Anatomical Study Research Articles

An Anatomical Study Using Computed Tomography, Magnetic Resonance Imaging, and Rhinoscopy of the Nasal Cavity of Domestic Cat (Felis silvestris catus L.) and Big Cats: Lion (Panthera leo leo L.), Leopard (Panthera pardus kotiya L.), and Cheetah (Acinonyx jubatus jubatus S.)

The objective of this work was to study the normal anatomy of the nasal cavity of the three species of big cats (leopard, lion, and cheetah) compared to the domestic cat through the use of computed tomography, magnetic resonance imaging, and rhinoscopy. Computed tomography allowed us to clearly visualize the entire bony and cartilaginous framework that supports the nasal cavity. Magnetic resonance imaging permitted better visualization of the soft tissues of this cavity. On the other hand, rhinoscopy enabled the direct visualization of the mucosa of the vestibule and nasal cavity, which is very useful in the diagnosis of masses or foreign bodies. Furthermore, with this technique, it has been possible to observe several small orifices from the nasolacrimal duct, the pharyngeal auditory tube, and the lateral nasal gland. Computed tomography, magnetic resonance imaging, and rhinoscopy are useful tools in analysis of the anatomical characteristics of the nasal cavity in these species.

Irrigation and Débridement of the Thumb Flexor Sheath for Tenosynovitis—An Anatomic Study for the Optimisation of Surgical Techniques in Cadaveric Specimens

Background: Treatment of a flexor tendon sheath infection of the thumb usually involves prompt surgical irrigation and debridement (ID). There are few descriptions of this procedure despite the unique anatomy of the thumb flexor sheath. The aim of this study was to investigate thumb flexor sheath ID and explore the relevant anatomy. Methods: The current ID technique was performed on eight embalmed cadaveric hands. Coloured latex was injected into the sheath, and the surrounding region was dissected. Outcomes of interest were the distribution of latex, the success of the procedure, and the anatomy of the radial bursa. Results: Latex was successfully injected into all specimens, although A1 pulley stenosis caused significant resistance to flow. Latex filled the radial bursa (four specimens), reached the distal boundary of the transverse carpal ligament (three), or did not pass the A1 pulley (one); in addition, latex was found in the deep spaces of the hand and wrist (five specimens). The radial bursa was located at a median (range) of 33.2 (23.9–34.5) mm proximal to the carpometacarpal joint and at 7.8 (0–14.0) mm distal to the distal border of the pronator quadratus. Conclusion: These findings contribute to the existing body of knowledge on the anatomy of the thumb flexor sheath and radial bursa, and will help guide hand surgeons to perform thorough ID for infection. A modified surgical technique is presented, which may help further inform the treatment of pyogenic flexor tenosynovitis and other serious hand conditions.

Suture-like pattern formation in the pterygospinous bridge of the human sphenoid bone.

The paper presents an anatomical study involving rare variations in the pterygospinous bridges found in Mongolian skulls. These structures extend between the lateral pterygoid plate and the sphenoid spine. Particularly interesting is the division of these bridges into two distinct parts of the similar length. The junctions within these structures resemble morphological patterns characteristic for the plain and zigzag sutures, which articulate the cranial bones.

The calcaneofibular ligament groove at the inferior fibula, an ultrasonographic anatomical landmark.

Calcaneofibular ligament (CFL) injuries are harder to diagnose than anterior talofibular ligament (ATFL) ones. This study aimed to clarify the fibular attachment of the CFL and verify the bony landmark for evaluating the CFL on ultrasonography. Fifty-nine ankles were used in this anatomical study. To confirm the control function of the CFL, we performed passive movement manually using cadaveric ankles and observed the ankle positions where the CFLs were tense. Histological observation of CFL attachment of the fibula was performed using Masson's trichrome stain. The ATFL and CFL were removed, and the bone morphology of the CFL attachment and inferior fibular end was imaged using a stereomicroscope and a 3D scanner. Using ultrasonography, we evaluated the bone morphology of the fibular attachment of the CFL in short-axis images of 27 healthy adult ankles. The CFL was tensed according to ankle motions: supination, maximum dorsi flexion, maximum plantar flexion, and mild plantar flexion-external rotation. Below the CFL attachment of the fibula was a slight groove between the inferior tip and the obscure tubercle of the fibula. This groove was observed in 81.5% of cases using short-axis ultrasonography. The CFL was tensed in various ankle positions to control the movements of the talocrural and subtalar joints. There was a slight groove at the inferior end of the fibula where the CFL coursed downward. We called it the CFL groove and proposed that it could serve as a landmark for the short-axis image of ultrasonography.

