MORPHOLOGICAL PECULIARITIES AND VARIABILITY OF THE MARGINAL MANDIBULAR BRANCH

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Ramura marginală a mandibulei (RMM) frecvent este unică, fapt ce determină o susceptibilitate sporită a acesteia la leziunile iatrogene. Scopul lucrării. Determinarea particularităților morfologice ale RMM în dependență de gen, lateralitate și tipul antropometric al capului. Material și Metode. Studiul a fost realizat pe un lot de cadavre umane formolizate din fondul Catedrei de anatomie și anatomie clinică a USMF „Nicolae Testemițanu”, care a inclus 75 de hemi-fețe (59 bărbați/16 femei). Variabilele calitative și cantitative au fost procesate prin metodele statisticii descriptive și inferențiale în programul Excel 2016. Rezultate. În 54,7% a fost depistată doar o singură RMM; 2 RMM – 38,7%; 3 RMM – 5,3%; 4 RMM – 1,3%. La bărbați RMM a variat bilateral între 1-3 ramuri, cu o medie de 1,5 RMM, iar la femei între 1-2 ramuri pe dreapta și 1-4 ramuri pe stânga, media fiind de 1,6 RMM; pe criteriul de gen p = 0,845. Pe hemi-fețele din dreapta media a fost de 1,4 RMM, iar pe cele din stânga – 1,6 RMM, p = 0,204. Mezocefalii au avut o medie a RMM de 1,47 ± 0,68 (IÎ 95% = 1,47 ± 0,18), brahicefalii – 1,63 ± 0,52 (IÎ 95%1,63 ± 0,36) și dolicocefalii – 1,89±0,60 (IÎ 95% = 1,89 ± 0,39), varianța frecvenței intergrupale a fost de 1,698, gl = 2, p = 0,190. În 5,3% cazuri a fost depistată o variantă inedită a originii RMM de la ramura temporofacială. Concluzii. Variabilitatea numerică a RMM la bărbați a fost mai joasă decât la femei, iar pe criteriul lateralității RMM a prevalat pe partea stângă. Cea mai înaltă valoare medie s-a atestat la dolicocefali, iar cea mai joasă la mezocefali. Cunoașterea variantelor RMM are o importanță clinică majoră pentru chirurgia capului și gâtului.Background. The marginal mandibular branch (MMB) often is a single branch, thus increasing its susceptibility to iatrogenic lesions. Objective of the study. The purpose of our study was to determine the variability and morphological specific features of the MMB dependent on gender, side of the body and anthropometric type of the head. Material and Methods. The study was carried out at the Department of anatomy and clinical anatomy of Nicolae Testemitanu University on 75 formalized cadaveric hemi-heads (59 male/16 female). The quantitative and qualitative variables were analysed by Excel 2016 processing program, using the methods of descriptive and inferential statistics. Results. In 54.7% of cases a single MMB was marked out; 2 MMB – 38.7%; 3 MMB – 5.3%; 4 MMB – 1.3%. In male individuals MMB bilaterally varied between 1-3 branches, with a mean value of 1.5 MMB, and in female the variation on the right side was 1-2 MMB, and on the left side 1-4 MMB, with a mean of 1.6 MMB; for gender criterion p = 0.845. On the right hemi-heads the mean number of MMB was 1.4 MMB, and on the left side it was 1.6 MMB, p = 0.204. In mesocephalic cadavers the mean number of MMB was 1.47 ± 0.68 (CI 95% = 1.47 ± 0.18), in brachicephalic – 1.63 ± 0.52 (CI 95%1.63 ± 0.36), and in dolichocephalic – 1.89 ± 0.60, (CI 95% = 1.89 ± 0.39), the variance of frequency between groups was 1.698, df = 2, p = 0.190. In 5.3% of cases, an unusual variant of MMB origin from the temporofacial division of the facial nerve was established. Conclusion. The number variability of the MMB in male was lower than in female, and by laterality criterion, the number of the MMB prevailed on the left side. The highest mean value was determined in dolichocephalic individuals, and the lowest in mesocephalic ones. The variability of the MMB is of a great clinical significance for the head and neck surgery

