Identification Of Anatomical Variations Research Articles

Identification of Anatomical Variations in the Nose and Paranasal Sinuses to Ensure Safe and Complete Endoscopic Sinus and Skull Base Surgery in the North Indian Population

Introduction: The surgical sciences are changing from open to minimum invasive so thats why we were interested in getting the knowledge of anatomy again, so that MIS can become easier with minimum technical difficulties. Objective: The identification of anatomical variations in the nose and paranasal sinuses, which are important to ensure safe and complete endoscopic sinus and skull base surgery. Materials and Methods: Prospective study was conducted for 1 year with 90 patients. All the patients who presented to the outpatient department with complaints of nasal and cranial symptoms were subjected to the computed tomography nose and paranasal sinus. Results: Our results were comparable to other older studies; some variables were noted that are important doing endoscopic surgeries. Conclusion: The most common anatomical variant studied was deviated nasal septum, followed by inferior turbinate concha bullosa, maxillary sinusitis, and anterior ethmoid sinusitis.

Identification of Significant Anatomical Variations in the Nose and Anterior Skull Base Using Computed Tomography: A Cross-Sectional Study.

IntroductionThis study is aimed at the identification of anatomic variations in the nose, paranasal sinuses (PNS), and anterior skull base, which are substantially important to ensure safe and complete endoscopic sinus and skull base surgery.Materials and methodsThis cross-sectional study was conducted at the Dow Institute of Radiology, Dow International Medical College, Dow University Hospital. We included adult patients (i.e., those aged 18 years or older) undergoing a non-contrast CT of the nose and PNS. Two consultant radiologists reviewed the scans on the picture archiving and communication system independently. Any conflict was resolved with consensus. Anatomical variations in the nose, PNS, and anterior skull base of both sides were evaluated.ResultsWe reviewed the CT of the PNS of 130 patients with an age of 35.8 ± 14.48 years (mean ± standard deviation). The proportion of men (64/130; 49.2%) and women (66/130; 50.8%) was equal. All patients had one or more variations. The most common abnormality was a deviated nasal septum (DNS), observed in 115 of 130 participants (88.5%) with unilateral occurrence predominant. It was followed by inferior nasal turbinate hypertrophy and agger nasi cells in 76.2% and 67.7% patients, respectively. Optic nerve variation type I (160/260 sinuses; 61.5%) and Keros type II, for olfactory depth (162/260 sinuses; 62.3%), were most common.ConclusionsHere we report anatomical variations in PNS in all patients of our study; the commonest of all anatomical variations was a DNS. A CT scan is instrumental in surgical planning and patient safety in functional endoscopic sinus surgery.

Identification of Celiac Trunk Variations using Multi-Detector Computed Tomographic Angiography

Introduction: Variation in celiac trunk is common and has importance in preoperative planning to reduce the risk of accidental vascular injuries during surgical and radiological intervention. Our aim was to measure the prevalence of coeliac trunk types and describe its different variations using MDCT angiography among patients in Hospital Tengku Ampuan Afzan (HTAA), Kuantan. Materials and method: A retrospective cross sectional study was conducted. Computed Tomographic Angiography (CTA) images were retrieved from July till December 2017. Images were reconstructed in 3D Volume Rendering (VR) format using workstation and reviewed for the normal and anatomical variations of the celiac trunk. The variations were classified using Uflacker’s classification. The results were calculated using IBM SPSS statistic version 22. Results: A total of 140 cases were found, from which 23 were excluded. Mean age was 57.3 years and male/female percentage was 65.8/34.2. Anatomical variation of the CT was found in 54 (46.2%) cases. The most common variation was the origin of inferior phrenic artery (IPA) from the CT in 21 (17.9%) cases followed by celiac-colic trunk in 15 (12.8%) cases. However, 31 (26.5%) cases displayed variations not described in Uflacker’s classification. They include celiaco-phrenic trunk, coexistence of IPA with other Uflacker’s variations, Buhler arc, accessory hepatic artery from the CT and coexistence of celiac-colic trunk with gastro-splenic and hepato-splenic trunk in one case each. Conclusion: Accurate knowledge and identification of anatomical variations in CT is crucial before undergoing any surgical or invasive imaging procedure. This can help surgeons and interventional radiologists to prevent accidental vascular injuries and perform a safe procedure.