A Hardware-Based Orientation Detection System Using Dendritic Computation

Studying how objects are positioned is vital for improving technologies like robots, cameras, and virtual reality. In our earlier papers, we introduced a bio-inspired artificial visual system for orientation detection, demonstrating its superiority over traditional systems with higher recognition rates, greater biological resemblance, and increased resistance to noise. In this paper, we propose a hardware-based orientation detection system (ODS). The ODS is implemented by a multiple dendritic neuron model (DNM), and a neuronal pruning scheme for the DNM is proposed. After performing the neuronal pruning, only the synapses in the direct and inverse connections states are retained. The former can be realized by a comparator, and the latter can be replaced by a combination of a comparator and a logic NOT gate. For the dendritic function, the connection of synapses on dendrites can be realized with logic AND gates. Then, the output of the neuron is equivalent to a logic OR gate. Compared with other machine learning methods, this logic circuit circumvents floating-point arithmetic and therefore requires very little computing resources to perform complex classification. Furthermore, the ODS can be designed based on experience, so no learning process is required. The superiority of ODS is verified by experiments on binary, grayscale, and color image datasets. The ability to process data rapidly owing to advantages such as parallel computation and simple hardware implementation allows the ODS to be desirable in the era of big data. It is worth mentioning that the experimental results are corroborated with anatomical, physiological, and neuroscientific studies, which may provide us with a new insight for understanding the complex functions in the human brain.

An anatomical study on the variations and clinical significance of the corona mortis within a South African sample

IntroductionAnterior orthopaedic approaches, much like the Modified Stoppa approach, target fractures of the anterior column of the pelvis and acetabulum. The approach is described as a minimally invasive technique that may lead to iatrogenic haemorrhage and fatality in patients. Such mortality is due to the inadvertent severing of the corona mortis vessels, a clinical term referring to the anastomosis between the obturator vessels and the external iliac vessels typically via an accessory obturator vessel that courses over the pelvic brim. Knowledge regarding the prevalence and clinical significance of the corona mortis, especially within the South African population is lacking, and therefore further investigation of this anomaly is necessary. Materials and methodsThis study investigated the incidence and variations of the corona mortis vessels in a South African sample using 63 adult cadavers obtained from the Department of Anatomy, University of Pretoria. After careful dissection of the blood supply to the pelvis, the prevalence of corona mortis was investigated. Variations regarding the composition of the corona mortis and the incidence of aberrant obturator vessels were documented. ResultsThe incidence of corona mortis was observed in 67.5% of the study sample, with 91.6% being venous and 8.4% being arterial in composition. An incidence of 26.0% of aberrant obturator arteries and 8.1% of aberrant obturator veins were observed originating or draining directly into the external iliac system, respectively. A single rare instance of corona mortis was observed and involved an anastomosis with the superior vesical vein rather than the typical obturator vein. While variations amongst anomalous accessory vessels were observed which resulted in as many as 3 aberrant vessels coursing over the pelvic brim. No significant difference was concluded for the incidence of corona mortis between the left and right sides or between males and females. ConclusionMapping out the parameters of the corona mortis and examining the variation linked with the anomaly will aid orthopaedic surgeons in implementing anterior approaches with reduced vascular damage and iatrogenic deficit. Further understanding of its incidence in the South African population will in turn assist in interpreting its clinical significance.

