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Anatomical Considerations (anatomical + consideration)
Selected AbstractsThe Buccofacial Wall of Maxillary Sinus: An Anatomical Consideration for Sinus AugmentationCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2009Hun-Mu Yang DDS ABSTRACT Purpose: This study aimed to quantify the thickness of the buccofacial wall of the maxillary sinus where sinus augmentations are often performed. Materials and Methods: Fourteen sites located 15 and 20 mm superior to the anatomical cervical line (named as groups H15 and H20, respectively) and along the long axes of the mid and the interproximal of two premolars and two molars were measured from 74 Korean hemiface cadavers. Results: The buccofacial wall of the maxillary sinus was thinnest at the area between the maxillary second premolar and first molar in groups H15 and H20. The lowest mean thickness was 1.2 mm in both groups. The walls were thicker in males than in females, with statistically significant gender differences found at four and two sites on the anterior horizontal reference in groups H15 and H20, respectively. However, the thickness did not differ significantly with age or laterality. Incomplete septa were found in seven of the 74 specimens, and they were present in the area between the first and second molars in six (86%) of these cases. Conclusions: These observations indicate that anatomical characteristics of the buccofacial wall thickness of the maxillary sinus need to be considered when performing a window opening procedure for sinus augmentation. [source] Ulnar Artery as Access Site for Cardiac Catheterization: Anatomical ConsiderationsJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 1 2008DOBRIN VASSILEV M.D. Transradial approach to coronary angiography and angioplasty has been widely accepted in the last few years. As an alternative approach from the forearm, with some potential advantages, we decided to test the transulnar approach as a first-choice strategy. Methods and Results: Transulnar approach was tried in 131 patients. In 29 patients there was no palpable ulnar artery or Allen test was negative. From the remaining 92 patients we performed successful coronary angiography and angioplasties in 59 patients (64% success rate in those who had palpable artery). The most frequent reason for access site failure (54.5% of all failed procedures) was inability to introduce wire despite good arterial flow. We found that the ulnar artery was not the largest artery of the forearm (mean diameter 2.76 ± 0.08 mm compared with radial artery 3.11 ± 0.12 mm) and had relatively frequent anatomical anomalies,11.9%. There were no major local complications, with very few minor complications. Spasm frequency was 13.6%, which is higher than that reported for transradial studies. Conclusions: Transulnar artery approach is feasible for cardiac catheterization: however, it has higher access site failure rates in an unselected patient population. It could be used as an alternative option in selected patients, but operators must be prepared to overcome frequent anatomical anomalies and spasm. [source] ORIGINAL ARTICLE: Radiological review of intercostal artery: Anatomical considerations when performing procedures via intercostal spaceJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 4 2010S Choi Abstract Introduction: The aim of this study was to closely examine the course of the intercostal arteries within the intercostal spaces particularly with regard to where the arteries were located in relation to their adjacent ribs. The degree of tortuosity of the arteries was also examined, along with anatomical differences in different age groups. Methods: A total of 81 patients between the age of 30 and 90 years who had underwent a CT examination of the chest for any indication were included in the study. All studies were performed on a dual source 64 slice CT (Siemens Definition Erlangen Germany). Analysis of the intercostal arteries was performed on a CT workstation using volume rendered 3D reconstructions F, or each patient the 10'n intercostals pacesb ilaterally were examined for the course and tortuosity of the intercostal arteries. Results: The ICA is located relatively inferiorly in the intercostal space at costovertebral junction and it gradually becomes more superiorly positioned within the intercostal space it as courses laterally. This finding was consistent in all age groups. In addition, analysis of the data demonstrated increasing intercostal artery tortuosity with advancing age. Conclusion: In this study we have examined the course of the posterior intercostal arteries using MDCT. This study confirms the classical description of the course of ICA. We have shown that in the medial chest, posteriorly, the artery is located in the inferior half of the intercostal space. As it moves away from the costovertebral junction it travels closer to the inferior border of the rib above and reaches the intercostal groove. We have also shown that the artery tends to be more tortuous in elderly patients, decreasing the area of "safe" space for interventions. Both of these findings are relevant to radiologists and non-radiologists performing interventional procedures via the intercostal space. [source] Anatomical considerations for natural orifice translumenal endoscopic surgeryCLINICAL ANATOMY, Issue 5 2009Erica A. Moran Abstract Success in surgical procedures relies on the surgeon's understanding of anatomy and the ways in which the internal organs relate to one another. Recently, a new surgical technique has been introduced. Natural orifice translumenal endoscopic surgery (NOTES) uses the body's natural orifices (mouth, anus, urethra, or vagina) as entrance points to the peritoneal cavities (through the stomach, rectum, bladder, or posterior vaginal fornix). NOTES techniques have proven feasible in both animal and early human trials. While it remains to be seen what advantages NOTES possesses over traditional surgical