Daha Güvenli Bir Transsfenoidal Yaklaşım için Sfenoid Deliklerin Üç Boyutlu Anatomik Kılavuz Noktaları

AIm: The sphenoid ostium (SO) is an anatomical reference in transsphenoidal approach surgery. mATERIAl and mEThods: The morphological features of the SO were studied in 352 skull base by 3D-Doctor Demo version. REsulTs: The mean diameters of the SO were measured as 5.8 ± 1.3 mm (right) and 5.9 ± 1.2 mm (left), respectively. The mean distance from the SO to the midline was measured as 2.3 ± 1.1 mm (right) and 1.8 ± 0.9 mm (left), respectively. 8 bones had SO on one side, whilst 4 bones had no SO. In 5 bones there was a double SO structure on one side. 74.4% of ovoid SO specimens have the largest perimeter, therefore, allow the highest degree of surgical success. It was noted that they were not symmetrical (21.8%). Openings were found to be at different distances from the midline, some at different distances from the floor; in addition, differently shaped openings, as well as those with an opening absent on one side or with double openings, were observed. CoNClusIoN: Separate coordinates and safe routes must be calculated for right and left openings. The SO analysis could eliminate some of standardization measurements of an exposed surgical areaAmAÇ: Sfenoid ostium (SO), transsfenoidal yaklaşımlı cerrahide anatomik bir referanstır. yÖNTEm ve GEREÇlER: SO morfolojik özellikleri 3D-Doctor Demo versiyonu ile 352 kafa kaidesinde çalışıldı. BulGulAR: Ortalama SO çapı 5,8 ± 1,3 mm (sağ) ve 5,9 ± 1,2 mm (sol) olarak ölçüldü. SO'dan orta hatta kadar ortalama mesafe 2,3 ± 1,1 mm (sağ) ve 1,8 ± 0,9 mm (sol) olarak ölçüldü. 8 kemikte SO tek taraflı iken 4 kemikte SO yoktu. 5 kemikte bir tarafta çift SO yapısı bulunmaktaydı. Ovoid SO numunelerinin %74,4'ü en büyük perimetreye ve böylece en yüksek cerrahi başarı derecesine sahipti. Bunların simetrik olmadığı (%21,8) görüldü. Açıklıklar orta hattan farklı mesafelerde ve bazıları zeminden farklı mesafelerdeydi; ayrıca farklı büyüklükte şekiller ile birlikte bir tarafta açıklık olmayanlar veya çift açıklığı olanlar gözlendi. TARTIşmA: Sağ ve sol açıklıklar için farklı koordinatlar ve güvenli yollar hesaplanmalıdır. SO analizi, açığa çıkarılmış bir cerrahi alanın standardizasyon ölçümlerinin bazılarını ortadan kaldırabili

Three-Dimensional Anatomical Landmarks of the Sphenoid Ostium for a Safer Transsphenoidal Approach

WOS: 000352928500004PubMed ID: 26014003AIM: The sphenoid ostium (SO) is an anatomical reference in transsphenoidal approach surgery. MATERIAL and METHODS: The morphological features of the SO were studied in 352 skull base by 3D-Doctor Demo version. RESULTS: The mean diameters of the SO were measured as 5.8 1.3 mm (right) and 5.9 1.2 mm (left), respectively. The mean distance from the SO to the midline was measured as 2.3 1.1 mm (right) and 1.8 0.9 mm (left), respectively. 8 bones had SO on one side, whilst 4 bones had no SO. In S bones there was a double SO structure on one side. 74.4% of ovoid SO specimens have the largest perimeter, therefore, allow the highest degree of surgical success. It was noted that they were not symmetrical (21.8%). Openings were found to be at different distances from the midline, some at different distances from the floor; in addition, differently shaped openings, as well as those with an opening absent on one side or with double openings, were observed. CONCLUSION: Separate coordinates and safe routes must be calculated for right and left openings. The SO analysis could eliminate some of standardization measurements of an exposed surgical area

A Morphometric Study of the Inferior Orbital Fissure Using Three-Dimensional Anatomical Landmarks: Application to Orbital Surgery

WOS: 000269359800002PubMed ID: 19670289The inferior orbital fissure (IOF) is an important structure during orbital surgery, however, neither its anatomical features nor the procedures necessary to expose the IOF have been examined in detail. A morphometric analysis of the IOF was performed on 232 orbits using computer software. The longest and shortest borders of the IOF were 18.2 +/- 4.9 and 1.9 +/- 1.3 mm, respectively. The outer and the inner angles were 138.9 +/- 32.7 degrees and 38.4 +/- 24.7 degrees, respectively. The perimeter of the IOF was 50.6 +/- 13.5 mm and its area was 61.3 +/- 39.1 mm(2). Eight types of IOF were observed. Type 1 IOF was observed in 42.2% and the Type 2 IOF was identified in 15.9%. A statistically significant relation was found between the longest edge and area and the widest edge and area of the IOF. The findings of our study suggest that the removal of the lateral wall should begin inferiorly, just lateral to the IOF and extended superolaterally. These data may be useful during surgical approaches to the orbit. Clin. Anat. 22:649-654, 2009. (C) 2009 Wiley-Liss, Inc

The vascular anatomy of the lumbrical muscles in the hand

WOS: 000250073500006PubMed ID: 17825776The lumbrical. muscles are located in the midpalm, dorsal to the palmar aponeurosis. The main function of these muscles is an indirect contribution to interphalangeal joint extension by decreasing the flexor effect of the flexor digitorum profundus muscle. Due to their minor biomechanical. functions and suitable constructions, these muscles have been preferred in reconstructive surgery as local transposition flaps or pedicled flaps. Despite the surgical and clinical importance, vascular anatomical studies of these muscles are not well represented in the current literature. This study was performed in the Department of Anatomy of the Faculty of Medicine of the Ege University. Thirty-four cadaver hands, injected with red-coloured latex were used, and we aimed to describe the morphometry and vascular anatomy of the lumbrical, muscles. We measured the length and width of the muscles, after removing their epimisium, and the diameter and length of the arteries to the muscles. The outcomes of our study determined that the length and width of the lumbrical. muscles were reduced significantly from radial towards ulnar sides. The lumbrical muscles were supplied from both their palmar and dorsal surfaces by both superficial and deep palmar arches and/or their branches. We also described the level. of entry of the dominant arteries for each lumbrical muscle and measured the size of the vessels and muscles to guide some surgical approaches. This anatomical study could guide for some surgical approaches and reduce the deficiency about the vascular anatomical patterns of the lumbrical muscles in the literature. (c) 2006 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All. rights reserved