456 Arm Flexion to Overcome Gaps for Primary Radial Nerve Repair: An Anatomic Study

INTRODUCTION: It is now well known that direct nerve repairs fare better than grafted nerve repairs. There is currently renewed interest in direct repair of nerves achieved by limb flexion followed by serial distraction as it is the least morbid and most easily implemented surgical technique to provide extra nerve excursion. This is especially simple in the upper extremity, which can be easily immobilized post-operatively in a sling. METHODS: Four fresh and 11 fixed cadaver arms with shoulder intact were dissected to determine the relationship between degrees of EF (ranged from 0-90 degrees EF) and nerve gap length overcome with proximal excursion of the distal nerve. Additional excursion from brachialis branch neurectomy was also assessed. RESULTS: We found an approximately linear relationship between EF and RN excursion. Compliance of fresh cadaveric nerves more closely approximated that of surgical tissue. In fresh cadavers, there was 3mm of RN excursion per 10 degrees EF in the proximal half of the arm, and 4 mm excursion per 10 degrees EF with neurectomy. CONCLUSIONS: Elbow flexion can significantly augment the ability to achieve an end-to-end repair of the RN. To simplify our findings, 90-degree EF should readily overcome a RN gap of 3.5 cm, and additional brachialis neurectomy allows for total RN excursion of 4.7 cm on average in the proximal arm with 90-degrees EF. Given nerve regeneration rates of 1-2 mm/day, we recommend 14-27 days prior to full elbow extension from a RN repair performed with 90-degree EF without neurectomy, and 18-36 days for repair at 90-degree EF with neurectomy.

The Posterior Auricularis Muscle as Superficial Landmark for the Sigmoid Sinus and Transverse-Sigmoid Sinus Junction: An Anatomical Study

Neuronavigation systems coupled with previously reported external anatomical landmarks assist neurosurgeons during intracranial procedures. We aimed to verify whether the posterior auricularis muscle (PAM) could be used as an external landmark for identifying the sigmoid sinus (SS) and the transverse-sigmoid sinus junction (TSSJ) during posterior cranial fossa surgery. The PAM was dissected in 10 adult cadaveric heads, and after drilling the underlying bone, the relationships with the underlying SS and TSSJ were noted. The width and length of the PAM, and the distance between the muscle and reference points (asterion, mastoid tip, and midline), were measured. The PAM was identified in 18 sides (9 left, 9 right). The first 20 mm of the muscle length (mean 28.28 mm) consistently overlay the mastoid process anteriorly and the proximal half of the SS slightly posteriorly on all sides. The superior border was a mean of 2.22 mm inferior to the TSSJ, and, especially when the muscle length exceeded 20 mm, this border extended closer to the transverse sinus; it was usually found at a mean of 3.11 mm (range 0.0-13.80 mm) inferior to the distal third of the transverse sinus. Superficial landmarks give surgeons improved surgical access, avoiding overexposure of deep neuro-vascular structures and reducing brain retraction. On the basis of our cadaveric study, the PAM is a reliable and accurate direct landmark for identifying the SS and TSSJ. The PAM could potentially be used for guiding the retrosigmoid approach.