Particularitățile morfologice și variabilitatea ramurii marginale a mandibulei

Background. The marginal mandibular branch (MMB) often is a single branch, thus increasing its susceptibility to iatrogenic lesions. Objective of the study. The purpose of our study was to determine the variability and morphological specific features of the MMB dependent on gender, side of the body and anthropometric type of the head. Material and Methods. The study was carried out at the Department of anatomy and clinical anatomy of Nicolae Testemitanu University on 75 formalized cadaveric hemi-heads (59 male/16 female). The quantitative and qualitative variables were analysed by Excel 2016 processing program, using the methods of descriptive and inferential statistics. Results. In 54.7% of cases a single MMB was marked out; 2 MMB – 38.7%; 3 MMB – 5.3%; 4 MMB – 1.3%. In male individuals MMB bilaterally varied between 1-3 branches, with a mean value of 1.5 MMB, and in female the variation on the right side was 1-2 MMB, and on the left side 1-4 MMB, with a mean of 1.6 MMB; for gender criterion p = 0.845. On the right hemi-heads the mean number of MMB was 1.4 MMB, and on the left side it was 1.6 MMB, p = 0.204. In mesocephalic cadavers the mean number of MMB was 1.47 ± 0.68 (CI95% = 1.47 ± 0.18), in brachicephalic – 1.63 ± 0.52 (CI95%1.63 ± 0.36), and in dolichocephalic – 1.89 ± 0.60, (CI95% = 1.89 ± 0.39), the variance of frequency between groups was 1.698, df = 2, p = 0.190. In 5.3% of cases, an unusual variant of MMB origin from the temporofacial division of the facial nerve was established. Conclusion. The number variability of the MMB in male was lower than in female, and by laterality criterion, the number of the MMB prevailed on the left side. The highest mean value was determined in dolichocephalic individuals, and the lowest in mesocephalic ones. The variability of the MMB is of a great clinical significance for the head and neck surgery.Introducere. Ramura marginală a mandibulei (RMM) frecvent este unică, fapt ce determină o susceptibilitate sporită a acesteia la leziunile iatrogene. Scopul lucrării. Determinarea particularităților morfologice ale RMM în dependență de gen, lateralitate și tipul antropometric al capului. Material și Metode. Studiul a fost realizat pe un lot de cadavre umane formolizate din fondul Catedrei de anatomie și anatomie clinică a USMF „Nicolae Testemițanu”, care a inclus 75 de hemi-fețe (59 bărbați/16 femei). Variabilele calitative și cantitative au fost procesate prin metodele statisticii descriptive și inferențiale în programul Excel 2016. Rezultate. În 54,7% a fost depistată doar o singură RMM; 2 RMM – 38,7%; 3 RMM – 5,3%; 4 RMM – 1,3%. La bărbați RMM a variat bilateral între 1-3 ramuri, cu o medie de 1,5 RMM, iar la femei între 1-2 ramuri pe dreapta și 1-4 ramuri pe stânga, media fiind de 1,6 RMM; pe criteriul de gen p = 0,845. Pe hemi-fețele din dreapta media a fost de 1,4 RMM, iar pe cele din stânga – 1,6 RMM, p = 0,204. Mezocefalii au avut o medie a RMM de 1,47 ± 0,68 (IÎ95% = 1,47 ± 0,18), brahicefalii – 1,63 ± 0,52 (IÎ95%1,63 ± 0,36) și dolicocefalii – 1,89±0,60 (IÎ95% = 1,89 ± 0,39), varianța frecvenței intergrupale a fost de 1,698, gl = 2, p = 0,190. În 5,3% cazuri a fost depistată o variantă inedită a originii RMM de la ramura temporofacială. Concluzii. Variabilitatea numerică a RMM la bărbați a fost mai joasă decât la femei, iar pe criteriul lateralității RMM a prevalat pe partea stângă. Cea mai înaltă valoare medie s-a atestat la dolicocefali, iar cea mai joasă la mezocefali. Cunoașterea variantelor RMM are o importanță clinică majoră pentru chirurgia capului și gâtului

