 3.0).

Results: The presence of the PM muscle was confirmed in 29.9% of cases, with a comparable frequency in male (32.3%) and female (27.8%) fetuses. Bilateral occurrence was noted in 60% of positive cases. Five morphometric parameters of the PM (total length, muscle belly length and width, tendon length and width) were measured. In the subgroup of fetuses with bilateral presentation, no significant differences were found between the right and left sides. Due to the limited number of cases with a present PM muscle, no growth modeling or correlation with fetal age or sex was performed.

Conclusions: The findings highlight considerable anatomical variability of the PM muscle already in the prenatal period and provide preliminary reference data that may support advanced fetal imaging interpretation and retroperitoneal surgical planning.

Idiopathic facial palsy (Bell's palsy) as an entity is simply a spontaneous facial nerve palsy. Presenting a cluster of symptoms and alterations in superficial anatomy, nerves, muscles, skin and emotions are involved. Although this palsy strongly affects the peripheral nervous system, no definite studies exist confirming that it alters centrally the structure of the brain itself. Facial innervation, presents a web of fibers, rendering surgical procedures damage sensitive. This narrative review documents known literature to demonstrate that the complexity interacts with the ability of surgeons operating in the facial area. Comprehension of the topographical anatomy is essential for best outcomes.

Background: Elongation of the styloid process (SP) can impinge on adjacent neurovascular structures, provoking Eagle's syndrome. This study aimed to assess the length, angulation, and morphology of SP in adult Saudis and to explore their associations with age and sex.

Materials and methods: A retrospective analysis of 152 cervical computed tomography (CT) scans at a tertiary hospital in Riyadh. Participants were ≥ 25 years old (76 men, 76 women). Bilateral SP length, sagittal and transverse deviation angles, and morphology were recorded. Elongation of SP was defined as length ≥ 30 mm. Statistical tests were performed to assess associations between demographic variables and anatomical parameters.

Results: Elongated SPs (≥ 30 mm) were observed in 20% of the cases, with no significant differences between sexes or sides. The most common morphology identified was the uninterrupted elongated type (72%), followed by pseudo-articulated (21%) and segmented (7%). Elongation was more frequently associated with the pseudo-articulated and segmented forms. Although sex did not influence the rates of elongation, men showed longer SPs and greater sagittal deviation angles compared to women. Additionally, the left side demonstrated a higher transverse angle than the right. Aging was shown to have a weak, statistically significant correlation with SP length and orientation, suggesting potential progressive changes over time.

Conclusions: The findings of this study indicate a notable prevalence of elongated SPs in the Saudi population and highlight specific anatomical features that may contribute to Eagle's syndrome. These results underscore the diagnostic value of CT imaging for patients with unexplained orofacial symptoms.