Embalmed Cadavers Research Articles

Marginal mandibular branch of the facial nerve - anatomical peculiarities and clinical aspects.

The expanding number of parotid ablations, reconstructive and aesthetic surgeries of the head and neck, considerably increased the risk of the marginal mandibular branch (MMB) injury. The purpose of our study was to determine the anatomical peculiarities of the MMB depending on the facial nerve branching pattern (FNBP), gender and cephalometric type. The MMB was dissected on 75 hemiheads of adult embalmed cadavers. The origin, number of branches, topography and connections of the MMB were analyzed. Seven FNBP were identified: Type I (18.7%); Type II (14.7%); Type III (20%); Type IV (14.6%); Type V (5.3%); Type VI (18.7%); Type NI (8%, non-identified types). In males 1-3 MMB were determined and in females 1-4 MMB; p = 0.845. In males, bilaterally were identified 1-3 MMB. In females on the right side were found 1-2 MMB and on the left - 1-4 MMB; p = 0.204. A single MMB was revealed in 41 cases (54.7%), 2 MMB - in 29 cases (38.7%), 3 MMB - in 4 cases (5.3%) and in a single case 4 MMB (1.3%) were determined. Depending on the FNBP, the number of the MMB was: Type I - 1.2 ± 0.43; Type II - 1.5 ± 0.52; Type III - 1.6 ± 0.63; Type IV - 1.5 ± 0.52; Type V - 1.3 ± 0.50; Type VI - 1.9 ± 0.95; Type NI - 1.7 ± 0.82. IGFV = 1.403 (intergroup frequency variation); df = 6 (degree of freedom); p = 0.226. According to the cephalometric type the number of the MMB in mesocephalic type (MCT) was 1.5 ± 0.68; in brachycephalic type (BCT) - 1.6 ± 0.52; in dolichocephalic type (DCT) - 1.9 ± 0.60. IGFV = 1.698; df = 2; p = 0.190. A rare variant of the MMB origin from the temporofacial division of the facial nerve was highlighted in 5.3% of cases. The MMB varies depending on the FNBP, gender and cephalometric type. The highest variation degree was characteristic of females, Type VI and DCT. The lowest variation degree was determined in Type I and in MCT, without gender differences. The risk of iatrogenic lesions of the MMB is conditioned by two important aspects: its anatomical variability and large number of surgical interventions at that level.

Morphometric Analysis of Vertebral Artery in the Scaleno Vertebral Triangle

Background: The vertebral arteries (VA) play a vital role in supplying blood to the brainstem and cerebellum. Vertebral artery anomalies, including abnormal origins, courses, and structural irregularities, heighten the risk of cerebrovascular events. Typically, the vertebral arteries arise from the posterosuperior aspect of the first part of the subclavian artery. The aim of this study is to present the presence of variation in the origin of vertebral artery Material and Methods: Twenty-eight embalmed cadavers allotted for 1st year MBBS dissection in the Department of Anatomy were used for the study. The triangle of vertebral artery was exposed in all the cadavers, and examined the origin of vertebral artery. Dimensions of the Triangle of Vertebral artery (TVA) and vertebral artery were then measured using a digital vernier caliper and the area and height of the TVA were calculated. Result: In the present study, we have evaluated the morphometric parameters of the TVA and vertebral artery. Even though there were no noticeable differences in the boundaries of TVA of both sides, the morphometric parameters showed slight difference in the measurements, but not significant. Among the 28 cadavers the unilateral origin of VA in one cadaver was from the arch of aorta between the left common carotid artery (LCA) and left subclavian artery (LSCA) . Discussion & Conclusion: The mean height of TVA was 26.3mm (range, 23.7-33.7 mm) on the left and 26.2mm (range, 23.5-32.8 mm) on the right. In the current study it was observed the origin of VA from the arch of aorta between the left common carotid artery (LCA) and left subclavian artery (LSCA). The current study found that 3.6% of the variations in the origin of VA. This study highlights the variation in the origin of the vertebral artery and accentuates the importance of identifying these variations in clinical practice. KEYWORDS: Vertebral Artery, Subclavian artery, Arch of Aorta, foramen transversarium.

