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Anatomic Study (anatomic + study)

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Medical Sciences88%

Selected Abstracts

Potential Structures That Could Be Confused With a Nonrecurrent Inferior Laryngeal Nerve: An Anatomic Study,

THE LARYNGOSCOPE, Issue 1 2008
Eva Maranillo MD
Abstract Objectives: Study and detailed description of the large connections between the normally recurrent inferior laryngeal nerve (RILN) and the sympathetic trunk (ST) because these may be mistaken for a nonrecurrent inferior laryngeal nerve (NRILN). Study Design: Morphologic study of adult human necks. Methods: The necks of 144 human, adult, embalmed cadavers were examined (68 males, 76 females). They had been partially dissected by Cambridge preclinical medical students and then further dissected by the authors using magnification. The RILN, the ST, and their branches were identified and dissected. A total of 277 RILNs and STs (137 rights, 140 lefts) were observed. Results: A communicating branch (CB) with a similar diameter to the RILN occurred between the ST and the RILN in 48 of the 277 (17.3%) dissections, 24 from the 137 (17.5%) right dissections, and 24 from the 140 (17%) left dissections. In 12 cases, the CB was bilateral. The CB arose from the superior cervical sympathetic ganglion in 3 of the 48 (6.25%) cases, from the middle ganglion in 10 (21%) cases, from the stellate ganglion in 3 (6.25%) cases, and from the ST in 32 (66.6%) cases. One (0.36%) NRILN associated with a right retro-esophageal subclavian artery (arteria lusoria) was found. Conclusions: 1) The CB between the RILN and the ST may have a diameter and course similar to an NRILN and may be confused with it. 2) The occurrence of the CB is greater than the occurrence referred to in previous studies. 3) The occurrence of the CB is similar by side and sex. 4) The CB may arise at different levels from the cervical ST and ganglia and end in the thyroid area. 5) Other neural elements may also be confused with an RILN, such as the cardiac nerves and the collateral branches from an NRILN to the trachea and esophagus. [source]

The distal superficial femoral arterial branch to the sartorius muscle as a recipient vessel for soft tissue defects around the knee: Anatomic study and clinical applications

MICROSURGERY, Issue 6 2009
Fernando A. Herrera M.D.
Complex wounds surrounding the knee and proximal tibia pose a significant challenge for the reconstructive surgeon. Most of these defects can be managed using local or regional flaps alone. However, large defects with a wide zone of injury frequently require microvascular tissue transfers to aid in soft tissue coverage and closure of large cavities. We describe a unique recipient vessel for microvascular anastomosis for free flap reconstruction involving the knee and proximal tibia through anatomic and clinical studies. © 2009 Wiley-Liss, Inc. Microsurgery 2009. [source]

Anatomic study and clinical application of distally-based neuro-myocutaneous compound flaps in the leg

MICROSURGERY, Issue 6 2007
Ai-Xi Yu M.D., Ph.D.
Objective: Anatomical study on the anastomosis between the neurovascular axis and the musculocutaneous perforators in leg. The distally-based neuron-myocutaneous flap was used for repairing special patients with soft tissue defect in foot and ankle. Methods: Systematical observation was carried out on 30 injected lower legs about the anastomosis between the neurovascular axis and the musculocutaneous perforators, and we summarized the clinical experiences from February 2004 on 12 cases using distally-based neuron-myocutaneous flap for repairing special patients with soft tissue defect in foot and ankle. Results: The neuron-vessels of sural nerve anastomosed permanently with the musculocutaneous perforators of medial and lateral head of gastrocnemius. There were two to three anastomoses found, respectively. The medial anastomotic branches were found larger in caliber than the lateral ones. The spatium intermuscular branches of the posterior tibial artery gave off their junior branches and anastomosed with the vessels in or out of the soleus muscle. There were two to three muscular branches perforated out of the soleus muscle, with mean caliber 0.5 ± 0.2 mm and accompanying with one to two veins. The neuron-vessels of the superficial fibular nerve gave off alone its course two to three muscular branches to the long extensor muscle digits and the long fibular muscle, and one to two fasciocutaneous to the skin. The diameter of the muscular branches was 0.4 ± 0.2 mm in average. Accounting for the operating models in the 12 cases, we had distally-based sural neuron-myocutaneous flap in 7 cases, saphenous neuron-myocutaneous flap in 4 cases, and superficial fibular neuron-myocutaneous flap in 1 case. All these cases were followed up at least for 2,6 months and had the significant results of nice limb's shape and cured osteomyelitis. Conclusion: Distally-based neuro-myocutaneous flap in leg can live with reliable blood circulation. These flaps offer excellent donor sites for repairing special the soft tissue defect in foot and ankle. © 2007 Wiley-Liss, Inc. Microsurgery, 2007. [source]

Transfer of brachialis branch of musculocutaneous nerve for finger flexion: Anatomic study and case report

MICROSURGERY, Issue 5 2004
Yudong Gu M.D.
Based on an anatomic study, a transfer of the brachialis muscle branch of the musculocutaneous nerve (BMBMCN) to finger flexor functional fascicles of the median nerve was designed. Preliminary results of clinical application of this new procedure are reported. Dissection of 32 cadaver upper limbs revealed that BMBMCN derives from the musculocutaneous nerve at the distal 1/3 upper arm level. Mostly it is of single-branch type, with an average dissectable length of 5.2 cm. At this level, functional fascicles of finger flexors are located at the posterior 1/3 of the median nerve. BMBMCN can be directly coapted to these finger flexion fascicles. In one case of brachial plexus lower trunk injury, this neurotization procedure was done. No impairment of elbow flexion and wrist flexion was found postoperatively. Recovery of finger and thumb flexion was seen 1 year postoperatively. This neurotization is safe and effective for treating lower trunk injuries. © 2004 Wiley-Liss, Inc. Microsurgery 24:1,5, 2004. [source]

