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Routine Dissection (routine + dissection)
Selected AbstractsRoutine inclusion of level IV in neck dissection for squamous cell carcinoma of the larynx: Is it justified?HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2004Avi Khafif MD Abstract Background. Dissection of levels II,IV as part of an elective or therapeutic neck dissection is common practice during laryngectomy for laryngeal squamous cell carcinoma (SCC). The necessity of routine dissection at level IV has recently been questioned. The purpose of this study was to find the incidence of level IV metastases in patients with transglottic and supraglottic SCC who underwent neck dissections. Methods. The charts of 71 suitable patients were reviewed. Forty-two had supraglottic primary cancers, and 29 had transglottic primary tumors. Levels II,IV had been removed in them all, and their neck specimens were marked according to the levels of the neck. The surgical specimens were pathologically diagnosed. Results. Of 43 patients who underwent elective lateral neck dissection, the only one (2.3%) with level IV metastases also showed metastases at level II. Nine (32%) of the other 28 patients with clinical adenopathy had level IV metastases. Conclusions. Dissection of level IV as part of a therapeutic neck dissection for supraglottic and transglottic SCC is recommended for patients with clinically enlarged lymph nodes, but its necessity in the absence of detectable adenopathy is challenged. © 2004 Wiley Periodicals, Inc. Head Neck26: 309,312, 2004 [source] Sentinel lymph node biopsy in patients with melanoma and breast cancerINTERNAL MEDICINE JOURNAL, Issue 9 2001R. F. Uren Abstract Sentinel lymph node biopsy (SNLB) is a new method for staging regional node fields in patients with cancers that have a propensity to metastasise to lymph nodes. The majority of early experience has been obtained in patients with melanoma and breast cancer. The technique requires the close cooperation of nuclear medicine physicians, surgical oncologists and histopathologists to achieve the desired accuracy. It involves: (i) identification of all lymph nodes that directly drain a primary tumour site (the sentinel nodes) by the use of pre-operative lymphoscintigraphy, (ii) selective excision of these nodes by the surgeon, guided by pre-operative blue dye injection and a gamma detecting probe intra-operatively and (iii) careful histological examination of the sentinel nodes by the histopathologist using serial sections and immunohistochemical stains. If the nodes are normal it can be inferred with a high degree of accuracy that all nodes in the node field are normal. This means that radical dissections of draining node fields can be avoided in patients with normal lymph nodes. A further advantage of lyamphatic mapping is that drainage to sentinel nodes in unusual locations is identified, leading to more accurate nodal staging than could be achieved with routine dissection of the closest node field. (Intern Med J 2001; 31: 547,553) [source] Absence of the celiac trunk: Case report and review of the literatureCLINICAL ANATOMY, Issue 4 2008Shuang-Qin Yi Abstract The authors report a rare variation of the absence of the celiac trunk in a Japanese cadaver, with the left gastric, splenic, common hepatic, and superior mesenteric arteries arising independently from the abdominal aorta in the routine dissection of a 95-year-old Japanese male cadaver. The incidence and developmental and clinical significance of this variation is discussed with a detailed review of the literature. Knowledge of such case has important clinical significance in an abdominal operation or invasive arterial procedure, that is, Appleby procedure and liver transplantation, laparoscopic surgery, and radiological procedures in the upper abdomen. Clin. Anat. 21:283,286, 2008. © 2008 Wiley-Liss, Inc. [source] An unusual course of the left recurrent laryngeal nerveCLINICAL ANATOMY, Issue 3 2007Amir A. Khaki Abstract Variation in the course of the left recurrent laryngeal nerve is seemingly very rare. During the routine dissection of an adult male cadaver, the entire left recurrent laryngeal nerve after branching from the left vagus nerve was noted to travel medial to the ligamentum arteriosum. We hypothesize that this rare variation may occur, if the left recurrent laryngeal nerve passes inferior to the fifth rather than the sixth aortic arch during embryological development. As our case report demonstrates, the relationship between the ligamentum