High-resolution 3-T MR imaging of the temporal part of the caudate tail in children

This study aims to investigate the high-resolution 3-T MRI appearance and morphological variation of the temporal part of the caudate tail in pediatric subjects with normal brain MR examinations. One hundred pediatric patients were retrospectively evaluated using a high-resolution 3-T imaging protocol. Different morphological parameters including shape, size, and symmetry were evaluated. The appearance and shape of the caudate tail were classified into nodular, linear, or imperceptible. The location and relation of the caudate tail to the temporal horn and adjacent brain parenchyma were categorized. Relationships between age, gender, shape, location, side, and the cross-sectional area of the caudate tail were investigated. The caudate tail was imperceptible in 22 %, had a nodular shape in 66.5 %, and was flat in 11.5 %. There was asymmetry of the caudate tail between the two sides in 37 % of subjects. The caudate tail was completely embedded within the temporal lobe parenchyma in 8.3 %, completely protruding into the temporal horn in 27.5 %, or intermediate in 64.1 %. The mean cross-sectional area of the caudate tail was constant across ages despite the varied age range of the subjects. There was no difference in overall mean cross-sectional area of the caudate tail between the two sides. There is a wide variation in the appearance of the caudate tail adjacent to the temporal horn of the lateral ventricle. Identification of anatomical variation of the caudate tail may prevent potential diagnostic pitfalls, especially with respect to subependymal heterotopia.

De Quervain Disease: US Identification of Anatomic Variations in the First Extensor Compartment with an Emphasis on Subcompartmentalization

de Quervain Disease: US Identification of Anatomic Variations in the First Extensor Compartment with an Emphasis on Subcompartmentalization

De Quervain Disease: US Identification of Anatomic Variations in the First Extensor Compartment with an Emphasis on Subcompartmentalization

To demonstrate the usefulness of ultrasonography (US) in the detection of anatomic variations in the first extensor compartment of the wrist in patients with de Quervain disease. The institutional review board approved this study protocol and waived the informed consent requirement. Fifteen wrists in 13 women (age range, 41-62 years) in whom de Quervain disease was clinically diagnosed and who underwent surgery for intractable pain were included. A musculoskeletal radiologist performed US before surgery. The absence or presence and extent of subcompartmentalization within the first extensor compartment and the number of abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon slips were evaluated and recorded. Preoperative US findings were compared with surgical records and photographs. Subcompartmentalization within the first extensor compartment was observed during surgery in 11 of the 15 wrists (73%), including four (27%) that had subcompartmentalization only in the distal portion of this compartment. US was used to identify all 11 wrists showing subcompartmentalization within this compartment (sensitivity, 100%; 95% confidence interval [CI]: 74%, 100%), as well as three of the four wrists with distal incomplete subcompartmentalization. There was one wrist with false-positive distal incomplete subcompartmentalization. US had a positive predictive value in the detection of subcompartmentalization of 73% (95% CI: 47%, 91%). The number of tendon slips in this compartment detected with US was identical to that identified at surgery with one exception. US can be used to depict various types of anatomic variations in the first extensor compartment in patients with de Quervain disease.

The Role of Intracardiac Echocardiography in Atrial Fibrillation Ablation.

Radiofrequency catheter ablation of pulmonary veins has emerged as an effective therapy for patients with symptomatic atrial fibrillation. Advances in real-time intracardiac echocardiography with 2D and Doppler color flow imaging have led to it integration in atrial fibrillation ablation procedures. It allows imaging of the left atrium and pulmonary veins, including identification of anatomic variations. It has an important role in guiding transseptal catheterization, imaging the pulmonary vein ostia, assisting in accurate placement of mapping and ablation catheters, monitoring lesion morphology and flow changes in the ablated pulmonary veins, hence allowing titration of energy delivery. Importantly, it allows instant detection of procedural complications.