Visualizing the human olfactory projection and ancillary structures in a 3D reconstruction

Visualizing in 3D the histological microanatomy of the human olfactory projection from the olfactory mucosa in the nasal cavity to the olfactory bulbs in the cranial cavity necessitates a workflow for handling a great many sections. Here, we assembled a 3D reconstruction of a 7.45 cm3en-bloc specimen extracted from an embalmed human cadaver. A series of 10 µm coronal sections was stained with quadruple fluorescence histology and scanned in four channels. A trained anatomist manually segmented six structures of interest in a subset of the sections to generate the ground truth. Six convolutional neural networks were then trained for automatic segmentation of these structures in 1234 sections. A high-performance computing solution was engineered to register the sections based on the fluorescence signal and segmented structures. The resulting 3D visualization offers several novel didactic opportunities of interactive exploration and virtual manipulation. By extrapolating manual counts of OSNs in a subset of sections to the calculated volume of the envelope of the entire olfactory epithelium, we computed a total of ~2.7 million OSNs in the specimen. Such empirically derived information helps assess the extent to which the organizational principles of the human olfactory projection may differ from those in mice.

Unilateral observation of axillary (Langer’s) arch during dissection: A case report

The axilla is a clinically significant region with a complex structure. One of the most common anatomical variations in this area is Langer’s axillary arch, also known as the axillopectoral muscle, pectodorsal muscle, or arcus axillaris. During a routine dissection of an embalmed elderly female cadaver for educational purposes, we identified an unusual muscle slip originating from the latissimus dorsi. This muscle crossed over the neurovascular structures in the axilla and inserted into the pectoralis major, forming a rare axillary arch (of Langer’s). This variation can be clinically relevant, as it may cause neurovascular compression, leading to conditions like thoracic outlet syndrome, hyperabduction syndrome, or median nerve entrapment. Recognizing this arch before surgery is important in axillary and breast reconstruction procedures, allowing surgeons to decide whether to preserve or cut the arch during the operation.

Surgical cystectomy training using human cadavers embalmed using Thiel's method: a pilot study.

To develop the use of Thiel soft embalmed human cadavers (TeC) in open radical cystectomy (ORC) training for the first time, to investigate the effect of cadaveric training on surgical trainees' technical skills/performance and to determine how trainees perceive the use of cadaveric workshops. A 3-day hands-on workshop was organised. Ten trainees performed ORC on five TeC, supervised by five experts. Feedback from trainees and mentors was evaluated on a five-point Likert scale. All procedures were completed in a fully equipped surgical environment and complied with the principles outlined in the Declaration of Helsinki. The workshop participants evaluated the anatomical and manipulation characteristics of the TeC as similar to real-life conditions. The colour and consistency of the urethra and ureter differed little from those in live patients. The trainees stated that the TeC were beneficial for learning the stages of ORC and urinary diversion (UD), while their self-confidence increased. In terms of realism, all steps of radical cystectomy (RC) were rated 4 out of 5 or higher on the Likert scale by both trainees and faculty. The use of TeC for RC und UD was perceived as favourable by trainees and faculty. The TeC demonstrated a surprising ability to mimic real-life anatomy and represent a new and effective surgical training tool.

An anatomical and histological narrative of a subcutaneous muscle of the anterior abdominal wall in human cadavers: a case report

This report investigates a subcutaneous muscle layer found during routine dissections in four formalin embalmed human cadavers donated for medical training. The gross and microscopic morphology is described and potential implications in humans are raised. Tissue samples were taken from representative regions of the anterior abdominal wall and stained using Haematoxylin & Eosin followed by Masson’s Trichrome. The muscle tissue was seen in the deepest layers of the hypodermis of the anterior abdominal wall, with variable presentation between cadavers. Visually, it appeared as a thin greyish-pink or brown layer with variable morphology based on location, namely, sheet like, discontinuous, and enmeshed within fascial layers, with a thickness ranging from 1 to 5 mm. Tissue staining revealed muscle fibres in all samples. Our incidental findings add gross and histological evidence for the presence of a subcutaneous muscle layer found in the anterior abdominal wall of humans.

Critical appraisal of Genelyn soft embalming for cadaveric surgical skill training: A systematic review.