Topographic and morphometric aspects of the internal jugular vein

Background. Lately, due to the increasing number of intravascular manipulations, the internal jugular vein (IJV) is more frequently punctured and catheterized, and success of that procedure very much depends on IJV relationship with the common carotid artery (CCA), especially when are known its atypical positions. The topographical and morphometric peculiarities of the IJV were studied according to gender and laterality in patients undergoing Doppler sonographic examination. Materials and methods. The blood vessels of the neck of 134 patients, without vascular pathology, were examined by Doppler sonography. The examination protocols and Doppler images were taken from the electronic database of the MSPI Republican Center of Medical Diagnostics, Chisinau, Republic of Moldova. The obtained data were statistically processed and the arithmetic mean and standard deviation were calculated. Results. Five types of the IJV position towards CCA were identified: anterolateral position – 38.0% (14.2%/23.8% – male/female); lateral position – 35.0% (20.9%/14.1% – male/female); posterolateral position – 20.9% (17.2%/3.7% – male/female); posterior position – 5.2% (4.3%/0.9% – male/female) and medial position – 0.7%, established only in males. IJV described a straight trajectory in 77.6% (43.3%/34.3% – male/female), and in 22.4% (14.2%/8.2% – male/female) – it was tortuous. The average length of the IJV constituted 14.8±0.56 cm; in male – 15.0±0.62 cm, and in female – 14.2±0.44 cm; on the right side it was 14.9±0.6 cm, and on the left one – 14.4±0.52 cm. The diameter of the IJV, in its middle portion, was 15.1±0.49 mm; in male – 15.5±0.53 mm, and in female – 14.7±0.33 mm; on the right side in 66.4% the length was 15.7±0.56 mm, and for the remaining 33.6% it was 13.8±0.29 mm, similar with that of the left IJV. The thickness of IJV wall was 0.35 ±0.08 mm; in male – 0.45±0.09 mm, and in female – 0.3±0.09 mm. Conclusions. The most frequent position of the IJV towards CCA in female was the anterolateral one, and in male was the lateral position. The morphometric parameters of the right IJV had higher values

The morpho-clinical features of multiple sclerosis

Background. Multiple sclerosis (MS) is a chronic non-traumatic disease of the central nervous system, heterogeneous, affecting young people. The forms of evolution and clinical manifestation of MS were estimated according to gender and age. Materials and methods. The studied group consisted of 39 patients with MS, hospitalized in the "Diomid Gherman" Institute of Neurology and Neurosurgery. The study was based on the research and analysis of the medical observation charts taken from the archive of the nominated institution. Descriptive statistical methods were used to process the obtained data. Results. It was found: that 35.9% were men aged between 24-42 years, the average age being 29.3±1.6 years, and 64.1% were women - aged between 18-47 years, and the average age being 26, 4±2.1 years. The male: female ratio was 1:1.8. According to age categories: under 20 years – 20.5% (7.7% men, 12.8% women); 21-30 years – 41% (12.8% men, 28.2% women); 31-40 years – 25.6% (10.2% men and 15.4% women); 41-50 years – 12.8% (5.1% men and 7.7% women). Clinical manifestations: sensitivity disorders: in 64.1% of patients; visual disturbances – at 59%; cerebellar disorders – at 51.3%; motor disorders – at 30.8%. Clinical forms of disease evolution: relapsing-remitting multiple sclerosis (RRMS) – in 59% (18% men and 41% women); primaryprogressive multiple sclerosis (PPMS) – in 18% (7.7% men and 10.3% women); secondaryprogressive multiple sclerosis (SPMS) – in 12.8% (2.6% men and 10.2% women); progressive relapsing multiple sclerosis (PRMS) – in 10.3% (7.7% men and 2.6% women). Patients with RRMS endured from 1 to 5 flares, the average being 3.5 flares; those with PPMS – from 1 to 7 flares, an average of 4.8; those with SPMS and PRMS – 2-3 flares, which are maintained for quite a long time. Conclusions. The average age of patients with MS was 26.4±2.1 years, the most numerous being from the 21-30 age category, with a male: female ratio of 1:1.8. The majority of patients with MS showed a polymorphous clinical picture, more frequently showing sensory, visual and cerebellar disorders

