CT Evaluation of the Intraorbital Structures Concerning Endoscopic Approaches to the Lamina Papyracea

Background: The relationship between the intraorbital structures and medial wall of the orbit is essential for surgical approaches. Objective: The goal was to provide an improved understanding of the dimensions of extraocular muscles and the approximate location of the intraorbital structures with respect to the lamina papyracea (LP). Material and Methods: This retrospective study was performed using the multiplanar reconstruction of Computed Tomography (CT) scans of 200 orbits. Results: We measured the mean diameters of intraorbital structures. The mean horizontal distances from LP to medial and inferior rectus muscles, globe, and infraorbital canal were found as 3.9 ± 1.2 mm, 11.5 ± 1.6 mm, 7.8 ± 1.5 mm and 16.1 ± 2.0 mm and as 0.6 ± 0.4 mm, 4.7 ± 1.3 mm, 7.2 ± 1.8 mm, 12.5 ± 2.3 mm at the depth of the anterior (AEF) and posterior ethmoidal foramen, respectively. All morphometric results were compared with respect to age, sex and laterality and higher in males than females. The measurement results indicated that subjects in first and second age groups showed statistically significant differences in distances from the LP to the globe, medial and inferior rectus muscles at the depth of AEF (p<0.05). But, there was no difference between right and left. Conclusion: CT imaging which can offer an accurate understanding of the regional anatomy of and around the LP may be helpful in preoperative planning and prediction of postoperative outcomes. It can allow the surgeon to prevent possible orbital injury during surgical interventions

An assessment of nasal and orbital parameters in human fetuses

Background: Nasal bone aplasia and hypoplasia have been reported on fetuses with aneuploidy. Trisomy 21 is one of the most common chromosomal abnormality detected in new-borns. The purpose of our study is to obtain data of some face parameters in Turkish fetal population and to contribute creation of reference ranges that may be used for prenatal diagnosis.Methods: This study was performed in 66 spontaneously aborted fetuses (47 second trimester and 19 third trimester) (28 male and 38 female) with no detectable external pathology or anomalies. Measurements were designed as nasal bone length (NBL), nose length (NL), nose width (NW), nostril width (NsW),                intraocular distance (IOD), innercanthal distance (ICD), outercanthal distance (OCD), orbital diameter (OD), biparietal diameter (BPD).Results: In comparison between genders, ICD and BPD averages were found significantly higher in male fetuses than female fetuses (P<0.05). There was not any statistically significant difference between averages of the values on the right and left. The difference between second and the third trimester was significant in terms of all parameters (P<0.05). A strong correlation was detected between gestational age and our parameters.Conclusions: Present study has contributed to create reference ranges of Turkish community. When importance of early diagnosis is considered, we believe that this data will be useful for clinicians

Computed tomography evaluation of the morphometry and variations of the infraorbital canal relating to endoscopic surgery