Genelyn is a proprietary embalming solution used for preserving cadavers for surgical skill training (SST) and undergraduate teaching. The aim of this review is to examine the Genelyn embalming method critically by analyzing scientific publications that have employed this method for SST and undergraduate education. The systematic review process involved searching for all relevant articles in PubMed, Google Scholar, and Embase using the keywords "Genelyn," Genelyn embalming," "Genelyn embalmed cadaver," and "surgical skill training. All studies on Genelyn embalming published up to August 14, 2024, in the English language were eligible for inclusion. The literature review yielded 92 studies, 43 of which met the inclusion criteria. The Anatomical Quality Assurance (AQUA) tool from the International Evidence-Based Anatomy (iEBA) working group was used to assess and analyze the risk of bias in all the selected full-text articles. The selected studies reported that Genelyn embalming provided life-like joint range of motion, tissue pliability, and color. Cadaveric studies assessing embalming solutions typically had smaller sample sizes, and few of them compared Genelyn embalmed cadavers (GECs) with the other soft embalming solutions. Unlike Theil's embalming, Genelyn embalming is cost-effective, with easy steps for the preparation and storage of the solution and convenient handling of cadavers. Therefore, GECs serve as an efficient tool for SSTs.

Anatomical Variations of the Bifurcation Levels of the Common Carotid Artery and Superior Thyroid Artery.

Variations in the carotid arterial system significantly impact atherosclerosis's clinical and surgical management, which predominantly occurs at arterial bifurcations. This study aimed at evaluating anatomical variations in the bifurcation levels of the common carotid artery (CCA) and the superior thyroidartery (STA), emphasizing clinical relevance. This was an observational cross-sectional study conducted in June 2021 using 32 embalmed cadavers of adult age from medical schools in Khartoum, Sudan. Sixty-four carotids were examined, noting the levels of CCA bifurcation and STA origin, and their symmetry across both sides of the body. Results: Among the cadavers studied, CCA bifurcation most commonly occurred at the superior border of the thyroid cartilage (46.9%), followed by the body of the hyoid bone (40.1%). The STA predominantly originated from the external carotid artery (ECA) (65.6%). Conclusion: No significant correlation was found between the bifurcation levels of the CCA and the origins of the STA. Bilateral symmetry in the bifurcation of the CCA and the origin of the STA was observed in most cases. The study highlights notable variations in the anatomy of the carotid arteries. These findings suggest that pre-surgical imaging and careful planning are crucial to accommodate anatomical diversities.

Retrospective denoising and sharpening effects on postmortem computed tomography images of formalin-fixed human cadavers for human anatomy education and research

BackgroundThe value of formalin-fixed postmortem computed tomography (PMCT) has significantly increased in human anatomy education and research. However, improving embalmed PMCT images with high noise, low contrast, and multiple artifacts is an important challenge in enhancing the quality of clinical images. Retrospective denoising methods for embalmed PMCT data are essential for anatomical education and research when new-generation CT scanners with denoising functions are unavailable. MethodsThe three currently available standalone software denoising methods, including image summation methods (Fused CT), noise-reduction system methods (iNoir), and iterative reconstruction (IR, SafeCT), were used to analyze the retrospective noise-reduction effect on 13 human formalin-fixed PMCT datasets. ResultsFused CT had some advantages; however, it was not useful for embalmed cadavers because of high noise, which doubled with the addition. iNoir and SafeCT improved the visual image quality of the noisy cadaver images. Statistical examination showed a 22–67 % and 18–56 % improvement in noise reduction in the non-artifact and metal artifact parts, respectively, depending on the methods and denoising intensities. However, this improvement was not statistically or morphologically significant in the presence of strong metal artifacts. In contrast, the scattered metal and streak artifacts peculiar to cadaveric images showed effective morphological and statistical improvement. ConclusionsRetrospective denoising of embalmed PMCT images showed significant morphological and statistical improvements in noise reduction and is feasible for current anatomy education and research.

Retrocolic Fascia-An Anatomical and Multidetector Computed Tomographic Angiography (MDCTA) Morphometric Analysis in Patients with Right Colon Cancer.

