Branching pattern of marginal mandibular nerve-an anatomical study

Background: Marginal Mandibular nerve, a branch of facial nerve, emerges at the lower part of the anterior border of parotid gland. It supplies risorius, muscles of lower lip and chin and joins mental nerve. This nerve has an important relationship with the lower border of mandible and is likely to be damaged during procedures in or around the submandibular area and can lead to certain morbid conditions like deviation of angle of mouth, drooling of saliva and difficulty in phonation.Methods: Sixty formalin preserved specimens of head and neck were used for studying the branching pattern of marginal mandibular nerve. The present study was conducted in the department of Anatomy Govt Medical College Srinagar over a period of two and a half years from 2015 to 2017. Cadaveric dissection was also used in the study during the routine teaching of undergraduate MBBS and BDS students in the department. The photographs of the variations seen during the study were taken.Results: In Forty-seven specimens (78.33%) there was a single branch of marginal mandibular nerve, in 10 specimens (16.6%) there were two branches of marginal mandibular nerve and in three specimens (5.0%) the marginal mandibular nerve was having three branches.Conclusions: From the above study it was concluded that marginal mandibular nerve can have two or three branches. Therefore, it is advisable to take due care during surgical procedures in the lower part of face and upper part of neck to preserve marginal mandibular nerve and to ensure cosmesis and prevent morbidity

Angiographic anatomy of the coronary sinus venous system in adult Kashmiri population

Background: Knowledge of the coronary sinus venous anatomy is an important factor because of its relevance in electrophysiological procedures such as chronic resynchronisation therapy, mapping and ablation of arrhythmias. The advent of advanced invasive and interventional cardiac treatment and management tools for common disorders like heart failure has made understanding of coronary sinus anatomy necessary. The aim was to study the angiographic anatomy of coronary sinus and its tributaries in adult Kashmiri population and provide anatomical basis for cannulation of coronary sinus and its tributaries.Methods: Authors analysed the levophase angiogram of 150 subjects undergoing routine coronary angiography in the right anterior oblique and left anterior oblique view with the necessary caudal or cranial angulations.Results: The coronary sinus was formed by the union of GCV+LMV in 93.3% of subjects and by the union of GCV+PLV in 6.7% of subjects. The GCV and the MCV were the most consistent tributaries present in all the subjects. The mean length of CS was 71.70±9.7 mm when it was formed by GCV+LMV and 70.18±14.98 mm in case of GCV+PLV. The diameter of the CS ostium was 8.48±1.21mm. The mean diameter of GCV was 2.90±1.24 mm, MCV was 2.76±1.08 mm, LMV was 2.23±0.51 mm and the PLV was 2.25±0.53 mm. The opening angle of GCV was obtuse in all the cases, MCV drained at an acute angle in 62% subjects and LMV draining angle was acute in 31.33% cases. The valve of the CS was present in 32.7% subjects and absent in 67.3% subjects. The tortuosity was absent in 75.3%. The distance between CS ostium and the ostium of the vein ideal for lead implantation was between 10-40 mm in 76% subjects.Conclusions: The basic knowledge of coronary sinus and its tributaries play a significant role during electrophysiological procedures. The data obtained from the study can be utilised by interventional cardiologist for cannulation of coronary sinus in Kashmiri population