Introduction: The course of the infraorbital canal may leave the infraorbital nerve susceptible to injury during reconstructive and endoscopic surgery, particularly when surgically manipulating the roof of the maxillary sinus. Objective: We investigated both the morphometry and variations of the infraorbital canal with the aim to show the relationship between them relative to endoscopic approaches. Methods: This retrospective study was performed on paranasal multidetector computed tomography images of 200 patients. Results: The infraorbital canal corpus types were categorized as Type 1: within the maxillary bony roof (55.3%), Type 2: partially protruding into maxillary sinus (26.7%), Type 3: within the maxillary sinus (9.5%), Type 4: located anatomically at the outer limit of the zygomatic recess of the maxillary bone (8.5%). The internal angulation and the length of the infraorbital canal, the infraorbital foramen entry angles and the distances related to the infraorbital foramen localization were measured and their relationships with the infraorbital canal variations were analyzed. We reported that the internal angulations in both sagittal and axial sections were mostly found in infraorbital canal Type 1 and 4 (69.2%, 64.7%) but, there were commonly no angulation in Type 3 (68.4%) (p < 0.001). The length of the infraorbital canal and the distances from the infraorbital foramen to the infraorbital rim and piriform aperture was measured as the longest in Type 3 and the smallest in Type 1 (p < 0.001). The sagittal infraorbital foramen entry angles were detected significantly smaller in Type 3 and larger in Type 1 than that in other types (p = 0.003). The maxillary sinus septa and the Haller cell were observed in 28% and 16% of the images, respectively. Conclusion: Precise knowledge of the infraorbital canal corpus types and relationship with the morphometry allow surgeons to choose an appropriate surgical approach to avoid iatrogenic infraorbital nerve injury. Resumo: Introdução: O trajeto do canal infraorbitário pode predispor o nervo infraorbitário a lesões durante cirurgias reconstrutoras e endoscópicas com manipulação do teto do seio maxilar. Objetivo: Investigamos a morfometria e as variações do canal infraorbitário e objetivamos demonstrar a relação entre elas, visando as abordagens endoscópicas. Método: Este estudo retrospectivo foi realizado em imagens de tomografia computadorizada multidetectora de seios paranasais de 200 pacientes. Resultados: Os tipos de corpos do canal infraorbitário foram categorizados como Tipo 1; inseridos no teto ósseo maxilar (55,3%), Tipo 2; projetando-se parcialmente dentro do seio maxilar (26,7%), Tipo 3; dentro do seio maxilar (9,5%), Tipo 4; localizado anatomicamente no limite externo do recesso zigomático do osso maxilar (8,5%). A angulação interna e o comprimento do canal infraorbitário, os ângulos de entrada do forame infraorbitário e as distâncias relacionadas à localização do forame foram medidos e suas relações com as variações do canal infraorbitário foram analisadas. Observamos que as angulações internas em ambos os cortes sagital e axial foram encontradas em sua maioria em canais infraorbitários Tipo 1 e 4 (69,2%, 64,7%) e, no geral, não houve angulação no canal Tipo 3 (68,4%) (p < 0,001). O comprimento do canal infraorbitário e as distâncias desde o forame infraorbitário até o rebordo infraorbitário e a abertura piriforme foram medidos e os mais longos foram identificadas no Tipo 3 e os mais curtos no Tipo 1 (p < 0,001). Os ângulos de entrada do forame infraorbitário em projeção sagital foram significativamente menores no Tipo 3 e maiores no Tipo 1, em relação aos outros tipos (p = 0,003). Septos nos seios maxilares e as células de Haller foram observados em 28% e 16% das imagens, respectivamente. Conclusão: O conhecimento preciso dos tipos de corpo do canal infraorbitário e a relação com a morfometria permitem que o cirurgião escolha uma abordagem cirúrgica apropriada para evitar lesões iatrogênicas do nervo infraorbitário. Keywords: Endoscopic sinus surgery, Infraorbital canal, Infraorbital canal corpus types, Infraorbital foramen, Multidetector computed tomography, Palavras-chave: Cirurgia endoscópica sinusal, Canal infraorbitário, Tipos de corpo do canal infraorbitário, Forame infraorbitário, Tomografia computadorizada multidetectore

Theoretical and vibrational spectroscopic approach to keto-enol tautomerism in methy1-2-(4-methoxybenzoyl)-3-(4-methoxyphenyl)-3-oxopropanoylcarbamate

A carbamate compound having tricarbonyl groups, methy1-2-(4-methoxybenzoyl)-3-(4-methoxypheny1)-3-oxopropanoylcarbamate (BPOC) was investigated from theoretical and vibrational spectroscopic point of view employing quantum chemical methods. Hybrid Density Functionals (B3LYP, X3LYP and B3PW91) with 6-311 G(d,p) basis set were used for the calculations. Rotational barrier and conformational analyses were performed to find the most stable conformers of keto and enol forms of the molecule. Three transition states for keto-enol tautomerism in gas phase were determined. The results of the calculations show that enol-1 form of BPOC is more stable than keto and enol-2 forms. Hydrogen bonding investigation including Natural bond orbital analysis (NBO) for all the tautomeric structures was employed to compare intra-molecular interactions. The energies of HOMO and LUMO molecular orbitals for all tautomeric forms of BPOC were predicted. Normal Coordinate Analysis (NCA) was carried out for the enol-1 to assign vibrational bands of IR and Raman spectra. The scaling factors were calculated as 0.9721, 0.9697 and 0.9685 for B3LYP, X3LYP and B3PW91 methods, respectively. The correlation graphs of experimental versus calculated vibrational wavenumbers were plotted and X3LYP method gave better frequency agreement than the others. (C) 2016 Elsevier B.V. All rights reserved