This study aims to delineate anatomical landmarks crucial for complete mesocolic excision, focusing on Gerota's fascia, which guides surgical dissection in right-sided colon cancer, forming the posterior limit. Employing a multimodal approach, the research aims to understand the fascial anatomy and its variations under pathological conditions. Three methods were applied: a pilot dissection on an embalmed cadaver for clear anatomical presentation of prerenal fascia, Mimics segmentation of the fascia and its relationship with the colon, and a retrospective analysis of MDCTA scans from 196 patients (mean age 65.73 y, 118 F/78 M). Systematic measurements of fascial thickness were taken at key renal levels-upper pole, hilum, lower pole, and infra-renal. Covariates analyzed included Body Mass Index, age, and sex. The pilot dissection revealed the renal fascia of Gerota as the only true retrocolic compact connective tissue and the fusion fascia of Toldt as a mesh of strands of loose connective tissue and fat lobules. MDCTA showed clearer visualization of Gerota's fascia at the hilum and inferior renal pole, predominantly on the left. There were significant differences in fascial thickness between sides (1.30 mm on the right and 1.34 mm on the left) and a positive correlation with BMI, whereas age and sex showed no significant effects. Gerota's fascia is a critical anatomical landmark in CME for right colon cancer. This study highlights the fascia's structural integrity, unaffected by the tumor, underscoring its importance in surgical navigation.

Anatomical Trajectory of the Corrugator Supercilii Muscle in Koreans: Implications for Aesthetic and Clinical Practices.

Understanding the attachment patterns of the corrugator supercilii (CS) muscle is vital for treatments designed to improve facial symmetry and functionality. The aim of this research was to elucidate the anatomical trajectory and intricate relationships of the CS within the upper face and midface, specifically focusing on its connections with the frontalis (FT) and orbicularis oculi (OOc) muscles. The CS was examined in 41 specimens of embalmed adult Korean cadavers with microdissection, histological analyses, and microcomputed tomography, performing an in-depth exploration of its anatomical positioning and the intricate interactions with adjacent muscles. Some lower fibers of the CS extended to the upper orbital part of the OOc in 59.5% of cases, while the CS interdigitated or blended exclusively with the FT in 40.5% of cases. The fibers of the CS demonstrated diverse extensions toward the upper face and midface, exhibiting varied trajectories and lengths. Additionally, lower fibers of the CS extended to significant anatomical landmarks such as the OOc, malaris muscle, and the superficial musculoaponeurotic system (SMAS). In this study, we demonstrate that precise understanding of the CS and its relationship with the FT and OOc is crucial for optimizing invasive or noninvasive treatment like botulinum toxin injection, SMAS lifting, and browplasty surgery. The extension of lower fibers of the CS to significant anatomical landmarks indicates complex interactions with adjacent facial structures, highlighting the necessity of detailed anatomical knowledge for clinical applications.

The Importance of Topographical Recognition of Pulmonary Arteries in Diagnostics and Treatment of CTEPH, Based on an Analysis of a Dissected Case Model-A Pilot Study.

Knowledge of the anatomy of pulmonary arteries is essential in many invasive procedures concerning pulmonary circulation. In the diagnosis and treatment of chronic thromboembolic pulmonary hypertension (CTEPH), two-dimensional (2D) pulmonary angiography is used. Recognizing the topographic course of the pulmonary arteries and understanding the status in three dimensions (3D) is paramount. This study aimed to evaluate and describe the branching variant of pulmonary arteries in a single case, as well as morphological parameters of the segmental arteries, like length, diameter and branching angles. One pair of embalmed human cadaver lungs was dissected by a scalpel and surgical forceps and was measured up to the subsegmental arteries. The diameters (ranging from 3.04 to 9.29 mm) and lengths (ranging from 9.09 to 53.91 mm) of the pulmonary segmental arteries varied. The proximal branching angles were wide and close to perpendicular, while distally, the angles between the segmental and subsegmental arteries were narrower (30-45°). Upon evaluating the branching, rare variations were identified and delineated, notably in the lower lobes of both lungs. Utilizing knowledge and data in clinical settings is instrumental for effectively diagnosing and treating CTEPH. Further research is required to explore the complications in invasive procedures related to various anatomical variations.