Specific features of the internal acoustic meatus

Background. The anatomical specific features of the internal acoustic meatus (IAM) are of high clinical significance in surgical access of the medial cranial fossa and in otologic surgery. The purpose of our study was to establish the anatomical variants and morphometric parameters of the internal acoustic opening (IAO) and of the IAM for a better comprehension of the course of the meatal segment of the facial nerve. Material and Methods. The research was carried out on 82 dry temporal bones (41 right and 41 left) of unknown age and gender. The bones belonged to the Department of anatomy and clinical anatomy of Nicolae Testemitanu SUMPh. The external shape, length and angles that formed between the longitudinal axis of the temporal bone pyramid (LAP) and the anterior and posterior walls of the IAM were examined and measured by a ruler, a protractor and a vernier caliper. The descriptive and inferential methods of statistical analysis were used. Results. The shape of the IAO varied from transverse and vertical oval shapes, to heart-like, semioval and quadrangular ones. In some cases, a partial or total septum of the IAM were revealed. The mean value of the transverse diameter (TD) of the IAO was 7.7±2.11 mm. On the right side the mean was 8.2±2.22, and on the left – 7.2±1.89 mm, p=0.031. The mean value of the vertical diameter (VD) of the IAO was 5.3±1.43 mm. On the right bones the mean was 5.6±1.58, and on the left ones – 5.0±1.22 mm, p=0.082. The mean length of the IAM was 10.1±2.83. On the right side the mean was 10.5±2.96, and on the left – 9.7±2.67 mm, p=0.214. The mean value of the angle that forms between the anterior wall of the IAM and the LAP was 21.4±13.67°. On the right side the mean was 22.2±14.62°, and on the left – 20.5±12.78°, p=0.564. The mean value of the angle formed between the posterior wall of the IAM and LAP was 82.4±8.02°. On the right bones the mean was 84.3±7.93, and on the left ones, it was 80.5±7.76°, p=0.032 Conclusions. Both the IAO and the IAM were variable. The morphological variants were characteristic for both sides’ samples. All the examined parameters were higher on the right temporal bones

The morphofunctional peculiarities of the esophago-gastric junction in clinical aspect

Background. The esophago-gastric junction (EGJ) has a physiological sphincter that enables the passage of the alimentary bolus and prevents the gastroesophageal reflux (GER). The medical community highlighted this junction as an important clinico-anatomical entity, due to its morphopathological substrate for several diseases, one of them being the gastroesophageal reflux disease (GERD). In order to determine the pathogenic link between the morphological structure of the EGJ and onset of the GERD, the patients were examined by paraclinical methods. Materials and methods. The study was carried out on 250 patients, hospitalized at the MSPI CRH "Timofei Mosneaga" during the years 2019-2022. The endoscopic and radiological results were taken from the observation sheets of the patients and were statistically analysed. Results. The patients included into the study were aged between 19-73 years (with a mean age of 55.5±2.3 years). The endoscopic examination was carried out on 121 patients (48.4%) and the radiological examination on 129 (51.6%). By endoscopic examination, non-erosive GERD was established in 62.8% of patients (with a mean age of 41.8±0.8 years) and erosive GERD – in 37.2% of patients (with a mean age of 48.02±0.5 years). The diagnosis of the erosive GERD was established depending on the degree of the mucosal changes. Non-confluent unique erosions were identified in 22.2% (degree I); confluent erosions with partial lesion of the mucosa – 33.4% (degree II); ulcerative lesions of the lower 1/3 of the esophageal mucosa – 24.4% (degree III); chronic peptic ulcer of the esophagus – 20% (degree IV). The incompetence of the inferior esophageal sphincter (IES), diagnosed endoscopically had the following rate: degree I – 28.3%, degree II – 33.9% and degree III – 37.8%. By barium sulfate x-ray examination were determined the types of the GER: high level (up to the C6 vertebra) – in 29.4%; middle level (up to T6) – 47.3%, and low level (up to T11-12) – 23.3%. Conclusions. GERD is onset in case of incapacity of the anti-reflux mechanisms. In 2/3 of the endoscopically examined patients, a II-nd and III-rd degree failure of the IES was determined; in 1/2 of the radiologically examined patients a medium degree of the GER; in 1/4 – a high degree was revealed. Both endoscopic and radiological, diagnostic methods, are up-to-date and useful in GERD diagnostics