An alternative method for restoring opposition after median nerve injury: an anatomical feasibility study for the use of neurotisation

Opposition, one of the most important functions of the hand, is lost or impaired after median nerve injury. Complete recovery does not always occur after treatment, and various techniques of opponensplasty are used for restoring opposition. This study was performed in order to develop an alternative method for selective restoration of thenar muscle function. Ten arms from 5 cadavers were used. The median nerve with its thenar motor branch (Tb) and the anterior interosseous nerve with its motor branch to pronator quadratus (PQb) were prepared in the distal forearm. The mean widths and the number of myelinated fibres of these nerves were: PQb 1.3±0.10 mm, Tb 1.4±0.12 mm and PQb 912±88 mm, Tb 1020±93 mm. The minimum necessary distance from the distal flexor crease of the wrist for neurotisation of the Tb by the PQb was 60±5.41 mm. It was concluded that PQb-Tb neurotisation would be possible anatomically. The advantages are that motor function is reestablished with a motor nerve, the diameters and the number of myelinated fibres of both nerves are similar, the loss of function after denervation of the pronator quadratus is slight and opponensplasty still remains as a final option

A Morphometric and Morphological Analysis of Plantaris in Fetal Cadavers

Objective: The plantaris is a muscle in the back of the leg that has a short body and a long, thin tendon. The muscle acts functionally with the gastrocnemius. Due to removal of the muscle does not cause a change in limb function, it is used as a potential source of graft. The aim of the present study was to investigate the morphological features and possible variations of plantaris in fetal cadavers.Methods: This study was carried out on the fetal cadaver collection of University of Necmettin Erbakan, Faculty of Medicine, Anatomy Department. 11 male and 9 female fetal cadavers (ages range: 28 to 40 weeks) were used. The muscle belly length (LB), width (WB) and thickness (TB) were measured. The plantaris insertion was classified into 4 types. Furtermore, the distal part of the tendon was classified as the fan-shaped and flat-shaped.Results: It was determined that plantaris was present in 36 of 40 (90%) lower extremities and absent in 4 (10%). The average muscle belly length (LB), width (WB) and thickness (TB) was found 13.29±3.73 mm, 4.72±1.77 mm and 3.65±1.17 mm, respectively. It was observed that the plantaris tendon often (Type 2, 67.5%) inserts in the anteromedial of the calcaneal tendon. Furthermore, the most common insertion type was observed as flat-shaped (86.11%). Conclusion: We believe that the data obtained from our study will be useful in procedures such as flexor tendinoplasties, reconstruction of hand tendons and lateral ankle ligaments, and repair of atrioventricular valves, which are planned to be performed in infancy and childhood

Possibility of Middle Meningeal Artery-to-Petrous Internal Carotid Artery Bypass: An Anatomic Study

The possibility of creating a middle meningeal artery (MMA)-to-petrous internal carotid artery (ICA) bypass was investigated in six cadavers (bilaterally). Such a procedure could be used to treat patients with high cervical vascular lesions and those with tumors of the infratemporal fossa invading the high cervical ICA. After a frontotemporal craniotomy, the foramen spinosum and foramen ovale were exposed extradurally. Immediately posterior to the foramen ovale and medial to the foramen spinosum, the petrous portion of the ICA was exposed with a diamond-tipped drill. The MMA was lifted from its groove, and a sufficient length was transected to perform a bypass with the petrous ICA medially. The mean width of the MMA at the site of anastomosis was 2.3 ± 0.35 mm. The mean length of MMA from the foramen spinosum to the site of the anastomosis was 9.6 ± 1.7 mm. Based on these measurements, width and length of MMA appear to be sufficient for a bypass with petrous ICA