An osteologic study of human ethmoidal foramina with special reference to their classification and symmetry

The present investigation was designed to study the anatomy of the ethmoidal foramina in adult human dry skulls. In addition to investigate the number of ethmoidal foramina that can be found on the orbital wall, we also addressed their classification and symmetry. The analysis of 1089 orbits demonstrated that the average number of ethmoidal foramina/orbit was 2.07 (range 0 to 4). As for their classification, we devised the relative depth index (RDI) to differentiate the anterior from the posterior ethmoidal foramina. The index represents the ratio “distance of the foramen from the anterior lacrimal crest/length of the medial orbital wall”. The average index of the anterior and posterior ethmoidal foramina were 0.53±0.04 and 0.84±0.06 respectively. As the mean of the two indexes was 0.685, we used the latter value as a sort of numerical watershed to define the domains of the anterior and of the posterior ethmoidal foramina on the orbital wall. Thus all ethmoidal foramina with an RDI ≤ 0.68 were considered anterior ethmoidal foramina and all ethmoidal foramina with an RDI ≥ 0.69 were considered posterior ethmoidal foramina. In this way it is possible to properly classify foramina on orbits with 1, 3 or 4 ethmoidal foramina. As for their symmetry, in contrast to what had been previously reported, we observed that in most cases ethmoidal foramina have a highly symmetric arrangement both in terms of number of foramina on fellow orbits and of position along the orbital wall

Investigation of accessory transverse foramen in dry cervical vertebrae: incidence, variations, types, locations, and diagnostic implications

Abstract Background This research aimed to determine the incidence, variations, types, and potential locations of the accessory transverse foramen (ATF) in dry cervical vertebrae. A total of 250 Turkish dry cervical vertebrae were examined, with 500 transverse foramina investigated. The cervical vertebrae were categorized into five groups (C3–C7), and each cervical vertebra was assessed bilaterally to determine the location, incidence, and side of the ATF. Results ATF was observed in 21 vertebrae (8.4%) and was distributed posteriorly (76.2%), posterolaterally (19.04%), and posteromedially (4.8%) in relation to the location of the TF. The incidence of ATF was 4.8% in C3, 28.6% in C4, 9.5% in C5, 23.8% in C6, and 33.3% in C7. Furthermore, a statistically significant difference was observed in the unilateral or bilateral occurrence of the ATF (F = 3.079; p = 0.047, p < 0.05). Conclusions In this study, we have presented an investigative approach and discussed the potential implications of identifying the ATF in dry cervical vertebrae. The presence of ATF can be crucial in the diagnosis of variations in the vertebral artery (VA) and underlying disorders, potentially aiding in the determination of the cause of death or ancestry. Additionally, the posterior location of the ATF and its asymmetric distribution should be taken into account when evaluating dry cervical vertebrae, which may offer valuable information for the identification of variations

Branching Patterns and Variations of Facial Artery and Clinical Importance: A Cadaveric Study

Introduction: The facial artery (FA) was observed with distinctive variations and anomalous, which occur during the embryological developmental process due to the ablation of neural crest cells that impact embryonic aortic arch vessels, resulting in distinctive branching patterns. Therefore, this study aimed to investigate the types, clinical importance, localization, and differences of FA in fixed cadavers according to gender and body side. Methods: The current study was conducted on 19 formalin-fixed cadavers (68.4% males, n = 13; 31.6% females, n = 6). The types, variations, prevalence, and distance to nearby surgical landmarks of FA were recorded on both sides. Measurements were taken with a surgical microscope (Zeiss Meditec, Berlin, Germany) and a digital caliper (INCA, DCLA-0605, 0.6–150 mm). Results: Angular type % 73.1 (n = 14, right; n = 19, left), labial type % 5.3 (n = 1, right), alar type % 5.3 (n = 1, right), and nasal type % 5.3 (n = 1, right) were detected. The following parameters were significant according to gender; the distance between the ala of the nose and the origin of the FA on both sides (p = 0.007 right; p = 0.018 left), the diameter of FA at the cheilion (p = 0.019 left), diameters of the superior and inferior labial arteries at their origin (p = 0.031 right; p = 0.025 right) and PO lines. Conclusion: The significant differences in gender according to the distance of the FA and its branches from the origin should be considered to reduce complications during surgery. The differences in studies according to the types and variations of FA may be due to the scale of the study, gender, or study design