arteriosum and the left recurrent laryngeal nerve is not absolute. Although seemingly rare, cardiothoracic surgeons must consider variations of the left recurrent laryngeal nerve during surgical procedures in the region of the ligamentum arteriosum in order to minimize potential postoperative complications. Clin. Anat. 20:344,346, 2007. © 2006 Wiley-Liss, Inc. [source] A case of an accessory brachialis muscleCLINICAL ANATOMY, Issue 6 2006Marios Loukas Abstract Functionally, the brachialis muscle serves a critical role as the primary flexor of the arm at the elbow. However, few reports exist in the literature, which describe variations of this muscle. We present a case of an accessory brachialis muscle (AcBr), found during routine dissection at Harvard Medical School during 2003. The AcBr originated medially from the mid-shaft of the humerus and the medial intermuscular septum. During its course medially, toward the elbow, the AcBr crossed both the brachial artery and the median nerve. The distal tendon split to surround the median nerve before inserting into the common tendon of the antebrachial flexor compartment muscles. Embryological origins and clinical considerations including median nerve entrapment are considered. Clin. Anat. 19:550,553, 2006. © 2005 Wiley-Liss, Inc. [source] Three-headed biceps brachii muscle associated with duplicated musculocutaneous nerveCLINICAL ANATOMY, Issue 5 2005Marwan F. Abu-Hijleh Abstract A unilateral three-headed biceps brachii muscle coinciding with an unusual variant of the musculocutaneous nerve was found during routine dissection of a 79-year-old male cadaver. The supernumerary bicipital head originated from the antero-medial surface of the humerus just beyond the insertion of the coracobrachialis, and inserted into the conjoined tendon of biceps brachii. Associated with this muscular variant was a duplicated musculocutaneous nerve. The proximal musculocutaneous nerve conformed to the normal pattern only in its proximal part, and terminated after innervating the coracobrachialis and biceps brachii muscles. The distal musculocutaneous nerve arose from the median nerve in the lower arm, then passed laterally between the supernumerary bicipital head and the brachialis muscles, supplying both and terminating as the lateral cutaneous nerve of the forearm. The supernumerary bicipital head and the accompanying anomaly of the musculocutaneous nerve seem to be unique in literature. Clin. Anat. 18:376,379, 2005. © 2005 Wiley-Liss, Inc. [source] Rare case of the inferior mesenteric artery and the common hepatic artery arising from the superior mesenteric arteryCLINICAL ANATOMY, Issue 6 2004Tokuji Osawa Abstract We found a case in which inferior mesenteric artery and the common hepatic artery arose from the superior mesenteric artery, forming the common hepatomesenteric trunk, during a routine dissection carried out at Iwate Medical University in 2002. This variation is rare, but can be embryonically explained. A change in the positions of the disappearance of the ventral splanchnic arteries and the longitudinal anastomotic channel results in variations in the system of arteries distributed to the digestive organs. In the present case, the longitudinal anastomotic channel between the superior and the inferior mesenteric arteries survived to form the common mesenteric artery, which was joined by the common hepatic artery, forming the common hepatomesenteric trunk. Clin. Anat. 17:518,521, 2004. © 2004 Wiley-Liss, Inc. [source] Altered course of the right testicular arteryCLINICAL ANATOMY, Issue 1 2004M. Bülent Özdemir Abstract An unusual course of the right testicular artery was observed during routine dissection of the posterior abdominal wall of a 60-year-old male cadaver. It arose from the abdominal aorta, inferior and posterior to the origin of the right renal artery, and passed posterior to the inferior vena cava and right renal vein; it then arched anterior to the inferior pole of the right kidney and descended anterior to the psoas major muscle, crossing anterior to the genitofemoral nerve, ureter and the proximal part of the external iliac artery. Finally, it passed to the deep inguinal ring and through the inguinal canal to enter the spermatic cord with the other constituents. The left testicular artery arose from the abdominal aorta about 1 cm higher than the right testicular artery and followed a normal course. The embryologic basis and clinical importance of this case are discussed. Clin. Anat. 17:67,69, 2004. © 2003 Wiley-Liss, Inc. [source] | ||||||||||