Anatomic study of the prechiasmatic sulcus and its surgical implications

CLINICAL ANATOMY, Issue 6 2010
Bharat Guthikonda
Abstract To address a lack of anatomical descriptions in the literature regarding the prechiasmatic sulcus, we conducted an anatomical study of this sulcal region and discuss its clinical relevance to cranial base surgery. Our systematic morphometric analysis includes the variable types of chiasmatic sulcus and a classification schema that has surgical implications. We examined the sulcal region in 100 dry skulls; bony relationships measured included the interoptic distance, sulcal length/width, planum sphenoidale length, and sulcal angle. The varied anatomy of the prechiasmatic sulcii was classified as four types in combinations of wide to narrow, steep to flat. Its anterior border is the limbus sphenoidale at the posterior aspect of the planum sphenoidale. The sulcus extends posteriorly to the tuberculum sellae and laterally to the posteromedial aspect of each optic strut. Averages included an interoptic distance (19.3 ± 2.4 mm), sulcal length (7.45 ± 1.27 mm), planum sphenoidale length (19 ± 2.35 mm), and sulcal angle (31 ± 14.2 degrees). Eighteen percent of skulls had a chiasmatic ridge, a bony projection over the chiasmatic sulcus. The four types of prechiasmatic sulcus in our classification hold potential surgical relevance. Near the chiasmatic ridge, meningiomas may be hidden from the surgeon's view during a subfrontal or pterional approach. Preoperative evaluation by thin-cut CT scans of this region can help detect this ridge. Clin. Anat. 23:622,628, 2010. © 2010 Wiley-Liss, Inc. [source]

Transfer of brachialis branch of musculocutaneous nerve for finger flexion: Anatomic study and case report

MICROSURGERY, Issue 5 2004
Yudong Gu M.D.
Based on an anatomic study, a transfer of the brachialis muscle branch of the musculocutaneous nerve (BMBMCN) to finger flexor functional fascicles of the median nerve was designed. Preliminary results of clinical application of this new procedure are reported. Dissection of 32 cadaver upper limbs revealed that BMBMCN derives from the musculocutaneous nerve at the distal 1/3 upper arm level. Mostly it is of single-branch type, with an average dissectable length of 5.2 cm. At this level, functional fascicles of finger flexors are located at the posterior 1/3 of the median nerve. BMBMCN can be directly coapted to these finger flexion fascicles. In one case of brachial plexus lower trunk injury, this neurotization procedure was done. No impairment of elbow flexion and wrist flexion was found postoperatively. Recovery of finger and thumb flexion was seen 1 year postoperatively. This neurotization is safe and effective for treating lower trunk injuries. © 2004 Wiley-Liss, Inc. Microsurgery 24:1,5, 2004. [source]

Vascular grafts in the rat model: An anatomic study

MICROSURGERY, Issue 3 2001
Brantley Blain B.S.
Vascular grafts in animal models have been used extensively in the microsurgical laboratory, and the rat offers an excellent source of graft to meet these needs. In this study, we compiled a list of vessels that were previously identified in experimental literature for use as vascular grafts in the rat model. We then dissected and measured both arterial and venous grafts taken from these sites in 12 adult rats. The surgical procedure for approaching each vascular graft was recorded. The diameter and harvestable length, the start and end points, and the number of branches of the graft were tabulated. We believe that these data will provide valuable insight applicable to the use of the rat vascular graft in microsurgical research and training. © 2001 Wiley-Liss, Inc. Microsurgery 21:80,83 2001 [source]

Inferior retrotympanum revisited: An endoscopic anatomic study,

THE LARYNGOSCOPE, Issue 9 2010
Daniele Marchioni MD
Abstract Objectives/Hypothesis: To describe the inferior retrotympanic anatomy from an endoscopic perspective. Study Design: This was an anatomic study on a retrospective case series. Methods: During November 2009 and December 2009, videos from endoscopic middle ear procedures carried out between June 2007 and November 2009 and stored in our database were retrospectively reviewed. Surgeries in which the inferior retrotympanic region was visualized were included in the study. Accurate descriptions of the anatomic findings were made for each ear included in the study group. Results: The final study group consisted of 25 videos from 25 ear procedures. In 14/25 subjects, a bony ridge connecting the inferior portion of the styloid prominence to the anterior and inferior lip of the round window niche (Proctor's sustentaculum promontory) was identified and renamed the finiculus (from the Latin finis, - is: borderline), representing the ideal limit between the inferior retrotympanum and hypotympanum. In 14/25 patients, a complete sinus subtympanicus could be identified, lying between the subiculum and finiculus. Conclusions: Endoscopic exploration of the middle ear might guarantee a very good exposure of the inferior retrotympanum, allowing detailed anatomic descriptions of this hidden area. Improvement in our knowledge of its anatomy might decrease the possibility of residual disease during cholesteatoma surgery. Laryngoscope, 2010 [source]