452 Leg Flexion to Overcome Gaps for Direct Sciatic Nerve Repair: An Anatomic Study

INTRODUCTION: Direct nerve repairs fare better than grafted nerves, especially for large caliber nerves. Numerous surgical techniques are used to achieve tension-free end-to-end repairs for large gaps in the sciatic nerve (SN) and common peroneal nerve (CPN), including distal nerve mobilization, transposition, side-branch neurectomy, or even shortening of the femur with distraction osteogenesis. However, leg flexion with serial distraction is the simplest, least morbid, and most easily implemented technique. METHODS: Eight fresh cadavers with pelvis intact were dissected to determine the relationship between degrees of knee flexion (ranged from 0 to 90-degree flexion) and the gap length overcome with nerve excursion. Additional excursion from SN side-branch neurectomy was also assessed. RESULTS: We found an approximately linear relationship between knee flexion and nerve excursion. In the mid-thigh there was 7-9 mm of SN excursion per 10 degrees of flexion, and 10-11 mm of SN excursion per 10 degrees of flexion with neurectomy. There was 11-13 mm of CPN excursion per 10 degrees of flexion in the distal half of the thigh. CONCLUSIONS: Knee flexion can significantly augment the ability to achieve an end-to-end repair of the SN and CPN. Simplified, each 10 degrees of knee flexion provides about 1 cm of additional length for both nerves, which is essentially constant throughout the arc of flexion. Neurectomy allows approximately 1-2 cm in total additional length at full flexion in fresh cadavers. Approximately 10 cm total excursion can be gained at 90-degree knee flexion with side-branch neurectomies. We recommend 45-90 days of progressive extension to respect the safe regeneration timing of 1-2 mm/day from a repair performed with 90-degree knee flexion.

Preliminary Study on Application of Combined Monitoring of Neuroelectrophysiology-Intracranial Pressure-Cerebral Perfusion Pressure in Craniotomy for Intracranial Aneurysm Clipping: An Anatomical and Clinical Study

Preliminary Study on Application of Combined Monitoring of Neuroelectrophysiology-Intracranial Pressure-Cerebral Perfusion Pressure in Craniotomy for Intracranial Aneurysm Clipping: An Anatomical and Clinical Study

139 Alternative Anatomical Landmarks for the Lateral Femoral Cutaneous Nerve: Cadaveric Study With Implications for Difficult Decompressive Cases

INTRODUCTION: During decompressive procedures, localizing the lateral femoral cutaneous nerve (LFCN) using only the anterior superior iliac spine (ASIS) can be difficult due to variations in nerve course and specific patient anatomy, e.g., body habitus. Therefore, the present anatomical study was performed to provide additional landmarks for localizing this nerve. METHODS: The LFCN was dissected in 30 adult cadavers (60 sides). The nerve was exposed distal to the ASIS in the proximal thigh and along an imaginary line connecting the ASIS to the midpoint of the patella with the lower limb in a neutral position. RESULTS: The main trunk of the LFCN was identified deep to the fascia lata on all sides, 5-8 cm distal to the ASIS along the ASIS-patella line. The nerve was bordered by the sartorius muscle superficially and medially, the tensor fasciae latae muscle laterally, and the proximal rectus femoris tendon on its deep surface. Proximal to this triangular region, the LFCN was found to cross superficially to the proximal sartorius muscle on 58 sides and through the muscle on two sides. CONCLUSIONS: The study findings suggest an alternative method for identifying the LFCN, which could help locate the nerve during challenging cases and reduce the incidence of iatrogenic LFCN injuries resulting from inadequate anatomical landmarks.

363 Anatomic Study of Cervical Neural Foraminal Dimensions, Interpedicular Distance, and Disc Space Height From C2-T1 Using Computed Tomography of 1,000 Patients

INTRODUCTION: The normative relationships among cervical neuroforaminal dimensions (NFD), interpedicular distance (IPD), and disc space height (DSH) remain unknown. METHODS: We reviewed CT imaging of 1,000 patients between 18 and 35 years of age without spinal pathology to measure cervical NFD, defined as follows: foraminal height, sagittal anterior-to-posterior width, and area. Anterior, middle, and posterior DSH, and IPD were also measured. Interobserver reliability was assessed via the intraclass correlation coefficient (ICC) two-way mixed model on absolute agreement. RESULTS: Bilateral NFD followed bimodal distribution patterns moving caudally from C2-T1, whereas DSH measurements exhibited multimodal distribution patterns and IPD demonstrated a unimodal distribution clustered at the lower cervical spine. Significant differences were observed in NFD, DSH, and IPD measurements with respect to patient sex and race taking into consideration patient demographic and anthropometric characteristics. The African American cohort demonstrated the smallest NFD, DSH, and IPD measurements, followed by the Hispanic cohort, followed by the Caucasian cohort. Weak-to-moderate correlations were observed among NFD, DSH, and IPD measurements across all levels. CONCLUSIONS: This study describes 70,800 DSH, NFD, and IPD measurements from C2-T1 using CT imaging of young patients without spinal pathology. Findings from this study may provide normative guidelines necessary to establish the foundation for diagnosis of cervical neuroforaminal stenosis. Surprisingly, this study found no strong, or even moderate, correlations between normative NFD, DSH, and IPD measurements across all levels from C2-T1. Patient sex, ethnicity, and height are associated with NFD, DSH, and IPD, though patient weight is not.