Exploring the atlantic part of the vertebral artery in the South Indian population and its implications in spine surgery.

A descriptive, quantitative cross-sectional study of the atlantic part (V3) of the vertebral artery (VA). This study aimed to bridge the research gap in the morphometry of the V3 segment of the VA in the South Indian population. The microsurgical anatomy of this segment of the VA has been explored in various populations, and a thorough understanding of the anatomy and course of the VA, particularly the V3 segment, is essential to prevent iatrogenic complications. Several computed tomography studies but a few cadaveric studies have explored the V3 segment of the VA in the South Indian population. This study examined 40 VAs from 20 embalmed cadavers that were obtained from the voluntary donation program, and Institutional Ethical Clearance was obtained before the study. The length, diameter, and angle of the vertical, horizontal, and exit parts of the V3 segment of the VA were documented after its exposure. The mean lengths of the right and left VAs on each part were nearly similar, except for the mean length of the horizontal part (right: 38.937 mm, left: 40.237 mm) and total length of the V3 segment (right: 66.870 mm, left: 70.350 mm). These morphometric parameters are essential to spine surgeons who intend to operate on a small part (vertical, horizontal, or exit part) of the V3 segment of the VA. The mean values of the parameters obtained in this study give average measurements or safe limits to surgeons for safe surgical procedures such as the occipital condyle screw technique and C1 laminectomy.

Sihler's staining of the anterior belly of digastric muscle for botulinum toxin injection.

The anterior belly of the digastric muscle (ABDM) is the target of botulinum toxin injection; however, anatomical considerations related to the injection point are absent. This study used Sihler's staining to analyze the intramuscular nerve distribution of ABDM to identify the most effective botulinum toxin injection points. We used 12 specimens from 6 embalmed cadavers in this study. The specimens were manually dissected to preserve the mylohyoid nerve and subjected to Sihler's staining. From the gnathion to and hyoid bone, the ABDM was divided into three equal parts, distinguishing the anterior, middle, and posterior thirds. Only a branch of the mylohyoid nerve entered the ABDM, and its entry point was located in the middle-third region in all cases. The nerve endings were concentrated in the middle third (100%), followed by the anterior third (58.3%) and were not observed in the posterior third. The landmarks used in this study (gnathion and hyoid bone) are easily palpable on the skin surface, allowing clinicians to target the most effective injection site (middle third of ABDM). These results provide scientific and anatomic evidence for injection points, and will aid in the management of ABDM injection procedures in clinical practice.

Student performance in anatomy examinations depending on the modes of learning/teaching: onsite or online

Introduction: Traditionally, anatomy is a subject that involves a hands-on lab-based component using embalmed cadavers and histology slides. Due to the COVID-19 pandemic there were many changes to Sri Lankan medical education. This study analysed the effect on student performance in anatomy teaching/ learning methods with the start of COVID-19 pandemic in a Sri Lankan medical faculty. Methods: Three student groups with completely onsite (Batch A), transition to online midway through the semester (Batch B), and almost completely online (Batch C) were included. Their second-semester examination performance was analysed in total and component-wise [multiple-choice questions (MCQ), short-answer questions (SAQ) and objective-structured practical exams (OSPE I – Projections, OSPE II – Gross spot]. Descriptive analysis, Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests were used for comparison.Results: Allocated proportions for MCQ:SAQ:OSPE Rewere 30:40:30. Mean MCQ marks of batches A, B, C were 14.8,14.9, 16.4 and mean SAQ marks were 24, 25.1, 24 respectively with significant differences in both [MCQ-H(2)=29.1, p=< .001, SAQ- H(2)=11.3, p= .003). With MCQs batch C had the best performance (p=< .001), whereas batch B had better performance than batch A (p< .001) in SAQs. Mean OSPE marks were 24.8, 17.4, 20.7 with a significant difference (H(2)=334.8, p=< .001). Batch B had lower performance than batch A and C (< .001), while batch A had performed better than batch C (< .001) in OSPEs.Conclusion: MCQ performance was better in online learners while OSPE performance, which reflects the understanding of the three dimensional structure was better in onsite learners. This highlights the value of receiving hands-on experience with cadavers and histology practicals.