approaches, a clear understanding of human anatomy will be critical for successful, safe NOTES procedures. This article summarizes the development and the basic techniques of NOTES and reviews those anatomical considerations specific to NOTES. Clin. Anat. 22:627,632, 2009. © 2009 Wiley-Liss, Inc. [source] Anatomical considerations of the deep peroneal nerve for biopsy of the proximal fibula in ThaisCLINICAL ANATOMY, Issue 2 2009S. Chompoopong Abstract The present research aims to study the anatomical relationship between the deep peroneal nerve and the neighboring structures in the proximal fibula of Thais, with special regard to define the boundaries of a "safe" area when performing a biopsy of the proximal fibula. The proximal parts of 118 legs of 59 formalin-embalmed adult cadavers (31 males, 28 females) were investigated. The distance from the apex of the fibular head to the point of origin of the deep peroneal nerve, the distance from the most lateral prominence of the fibular head to the anterior intermuscular septum, and the angle between the deep peroneal nerve and the fibula axis were measured. The results showed that the mean distances from the apex of the fibular head to the point of origin of the deep peroneal nerve was 28.4 ± 4.8 mm and from the most lateral prominence of the fibular head to the anterior intermuscular septum was 14.9 ± 2.0 mm. The mean angle between the deep peroneal nerve and the fibular axis was 28.1° ± 7.2°. In conclusion, these findings suggest that a "safe" area for bone biopsy in the proximal fibula of Thais is palpable anterior to the fibular head and downward laterally, not lower than 28 mm or 8% of the fibular length and from the most lateral prominence transverse medially not further than 14 mm. The inferior boundary of this area is an oblique line of the deep peroneal nerve about 28° from the fibular axis. Clin. Anat. 22:256,260, 2009. © 2008 Wiley-Liss, Inc. [source] Feasibility and Outcome of Endoscopic Staple-Assisted Esophagodiverticulostomy for Zenker's Diverticulum,THE LARYNGOSCOPE, Issue 9 2001Erica R. Thaler MD Abstract Objectives/Hypothesis Endoscopic staple-assisted esophagodiverticulostomy (ESED) is a newly described method of surgically correcting Zenker's diverticulum. Initial reports on the ease and success of the surgery have been quite enthusiastic, making it seem the procedure of choice. We initiated the procedure in an algorithm of treatment of Zenker's diverticulum, to further explore the feasibility and outcome of this new technique. Study Design This is a case series of 23 patients with Zenker's diverticulum who have undergone surgical repair. For each patient, an attempt at ESED was made. If unsuccessful, an open approach was then taken. Results Seven of 23 patients (30%) were unable to be treated with ESED because of inability to expose the diverticulum or unfavorable anatomy of the diverticulum itself. Of the remaining 16 patients, ESED was successful in resolving the symptoms of diverticulum in 14 (87%). Two patients (13%) were somewhat improved but had persistent dysphagia. No significant complications occurred. All patients resumed oral diet within the first 24 hours after surgery. Conclusion Esophagodiverticulostomy is an excellent method of surgically correcting Zenker's diverticulum in many patients, but anatomical considerations may prevent its use, making open approaches of continued importance in a surgeon's armamentarium. [source] Placement of Brånemark implants in the maxillary tuber region: anatomical considerations, surgical technique and long-term resultsCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2009Arne Ridell Abstract Background: Fixture placement in the tuber area is one way to overcome the problem of insufficient bone volume for routine implant surgery in the posterior maxilla due to severe resorption of jawbone and an extensive enlargement of the maxillary sinus. However, little is known about the long-term results. Purpose: The aim of this study was to retrospectively evaluate the survival rate and marginal bone conditions at fixtures placed in the tuber region of the maxilla. Material and methods: Twenty-one patients previously treated with at least one implant in the tuber region of the maxilla were included in this retrospective analysis. A total of 23 standard Brånemark System fixtures with a turned surface had been surgically placed in the tuber regions and 71 additional implants in adjacent areas to support fixed dental bridges. All implants were allowed to heal for 6,8 months before abutment connection and following prosthetic treatment. The patients were radiographed after 1,12 years for evaluation of marginal bone levels. In addition, the relation between the apex of the fixture in the tuberosity area and the posterior border of the maxilla was measured. Results: Twenty of the 21 patients representing 22 tuber and 64 additional implants were radiographically evaluated. No implants in the tuber areas were lost during the follow-up whereas two fixtures in the anterior region had to be removed, one before loading and the other after 4 years of loading not interfering with the prosthesis stability. The mean marginal bone level at tuber implants was situated on average 1.6 mm (SD 1.1, n=22) from the abutment-fixture junction, whilst the other implants showed an average bone level of 1.9 mm (SD 0.8, n=64). The results were similar when comparing partially and totally edentulous patients. Conclusion: The present retrospective study shows good clinical outcome with standard Brånemark fixtures placed in the tuber region of the posterior maxilla using a two-stage procedure. In appropriate cases where bone of adequate volume and density is available, our data indicate that the technique can be used as an alternative to more extensive surgery and especially to the sinus lift procedure. However, prospective comparative studies are needed in order to evaluate the efficacy of the described technique for this purpose. [source] | ||||||||||