COMPARATIVE MORPHOANATOMIC AND HISTOCHEMICAL CHARACTERIZATION OF Cucurbita pepo L. SPECIMENS Microanalysis of Cucurbita pepo L. specimens

Cucurbita pepo L. is popularly known as pumpkin or zucchini. Compared to the others of the genus, it presents the greatest genetic variability. Thus, given its nutritional and medicinal benefits, it results in many widely cultivated and economically important specimens. Due to this, differentiation between specimens becomes necessary, mainly pumpkin and zucchini which have different characteristics, however they receive the same scientific nomenclature (C. pepo). It is noteworthy that the anatomical knowledge of the specimens helps with taxonomy. Furthermore, due to the economic value, when it comes to vegetative propagation, the identification of structural aspects is important for the success of propagation, which depends on the regeneration of plant tissues. This study aimed to characterize and differentiate two specimens of C. pepo through morphoanatomy and histochemistry. For anatomical study, usual methods in plant anatomy were used to prepare and analyze, under an optical microscope, semi-permanent slides containing transverse sections of the roots, stems, leaves, and paradermic sections of the leaf blades of C. pepo specimens. Histochemical tests were performed on cross-sections of the specimens' leaf blades to locate chemical compounds. The optical microscopic evaluation enabled the anatomical characterization, revealing distinct characters among the specimens. For example, the zucchini shows crystals in the root. Meanwhile, the pumpkin shows sclerenchymatic pericycle in the stem and secretory ducts in the stem and leaves. Histochemical techniques showed the presence of different compounds, differentiating in the presence of starch in the zucchini and triterpenes and steroids in the pumpkin. Correct characterization provides important information for quality control of the plant drug and taxonomic differentiation of the specimens since diagnostic characters vary.

Transpalpebral mini-orbitozygomatic approach for nonvascular skull base lesions: a single neurosurgeon's experience.

The authors aim to describe the advantages, utility, and disadvantages of the transpalpebral mini-orbitozygomatic (MOZ) approach for tumors of the lateral and superior orbit, orbital apex, anterior clinoid, anterior cranial fossa, middle cranial fossa, and parasellar region. The surgical approach from skin incision to closure is described while highlighting key technical and anatomical considerations, and cadaveric dissection demonstrates the surgical steps and focuses on important anatomy. Intraoperative images were included to supplement the cadaveric dissection. A retrospective review of adults who had undergone the MOZ approach for nonvascular pathology performed by a single neurosurgeon from 2017 to 2023 was included in this institutional review board-approved study. Descriptive statistics was used to summarize the data. Four representative cases were included to demonstrate the utility of the MOZ approach. The study included 65 patients (46 female, 19 male), average age 54.84 years, who had undergone transpalpebral MOZ surgery. Presenting symptoms included visual changes (53.8% of cases), vision loss (23.1%), diplopia (21.8%), and proptosis (13.8%). The optic nerve and optic chiasm were involved in 32.3% and 10.8% of cases, respectively. The most common pathology was meningioma (81.5% of cases), and gross-total resection was achieved in 50% of all cases. Major complications included an infection and a carotid injury. Improvement of preoperative symptoms was reported in 92.2% of cases. Visual acuity improved in 12 patients. The mean follow-up was 8.57 ± 8.45 months. The MOZ approach is safe and durable. The transpalpebral incision provides better cosmesis and functional outcomes than those of standard anterolateral approaches to the skull base. Careful consideration of the limits of the approach is paramount to appropriate application on a case-by-case basis. Further quantitative anatomical studies can help to define and compare the utility of the approach to open cranio-orbital and endoscopic transorbital approaches.