Anatomical study of the relationship between the lumbar intervertebral disc, nerves, and psoas major.

Cadaveric study; To describe the characteristics of the nerve and its relationship with the lumbar intervertebral disc and psoas major muscle. Nerve injury is an understudied complication of extreme lateral interbody fusion. A detailed description of the nerve anatomy would be helpful for surgeons to minimize the risk of this complication. The lumbar plexus and lumbar sympathetic nerve of 10 embalmed male cadavers were dissected, and the distribution, number, and spatial orientation of the nerves on the L1/2 to L4/5 intervertebral discs were examined. Metal wires were applied along nerve paths through the psoas major muscle. The position of the nerves was examined on CT. In zone III at L1/2 and L4/5, no nerves were found. In zone II and zone III at L2/3, no lumbar plexus was found, and only the ramus communicans passed through. At the L1-L5 level, the density of nerves in the posterior half of the psoas major muscle was greater than that in the anterior half. The lumbar plexus was found in all of zone IV. The genitofemoral nerve emerges superficially and anteriorly from the medial border of the psoas major at the L3-4 level, but at the L1/2 level, the sympathetic trunk is located in zone II. The remaining disc-level sympathetic trunks appear in zone I. No nerves were found in zone III of the L1/2 or L4/5 disc. In zones II and III of L2/3, the lumbar plexus appears safe. The genitofemoral nerve travels through zones II and III of L3/4. The distribution density of nerves in the posterior half of the psoas major muscle was greater than that in the anterior half of that muscle at the L1-L5 level.

Isthmus of the corpus callosum – An anatomical investigation

IntroductionThe corpus callosum, a principal commissural fibre-bundle of the brain, connects the two cerebral hemispheres, facilitating interhemispheric communication, cognitive and emotional processes. The anatomical definition of the isthmus of the corpus callosum remains unclear in literature with limited studies focusing on this region. This research addresses this gap by providing a detailed anatomical description of the isthmus of the corpus callosum in a South African cadaveric sample. MethodsDigital photographs of thirty embalmed cadaver brains were analysed and measurements of the corpus callosum and isthmus were taken, as seen on a midsagittal section. ResultsThe results revealed no significant differences in isthmus measurements when comparing the sex of the cadavers. The average length of the isthmus accounted for approximately 16.66 % of the total length of the corpus callosum. The isthmus constituted approximately 17.92 % of the corpus callosum surface area. Females tend to have a larger isthmus relative to the size of their corpus callosum. The prevalence of a posterior notch on the superior border of the corpus callosum was found to be approximately 46.66 % in the studied sample, with males showing a slightly higher prevalence. ConclusionSince the isthmus constituted almost 20 % of the total surface area of the corpus callosum, as seen on midsagittal sections, it should be acknowledged as a fifth part. It should further be included in the undergraduate neuroanatomy curriculum and textbooks, which is currently lacking this information. This research recommends expanding the sample size, encompassing diverse demographics, employing fresh cadavers, and utilize three-dimensional imaging to understand the isthmus of the corpus callosum and its relevance to neuropsychiatric conditions and brain morphology.

Morphology of the obturator nerve, an anatomical study with emphasis on its clinical implications

Background The goal of this cadaveric cross sectional study was to analyse the branching pattern of the obturator nerve morphologically and to determine its dimensions in embalmed cadavers. Methods In this cross sectional study, we examined 50 embalmed adult cadaveric lower limbs. Sex was not taken into consideration in the analysis; however, a side-based comparison was performed. The measurements were performed using a digital Vernier caliper. Results The branching of obturator nerve was observed at the pelvic cavity in 28 specimens (56%) and inside the obturator canal in 12 specimens (24%). The division of obturator nerve wasn’t observed in 10 specimens (20%). The length, width and thickness of the trunk of obturator nerve was 108.26 ± 9.53 mm, 2.84 ± 0.88 mm and 1.11 ± 0.35 mm. The width and thickness of the anterior and posterior divisions of obturator nerve measured 2.19 ± 0.82 mm, 0.9 ± 0.1 mm, 0.99 ± 0.6 mm and 0.71 ± 0.26 mm. The topography of branching of obturator nerve from the superior and inferior border of the obturator foramen was located at 1.48 ± 0.58 mm and 3.07 ± 1.1 mm away. The length of anterior division of the obturator nerve measured 110.88 ± 12.02 mm over the right side and 107.13 ± 7.81 mm over the left side. The width of the main trunk of obturator nerve was 2.87 ± 0.64 mm over the right side and 2.82 ± 0.64 mm over the left side. Conclusions We believe that morphometric data of the obturator nerve will be enlightening to the operating surgeon during procedures such as obturator nerve block, nerve transplantation, and obturator nerve repair. The dimensions of the obturator nerve observed in the present study can be utilized as a morphological database for our sample population.