APLICATIVE ASPECT OF THE AXILLARY ARTERY

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Tot mai frecvent în efectuarea coronarografiei este punctată artera axilară (AA). Cateterizarea ei oferă mai multă siguranță pentru obținerea accesului la sistemul vascular, deoarece este localizată în apropierea bulbului aortal și deține o presiune arterială mai fiabilă. Scopul lucrării. Studierea aspectului topografic al arterei axilare și identificarea unui reper osos necesar în realizarea abordului acesteia. Material și Metode. Studiu retrospectiv, descriptiv. S-a studiat AA pe 30 membre superioare colectate de la cadavre adulte formolizate și pe 90 angiografii preluate din baza de date a arhivei Centrului Medical „Euromed Diagnostic”. Prin disecția anatomică s-a urmărit topografia porțiunilor AA, iar prin analiza înscrierilor angiografice – cavitatea glenoidală în calitate de reper osos. Rezultate. S-a stabilit că, AA în porțiunile supra- și retropectorală este acoperită din toate părțile de fasciculele plexului brahial, iar în porțiunea ei infrapectorală, proximal de originea arterei subscapulare – nu este traversată din anterior de nici unul din acestea. În raport cu marginea inferioară a cavității glenoidale (CG), originea arterei subscapulare în 62,2% s-a determinat cu 5,0 mm distal de reperul dat; în 24,4% – cu 6-10 mm, iar în 13,4% – cu 11,0-20,0 mm inferior de el. Distanța de la cel mai distal punct de pe marginea inferioară a CG și marginea laterală a arterei axilare în mediu a constituit 10 mm. Concluzii. (1) Cel mai potrivit punct de acces în punctarea și cateterizarea AA este extremitatea proximală a porțiunii ei infrapectorale. (2) Pentru determinarea nivelului de origine a arterei subscapulare poate fi utilizat în calitate de reper osos marginea inferioară a CG.Background. The axillary artery (AA) is frequently punctured when performing the coronarography. Its catheterization provides more safety access to the vascular system, because it is located in the proximity to the bulb of the aorta and it has a more reliable arterial pressure. Objective of the study. Studying the topographic aspect of the axillary artery and identification of a bony landmark necessary for the axillary artery approach. Material and Methods. It is a retrospective, descriptive study. AA was studied on 30 upper limbs collected from formalized adult cadavers and on 90 angiograms taken from the database of the Medical Center „Euromed Diagnostic” archive. By anatomical dissection the topography of the AA portions was studied, and the glenoid cavity as a bony landmark was analyzed on the angiograms. Results. It has been established that AA in the supra- and retropectoral portions is covered on all the sides by the fascicles of the brachial plexus, but in its infrapectoral portion, proximal to the origin of the subscapular artery, it is not crossed by any of them. In relation to the lower edge of the glenoid cavity (GC), the origin of the subscapular artery in 62.2% was determined 5.0 mm distally to the given landmark; in 24.4% it was by 6-10 mm, and in 13.4% – by 11.0-20.0 mm below the landmark. The distance from the most distal point on the lower edge of the GC and the lateral edge of the axillary artery had a mean value of 10 mm. Conclusion. (1) The most appropriate access point for AA puncture and its catheterization is the proximal extremity of its infrapectoral portion. (2) In order to determine the level of origin of the subscapular artery, the lower edge of the GC can be used as a bone landmark