Minimally-invasive lag screw fixation technique for posterior malleolus fractures: A cadaveric study

Anatomical reduction and lag screw fixation of posterior malleolar (PM) ankle fractures typically involves an open posterolateral approach. The aim of this anatomical study was to assess whether a minimally-invasive, percutaneous posterior-to-anterior lag screw fixation technique is safe to perform. Eighteen cadaveric ankle specimens were used. A transverse incision was made at the lateral border of the Tendo Achilles (TA). Windows were made lateral to and through the substance of the TA and simulated reduction and placement of a single lag screw. Specimens were then fully dissected to ascertain proximity and damage to anatomical structures. Lag screw fixation was placed appropriately in all ankles. No injury to neurovascular structures, ankle joint or syndesmotic ligaments were observed. The mean distance from the soft tissue window to sural nerve was 10.0 mm (range 5–16), and 9.5 mm to short saphenous vein (4–14). Whilst the muscle belly of flexor hallucis longus (FHL) was pierced in six specimens, no injuries to the FHL tendon were observed. The mean distance from screw to syndesmosis was 9.3 mm (range 3–15) and 12.7 mm to the ankle joint (7–17). This study demonstrates that posterior percutaneous lag screw fixation is both safe and accurate. Further work is required to evaluate the precision of reduction and the biomechanical stability of this fixation technique. This novel minimally-invasive technique may be beneficial in avoiding the wound complications associated with open posterolateral ankle approaches and also offer a functional advantage due to minimal soft tissue disruption.

Access to the Lumbosacral Spine: A Current View.

The surgical approach to the lumbosacral spine has been the subject of experimental and scientific anatomical studies since the Hippocratic era. However, it was in the 20th century that, with the evolution of asepsis and antibiotic therapy, spine surgery began to evolve at breakneck speed, and the various possibilities of access roads became objects of development and discussion. As a result, pathologies of the lumbosacral spine can be accessed in different ways and positions, from the traditional posterior approach in the prone position to the anterior, oblique, lateral, and endoscopic approaches. The current article brings state-of-the-art access routes to the lumbosacral spine. This article objective is to elucidate the possibilities of accesses the lumbar spine for any purposes, as decompression, fusion, tumour resections, reconstruction or deformity correction, despites type of implants or implants positioning.

Anatomical study of the modified direct posterior gluteal splitting approach for acetabular fractures

BackgroundIn this study, we investigated the area that can be addressed with an approach in which the skin incision is made directly above the dorsal column with Thiel cadaveric specimens. MethodsSix Thiel cadaveric specimens were prepared. A skin incision was made directly above the dorsal column. The accessible proximal end from the proximal part of the greater sciatic notch to the gluteal ridge and the accessible distal end of the ischium were marked with a flat chisel. A molded 8-hole reconstruction plate was placed from the base of the ischium toward the gluteal ridge and fixed with 3 screws proximally and 2 screws distally. The length of the skin incision and the distance from each reference point on the bone to the reachable markings were assessed after the muscles were removed. ResultsMean skin incision length was 9.3 ± 0.7 (range, 8.0–10.0) cm. In 3 of 6 cases, proximal screws were inserted through different spaces between muscle fibers. In all cases, we were able to reach at least the greater sciatic notch, the gluteal ridge at the level of superior border of the acetabulum, and the base of the ischial tuberosity. In all cases, an 8-hole plate could be placed from the gluteal ridge to the base of the ischium. There were no superior gluteal artery or sciatic nerve injuries in any of the cases. ConclusionWe anatomically investigated the area that can be addressed with an approach in which the skin incision was made directly above the dorsal column. In all cases, we were able to access the areas needed to reduce the fracture and place the plates necessary to stabilize the fracture through a 9.3 ± 0.7 cm skin incision. This approach can be a useful minimally invasive posterior approach for acetabular fractures.