Superior Oblique Anterior Transposition with Horizontal Recti Recession-Resection for Total Third-Nerve Palsy

Aims. To report the results of lateral rectus muscle recession, medial rectus muscle resection, and superior oblique muscle transposition in the restoration and maintenance of ocular alignment in primary position for patients with total third-nerve palsy. Methods. The medical records of patients who underwent surgery between March 2007 and September 2011 for total third-nerve palsy were reviewed. All patients underwent a preoperative assessment, including a detailed ophthalmologic examination. Results. A total of 6 patients (age range, 14–45 years) were included. The median preoperative horizontal deviation was 67.5 Prism Diopter (PD) (interquartile range [IQR] 57.5–70) and vertical deviation was 13.5 PD (IQR 10–20). The median postoperative horizontal residual exodeviation was 8.0 PD (IQR 1–16), and the vertical deviation was 0 PD (IQR 0–4). The median correction of hypotropia following superior oblique transposition was 13.5 ± 2.9 PD (range, 10–16). All cases were vertically aligned within 5 PD. Four of the six cases were aligned within 10 PD of the horizontal deviation. Adduction and head posture were improved in all patients. All patients gained new area of binocular single vision in the primary position after the operation. Conclusion. Lateral rectus recession, medial rectus resection, and superior oblique transposition may be used to achieve satisfactory cosmetic and functional results in total third-nerve palsy

An endoscopic cadaveric study: Accessory maxillary ostia

Objective: Endoscopy is now being used for diagnosis and surgical treatment of disorders of the nose and paranasal sinuses. Direct observations of mucociliary clearance patterns have shown that there are clear cut pathways in the sinuses, with secretions always trying to leave through the natural ostia.' Maxillar ostia is exists behind the upper part of the medial wall and often at intersection region of the rear lower infindubulum and lower front surface of the ethmoid bulla. Accessory ostium exists at the 25-30% of the general population instead of the natural ostium. There are some features that differentiate the accessory ostium and natural ostium. Methods: To determine the incidence and location of the accessory ostium 29 fromaldehyde fixed adult cadaver was examined with endoscope. Results: The accessory ostium is encountered at 8 cases (13.8%). These are located at rare-middle, front-middle and rear in 2 (0.03%), 3 (0.05%), 3 (0.05%) cases respectively. Recognition of the maxillary ostia is tedious while performing endoscopic procedures which accounts for a high rate of orbital complications for a novice performing surgery in this region. Conclusion: It is therefore imperative to know the landmarks in this regions which may be obliterated by disease. Radiologist should be aware of this entity as it can appear as communication between the maxillary sinus and nasal cavity on sinus imaging examinations

Effect of Pulsed and Continuous Ultrasound Therapy on the Degree of Collateral Axonal Branching at the Lesion Site, Polyinnervation of Motor End Plates, and Recovery of Motor Function after Facial Nerve Reconstruction

The aim of the present study is to test whether ultrasound therapy of muscles denervated by nerve injury would improve the quality of their reinnervation by reduction of the collateral axonal branching at the lesion site and poly-innervation degree at the neuromuscular junctions. After transection and suture of the buccal branch of the facial nerve, pulsed or continuous type of ultrasound therapy was applied to the paralyzed whisker pad muscles of rats in the course of 2 months. Instead of reduction, we found a significant increase in the collateral axonal branching after continuous ultrasound therapy when compared to the branching determined after pulsed or sham ultrasound therapy. Both types of ultrasound therapy also failed to reduce the proportion of polyinnervated end plates in the reinnervated facial muscles. Accordingly, continuous ultrasound therapy failed to restore any parameter of the motor performance of the vibrissal hairs. Application of pulsed ultrasound therapy promoted slight improvements of the functional parameters angular velocity and acceleration. The inhomogeneous structural and functional results achieved after both types of ultrasound therapy let us conclude that further studies are required to evaluate its effects on peripheral nerve regeneration. Anat Rec, 302:1314-1324, 2019. (c) 2019 Wiley Periodicals, Inc