Morphometry of the thyroid cartilage, epiglottis and piriform sinus: An anatomical study.

The goal was to measure the piriform sinus, epiglottis, and thyroid cartilage in our sample population. This study included 22 adult embalmed cadavers available in the Department of Anatomy. Dimensions were measured using a digital Vernier caliper. The mean height of the thyroid laminae was 27 ± 1.4 mm at the right side and 25.5 ± 1.4 mm at the left side. Mean width of the thyroid lamina was 27.1 ± 1.3 mm at the right side and 27.4 ± 0.9 mm at the left side. The mean thickness of thyroid cartilage was found to be 4.4 ± 0.4 mm and 3.9 ± 0.5 mm over the right and left sides. The mean length, width and thickness of the epiglottis were 29.1 ± 0.5 mm, 22.2 ± 0.6 mm and 2.6 ± 0.3 mm correspondingly. The height, width and thickness of the right piriform sinus were 25 ± 0.5 mm, 14.2 ± 0.5 mm and 12.6 ± 0.5 mm, the same parameters were 25.3 ± 1.3 mm, 15.1 ± 0.7 mm and 13.3 ± 0.4 mm for the left side. The height and thickness of the thyroid cartilage were greater on the right side than on the left side (p<0.05). It was statistically observed that the width and thickness were greater on the left side than on the right side (p < 0.05). The data about the height, width and thickness of the thyroid cartilage, epiglottis and piriform sinus are essential during the laryngeal and other neck surgeries. They guide in the preoperative positioning, predicting the difficulty of intraoperative exposure and retractor pulling.

Hip External Rotation Decreases Ischiofemoral Distance: A Positive Correlation Between Cadaveric and Fluoroscopic Studies

PurposeTo determine the effect of hip external rotation or extension/adduction on minimizing the ischiofemoral distance (IFD) and assess the correlation between cadaveric and fluoroscopic IFD measurements in difference hip positions. MethodsThis cadaveric study involved 33 hip joints from 17 embalmed cadavers. IFD, the distance between the lesser trochanter and lateral ischium, was measured in different hip positions: neutral, external rotation at 30° and external rotation at 60° with the hip in both neutral extension and adduction as well as 10° hip extension and 10° hip adduction. Difference in IFD related to positions and correlation between cadaveric and fluoroscopic measurement were analyzed. ResultsIFD measurements showed that the greatest reduction occurred at 60° of external hip rotation, with a significant difference observed only between neutral and 60° external rotation in cadaveric groups (7.60±4.68 vs 5.05±3.48, 95% CI, 0.14 to 4.96; p=0.036). No substantial difference was observed between extension and adduction positions . Positive correlations were observed between cadaveric and fluoroscopic measurements, especially in the neutral position (r=0.492, p=0.004), external rotation at 30° (r=0.52, p=0.002), external rotation at 60° (r=0.419, p=0.015), and the extension/adduction positions combined with neutral rotation (r=0.396, p=0.023). ConclusionThe IFD significantly decreased with increasing degrees of hip external rotation, particularly at 60°. No significant reduction was observed in the extension/adduction positions. Additionally, positive correlations were observed between cadaveric and fluoroscopic measurements for specific hip positions: neutral rotation, external rotation at 30° and 60°, and extension/adduction at 10° with neutral rotation. Clinical RelevanceSurgeons can use this knowledge to improve hip impingement assessment through radiography, focusing on positions where IFD reduction is most notable. Understanding the relationship between hip positions and IFD can enhance the diagnosis of ischiofemoral impingement syndrome and benefiting patient care and outcomes.