Surgical and Radiologic Anatomy最新文献

Purpose: To evaluate the presence and measure the depth of newly found air space located posteriorly to the basal turn of the cochlea-retrocochlear recess (RCR).

Method: The area of subtympanic sinus was explored bilaterally using multi-planar reconstruction tools in 280 temporal bone computed tomography scans. We searched for RCR and measured its depth whenever present. We evaluated the presence of subcochlear canaliculus and the position of the jugular fossa bordering the RCR.

Results: The RCR in 192 out of 280 evaluated temporal bones (69%), more commonly in children under 2 years old than aged three to five (p < 0.001). The mean depth of the RCR for the whole studied group measured from posterior pillar of the round window niche was 3.9 ± 1.8 mm, and from promontory - 6.6 ± 1.8 mm. The influence of the jugular fossa on the shape of the RCR was confirmed in 88 out of 192 temporal bones with RCR present (46%), more commonly on the right side (p < 0.001). We found subcochlear canaliculus in only 7.5% of examined bones.

Conclusion: The RCR is a commonly found anatomical space in the vicinity of subtympanic sinus. Its final shape may be affected by the jugular fossa, especially on the right side. The RCR may play role in preoperative evaluation for cholesteatoma surgery or cochlear implantation.

Purpose: Tendons of the flexor hallucis longus (FHL) and flexor digitalis longus (FDL) are used in reconstructive foot surgery in general and have important clinical significance. These tendons intersect at the plantar surface and exhibit different interconnections, complicating the tendon acquisition process. The aim of this study was to establish a comprehensive understanding of these interconnections through an improved classification system and to identify anatomical characteristics based on the data.

Methods: 100 embalmed feet were dissected to observe plantar cross-linking sites. The improved classification system was used to classify the interconnections and the relevant data of the interconnections were measured.

Results: Four types of interconnections between the FHL and FDL tendons were classified. Type Ⅰ, a proximal to distal interconnection of the FHL to the FDL was observed in 92 cases; Type Ⅱ, a proximal to distal interconnection of the FHL to the FDL, accompanied by an additional proximal-to-distal interconnection from the FDL to the FHL, was noted in 4 cases; Type Ⅲ, two parallel proximal to distal interconnections of FHL to FDL were detected in 3 cases; Type Ⅳ, a thin fascial interconnection rather than a fibrous one between the FHL and the FDL was found in 1 case. The mean length and width of the interconnections were (16.59 ± 4.93) mm and (2.91 ± 0.77) mm respectively.

Conclusion: In the present study, the classification of the FHL to FDL interconnection serves as a complement to the existing body of literature. Knowledge of the anatomical variations in these interconnections is critical to preserve the blood vessels and nerves during foot reconstructions.

Purpose: The septal pouch is an anatomical variant resulting from incomplete fusion between the septum primum and the septum secundum at the interatrial septum. This partial fusion creates a conical pouch, which is potentially predisposed to thrombus formation, increasing the degree of thromboembolic risk. This cadaveric study aimed to evaluate the prevalence, morphology, and morphometry of septal pouches and their associations with other septal defects.

Methodology: The interatrial septa of 60 human hearts were examined for septal pouches. Characteristics such as pouch type, apex and base orientation, base width, depth, and morphological variants were documented.

Results: Atrial septal pouches (ASPs) were identified in 22/60 (37%) specimens. Right atrial septal pouches (RSPs) were predominant (30%), whereas left atrial septal pouches (LSPs) were found in 7% of the patients. Most RSPs exhibited a thin, membranous, flattened morphology, although some were thick and muscular. All LSPs were thin and flattened, with a superiorly directed ostium and an inferiorly directed apex. Histologically, the pouches demonstrated a trilaminar arrangement, comprising the myocardium sandwiched between two endocardial layers, with collagen-rich connective tissue beneath.

Conclusion: This study highlights important anatomical insights regarding septal pouches, emphasizing the higher prevalence and varied morphometry of RSPs. Given their potential clinical significance in thromboembolic phenomena, further investigation into septal pouch involvement in cardiovascular diseases is warranted.

Purpose: This study investigated the morphology of isthmus in mandibular first molar of a Malaysian subpopulation.

Method: A total of 140 double-rooted mandibular first molars were scanned using micro-computed tomography. Fan et al. classification was used to classify the isthmus morphology. The chi-square test was used to compare the qualitative variables. The independent samples t-test and Mann Whitney U test were used to compare the quantitative variables.

Results: The prevalence of isthmus was 77.1%. The mesial root had the majority of isthmuses [135 (89.4%)]. Of these, 65.2% were "Mixed" type. The distal roots had only 16 (10.6%) of all isthmuses. Of these, 12 (75%) were "Mixed" type. No significant difference in the type of isthmus between the mesial and distal roots (p = 0.335). However, a significant association was found between root type and the presence of isthmus (p < 0.001). There was no significant difference neither in the volume of canal part with isthmus (p = 0.703 for sheet and 0.149 for mixed types) nor in the percentage volume (p = 0.601 for sheet and 0.299 for mixed types) between the mesial and distal roots in sheet and mixed isthmus types.

Conclusion: In this population, the mandibular first molar showed a high complexity in the isthmus anatomy, especially in the mesial root.

Purpose: The ulnar nerve might undergo compression due to traumatic or non-traumatic pathological conditions or altered anatomy within the extent of the distal arm to the proximal hand, leading to ulnar neuropathy. There are certain anatomical sites where the increased ulnar nerve cross-sectional area (CSA) values indicate probable compression and can be diagnosed by the high-resolution Ultrasonography (USG) or Magnetic Resonance Imaging (MRI) in symptomatic patients. The ulnar nerve CSA varies across the population, and there is limited data available for the Indian population. Hence, we aimed to evaluate the CSA measurement of the ulnar nerve in various predefined anatomical sites.

Methods: The CSA of the ulnar nerve was studied in 64 (34 Male, 30 Female) formalin-fixed cadaveric upper limbs in various predefined anatomical sites. The statistical analysis was done using Microsoft Excel and Stata 12 software.

Results: The average CSA of the ulnar nerve was 4.77 ± 2.21 mm² at the level of the medial epicondyle and 2.21 ± 0.86 mm² at the level of the wrist. The CSA values were higher in males than in females. This study has also reported the distances of the branch points of the ulnar nerve supplying the flexor carpi ulnaris and flexor digitorum profundus muscles, the dorsal cutaneous and palmar cutaneous branches from the nearest bony landmarks.

Conclusion: Thus, this study provides a baseline value of ulnar nerve CSA for the East Indian population, which might help clinicians to diagnose ulnar neuropathy.