Aspectul aplicativ al arterei axilare

Background. The axillary artery (AA) is frequently punctured when performing the coronarography. Its catheterization provides more safety access to the vascular system, because it is located in the proximity to the bulb of the aorta and it has a more reliable arterial pressure. Objective of the study. Studying the topographic aspect of the axillary artery and identification of a bony landmark necessary for the axillary artery approach. Material and Methods. It is a retrospective, descriptive study. AA was studied on 30 upper limbs collected from formalized adult cadavers and on 90 angiograms taken from the database of the Medical Center „Euromed Diagnostic” archive. By anatomical dissection the topography of the AA portions was studied, and the glenoid cavity as a bony landmark was analyzed on the angiograms. Results. It has been established that AA in the supra- and retropectoral portions is covered on all the sides by the fascicles of the brachial plexus, but in its infrapectoral portion, proximal to the origin of the subscapular artery, it is not crossed by any of them. In relation to the lower edge of the glenoid cavity (GC), the origin of the subscapular artery in 62.2% was determined 5.0 mm distally to the given landmark; in 24.4% it was by 6-10 mm, and in 13.4% – by 11.0-20.0 mm below the landmark. The distance from the most distal point on the lower edge of the GC and the lateral edge of the axillary artery had a mean value of 10 mm. Conclusion. (1) The most appropriate access point for AA puncture and its catheterization is the proximal extremity of its infrapectoral portion. (2) In order to determine the level of origin of the subscapular artery, the lower edge of the GC can be used as a bone landmark.Introducere. Tot mai frecvent în efectuarea coronarografiei este punctată artera axilară (AA). Cateterizarea ei oferă mai multă siguranță pentru obținerea accesului la sistemul vascular, deoarece este localizată în apropierea bulbului aortal și deține o presiune arterială mai fiabilă. Scopul lucrării. Studierea aspectului topografic al arterei axilare și identificarea unui reper osos necesar în realizarea abordului acesteia. Material și Metode. Studiu retrospectiv, descriptiv. S-a studiat AA pe 30 membre superioare colectate de la cadavre adulte formolizate și pe 90 angiografii preluate din baza de date a arhivei Centrului Medical „Euromed Diagnostic”. Prin disecția anatomică s-a urmărit topografia porțiunilor AA, iar prin analiza înscrierilor angiografice – cavitatea glenoidală în calitate de reper osos. Rezultate. S-a stabilit că, AA în porțiunile supra- și retropectorală este acoperită din toate părțile de fasciculele plexului brahial, iar în porțiunea ei infrapectorală, proximal de originea arterei subscapulare – nu este traversată din anterior de nici unul din acestea. În raport cu marginea inferioară a cavității glenoidale (CG), originea arterei subscapulare în 62,2% s-a determinat cu 5,0 mm distal de reperul dat; în 24,4% – cu 6-10 mm, iar în 13,4% – cu 11,0-20,0 mm inferior de el. Distanța de la cel mai distal punct de pe marginea inferioară a CG și marginea laterală a arterei axilare în mediu a constituit 10 mm. Concluzii. (1) Cel mai potrivit punct de acces în punctarea și cateterizarea AA este extremitatea proximală a porțiunii ei infrapectorale. (2) Pentru determinarea nivelului de origine a arterei subscapulare poate fi utilizat în calitate de reper osos marginea inferioară a CG