Anterolateral keyhole transorbital routes to the skull base: a comparative anatomical study.

Although keyhole transorbital approaches are gaining traction, their indications have not been adequately studied comparatively. In this study the authors have defined them also as transwing approaches-meaning that they use the different facies of the sphenoid wing for cranial entry-and sought to compare the four major ones: 1) lateral orbitocraniotomy through a lateral canthal incision (LatOrb); 2) modified orbitozygomatic approach through a palpebral incision (ModOzPalp); 3) modified orbitozygomatic approach through an eyebrow incision (ModOzEyB); and 4) supraorbital craniotomy through an eyebrow incision (SupraOrb), coupled with its expanded version (SupraTransOrb). Cadaveric dissections were performed at the neuroanatomy lab. To delineate the skull base exposure, four formalin-fixed heads were used, with two sides dedicated to each approach. The outer limits were assessed via image guidance and were mapped and illustrated accordingly. A fifth head was dissected purely endoscopically, just to facilitate an overview of the transwing concept. Qualitative features were also rigorously examined. The LatOrb proves to be more versatile in the middle cranial fossa (MCF), whereas the anterior cranial fossa (ACF) exposure is limited to a small area above the sphenoid ridge. An anterior clinoidectomy is possible; however, the exposure of the roof of the optic canal is suboptimal. The ModOzPalp adequately exposes both the ACF and MCF. Its lateral trajectory allows the inferior to superior view, yet there is restricted access to the medial anterior skull base (olfactory groove). The ModOzEyB also provides extensive exposure of the ACF and MCF, but has a more superior to inferior trajectory compared to the ModOzPalp, making it more appropriate for pathology reaching the medial anterior skull base or even the contralateral side. The anterior clinoidectomy is performed with improved visualization of the optic canal. The SupraOrb provides mainly anterior cranial base exposure, with minimal middle fossa. An anterior clinoidectomy can be performed, but without any direct observation of the superior orbital fissure. Some MCF access can be accomplished if the lateral sphenoid wing is drilled inferiorly, leading to its highly versatile variant, the SupraTransOrb. All the aforementioned approaches use the sphenoid wing as skull base corridor from a specific orientation point; hence these are designated as transwing approaches. Their peculiarities mandate careful case selection for the effective and safe completion of the surgical goals.

The minimally invasive sacrospinous fixation under visual guidance: An anatomical study

ObjectiveSacrospinous fixation is the gold standard procedure for management of apical pelvic organ prolapse by the vaginal route. However, there may be a relevant risk of neurovascular injury due to the proximity of neurovascular structures. We propose an anatomical study concerning the sacrospinous ligament with a new innovative minimally invasive technology using both a suture capturing device and a chip-on-the-tip endoscope to perform sacropinous fixation.Study design: Bilateral sacrospinous fixation was performed in three female cadavers, in the course of the anatomical study conducted with a specific device (the Suture Capturing I Stitch™ Device) under real time visual guidance with a chip-on -the-tip endoscope, the NanoScope™ system. ResultsIdentification of ischial spine and sacrospinous ligament as well as feasibility of sacrospinous fixation under NanoScope™ control were always possible on both sides. ConclusionsThis new innovative minimally invasive technology using both a suture capturing device and a chip-on-the-tip endoscope is relevant and could be an advantage in terms of safety and better placement of the suture on the sacrospinous ligament.

Advancements and Perspectives in Rachana Sharir Research: A Comprehensive Review

Abstract: Rachana Sharir is an essential branch of Ayurveda that deals with the structural and functional aspects of the human body. Research in this field has expanded over the years to cover a broad range of anatomical, physiological, and embryological studies. This article provides an overview of the recent advancements and perspectives in Rachana Sharir research, exploring its contemporary significance in healthcare and medical education. Through a systematic review of literature and analysis of current trends, this article highlights the evolving landscape of Rachana Sharir research, its interdisciplinary connections, and potential implications for clinical practice and education.