Numerical variants of the facial nerve trunk

Introducere. Dezvoltarea nervului facial este codificată de genele HOX, modificările cărora, condiționează apariția variantelor și anomaliilor de dezvoltare. Scopul lucrării. Studierea variabilității anatomice a trunchiului nervului facial. Material si metode. Cercetarea a fost realizată la Catedra de anatomie și anatomie clinică a Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu”. Trunchiul nervului facial (TNF) a fost studiat pe 75 de hemifețe formolizate de adulți, dintre care 59 bărbați (78,7%) și 16 femei (21,3%). Hemifețele din dreapta au constituit 35 specimene (46,7%), iar cele din stânga 40 (53,3%). Reprezentativitatea lotului a fost calculată în Programul EpiInfo 7.2.2.6, compartimentul „StatCalc-Sample Size and Power”. Analiza statistică s-a efectuat prin intermediul metodelor statisticii descriptive și inferențiale. Rezultate. Variante supranumerare ale trunchiului nervului facial au fost depistate doar la bărbați și doar pe hemifețele din partea dreaptă, dintre care în 4 cazuri (5,3%) – trunchi facial dublu și într-un caz (1,3%) – trunchi facial triplu. Valoarea medie a variabilității numerice a trunchiului nervului facial a fost de 1,1 TNF (p = 0,261). Pe partea dreaptă, media a fost de 1,2 TNF și pe stânga de 1,0 TNF, diferența fiind semnificativă statistic (p = 0,019). În cazurile ramificării atipice a nervului facial, valoarea medie a fost de 1,2 TNF, față de 1,0 TNF pentru ramificarea clasică. Diferența dintre cele două medii, evaluată prin testul t-student, a fost semnificativă statistic (p = 0,016). Concluzii. Variante numerice ale TNF au fost depistate doar la bărbați și doar pe partea dreaptă, rezultatele fiind semnificative statistic în dependență de partea capului și varianta de ramificare (p<0,05).Background. The development of the facial nerve is encoded by HOX genes, which changes can lead to the appearance of the developmental variants and abnormalities. Objective of the study. Studying the anatomical variability of the facial nerve trunk. Material and methods. The research was carried out at the Department of anatomy and clinical anatomy of „Nicolae Testemițanu” State University of Medicine and Pharmacy. The facial nerve trunk (FNT) was studied on 75 formalized adult hemifaces, of which 59 were males (78.7%) and 16 were females (21.3%). The hemifaces of the right side constituted 35 specimens (46.7%), and those of the left side 40 (53.3%). The representativeness of the samples was calculated in EpiInfo 7.2.2.6 Program, compartment StatCalc-Sample Size and Power. For the statistical analysis, the descriptive and inferential statistics methods were used. Results. Supernumerary variants of the facial nerve trunk were determined only in males and only on the right hemifaces, among which in 5.3% of cases the trunk was double and in 1.3% of cases, it was triple. The mean value of the numerical variability of the facial nerve trunk was 1.1 FNT (p = 0.261). On the right side, the mean value was 1.2 FNT and on the left 1.0 FNT (p = 0.019). In cases of the facial nerve atypical branching, the mean value was 1.2 FNT, compared to 1.0 FNT in cases of classic variant of the facial nerve branching. The difference between the mean values, evaluated by Student’s t-test, was statistically significant (p = 0.016). Conclusion. Numerical variants of the facial nerve trunk were present only in males and only on the right side. The results were statistically significant depending on the side of the head and branching variant (p<0.05). Keywords: facial nerve, trunk, variants

Morphology and variability of the parotid plexus

Department of anatomy and clinical anatomy, Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova, Department of oral and maxillofacial surgery and oral implantology „Arsenie Guţan”, Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova, Conferința Ştiinţifică Internaţională ”Probleme actuale ale morfologiei” dedicată celor 75 de ani de la fondarea Universităţii de Stat de Medicină și Farmacie Nicolae Testemiţanu, Chişinău, 30-31 octombrie 2020Abstract Background. Modern medicine cannot be imagine without usage of high technology devices that have become an indispensable part of many medical examination methods. Nevertheless, anatomical dissection of human cadavers should not be neglected. Considering the high incidence of the facial nerve impairments, we decided to refresh the knowledge about the extracranial branching of the VIIth cranial nerve applying anatomical dissection on human cadavers. Aim. The purpose of the study was to reveal the morphological specific features of the parotid plexus branching and types of connections among those branches that would definitely be useful in facial surgery. Material and methods. The study was carried out on 55 cadaveric semiheads that previously had been fixed in 10% formalin solution: 39 male and 16 female semiheads; 29 of those samples were left (21 male/8 female) and 26 right side semiheads (18 male/8 female). A unilateral dissection was made on 23 semiheads and 32 semiheads were bilaterally dissected. Some samples were marked out with black paper for better contrast. All the dissected anatomical samples were photographed and the obtained data were statistically processed. Results. The classic division of the facial nerve trunk into two primary branches: the temporofacial and cervicofacial one was detected in 39 cases (70,9%), in 15 cases (27,3 %) a diffuse type of the trunk division was detected and in 1 case there was a double trunk (1,8%). The following secondary divisions of the parotid plexus branches were highlighted: 1TB in 20 cases, 2 TB in 30 cases and 3 TB in 5 cases; 1 ZB in 5 cases, 2 ZB in 44 cases and 3 ZB in 6 cases; 2 BB in 9 cases, 3 BB in 13 cases, 4 BB in 16 cases, 5 BB in 14 cases, 6 BB in 2 cases and 8 BB in 1 case; 1 MMB in 45 cases, 2 MMB in 8 cases and 3 MMB in 2 cases; 1 CB in 42 cases, 2 CB in 10 cases and single cases of 3 CB, 4 CB and 6 CB respectively. Conclusions. One of the main characteristic feature of the parotid plexus branches, both in males and females was the wide range of individual variability