Superior Border Research Articles

Mental foramen of mandible in South Kerala population - A digital radiographic study

To assess whether there is sexual dimorphism in the location of mental foramen from base of mandible in South Kerala population.A two-year retrospective study was conducted in 200 subjects [100 males and 100 females] using digital radiographs. The location of mental foramen mandible was assessed from digital orthopantomogram. The vertical distance was measured from the superior border of the mental foramen to the lower border of the mandible and the inferior border of the mental foramen to the lower border of the mandible. The obtained data statistically analyzed using SPSS software version 20. Descriptive statistics was analyzed. Independent t-test was done to determine the association between gender and different parameters. The level of significance set at p ≤ 0.05.The average value of the distance of lower border of mandible from the superior and inferior border of mental foramen is found to be significantly higher in males than females.The study revealed that there is sexual dimorphism in the location of mental foramen in South Kerala population.

Assessment of Anatomical Location and Variation of Mandibular Foramen Using Cone-Beam Computed Tomography: A Cross-Sectional Study

Background: Determining the exact location of mandibular foramen is an important factor prior to Inferior Alveolar Nerve (IAN) block injection. The aim of this study is to assess the position of Mandibular Foramen (MF) and its variations using Cone-Beam Computed Tomography (CBCT).
 Methods: This study was conducted on CBCT images of 80 females and 80 males (18 to 68 years). The distance between the MF and the anterior border of ramus (A), inferior border of mandible (B), superior border of mandible (C), and occlusal plane was measured. Data were analyzed by the student t-test, bivariate correlation analysis, paired sample t-test, and Pearson’s correlation coefficient.
 Results: The mean amount of A, B and C distances, and the mean distance from the occlusal plane to the center of MF were 13.76, 24.24, 12.32, and 7.59 mm, respectively, with no significant difference between the right and left sides (p>0.05). The mean B and C distances were significantly smaller in females than males (p<0.05). The mean size of the measured angle was 43.2°. Significant correlations were noted between aging and decreased A distance, and reduction in the angle between the contralateral premolars and MF (p<0.05).
 Conclusion: Knowledge about the position of MF can enhance the surgical procedures in this region. Using a 21-25 mm needle would be associated with lower risk of needle fracture during IAN block injection. Also, needle insertion angle <45-degrees is optimal for the samples assessed in this study.

FACELIFT TECHNIQUES: AN OVERVIEW.

Facelift techniques can be classified according to the depth and extent of the dissection applied. Imbrication and plication of the SMAS referred to as "SMAS lifts" or "classical facelifts" are the most commonly used techniques. Plication techniques involve in-folding of the SMAS and suture suspension without any SMAS incision whereas imbrication techniques involve a SMAS incision with a portion of the SMAS either removed or transposed with or without limited subSMAS dissection. Ageing changes in the lower face and neck can be successfully treated with SMAS lift techniques. However, there is no lifting effect at midface level or improvement of the nasolabial folds since the retaining (zygomatic cutaneous and masseteric cutaneous) ligaments that prevent the transmission of traction to the malar portion of the facelift dissection are not released. Extended facelift techniques involve surgical release of these ligaments, and produce combined, balanced and harmonious rejuvenation of the midface, cheek, and lower face without requiring a separate midface lift procedure. There are different techniques having similar extended midface dissections with some variations: The extended SMAS technique involves a long skin flap and a distinct SMAS flap dissected and pulled separately. The high SMAS technique has a similar dissection but involves a higher SMAS flap along the superior border of the zygomatic arch. The deep plane facelift involves undermining of skin-SMAS flap as a single unit following a more limited subcutaneous dissection. In the composite plane facelift, in addition to deep plane facelift dissection, the lower part of the orbicularis oculi muscle is also dissected and included in the flap. As they have a single unit, deep and composite flap facelifts allow excellent blood supply to the overlying skin. In this article, various facelift techniques are discussed in detail in line with the relevant surgical anatomy.

Morphometric study of the lumbar vertebrae in dried anatomical collections

Background: The objective of this anatomical study was to perform the morphometry of dried lumbar vertebrae in human cadavers. Methods: This study utilized 200 adult human cadaveric dried lumbar vertebrae. The digital Vernier calipers was used to perform the measurements. The height, antero-posterior length, transverse length of the body of the vertebrae, interpedicular distance at the lateral ends, lamina length, height and thickness, superior and inferior articular facet height and width, mid sagittal and transverse diameter of vertebral foramen, height, width and thickness of the pars inter-articularis were measured. Results: The vertebral body’s anteroposterior length was more at the lower border than at the superior border (p < 0.01). The length of lamina was higher over the right in comparison to the left (p < 0.001). The height of lamina, width of inferior articular facet, diameter of lateral recess and thickness of pars inter-articularis were greater for the left sided specimens (p < 0.01). The statistical significance was not observed for the comparison of the remaining parameters (p > 0.05). Conclusion: This anatomical study offered several dimensions of lumbar vertebrae, which are essential in the surgical practice. The implants at the lumbar vertebrae need to be manufactured based on the anatomical dimensions of that particular sample population.

Elevated cerebrospinal fluid protein levels associated with poor short-term outcomes after spinal cord stimulation in patients with disorders of consciousness.

Spinal cord stimulation (SCS) is a promising treatment for patients with disorders of consciousness (DoC); however, the laboratory examinations and different electrodes (permanent #39286 vs. temporary percutaneous #3777, Medtronic, USA) that are associated with postoperative outcomes are unclear. The study aims to study the association between the change in postoperative cerebrospinal fluid (CSF) protein level and improvement in consciousness after SCS in DoC patients and to explore whether different electrodes were associated with elevated CSF protein levels. A total of 66 DoC patients who received SCS treatment from December 2019 to December 2021 were retrospectively analyzed. Patients were grouped according to their elevated CSF protein level. The clinical characteristics of the patients and SCS stimulation parameters were compared. The preoperative sagittal diameter of the spinal canal is the distance from the midpoint of the posterior border of the vertebral body to the midpoint of the posterior wall of the spinal canal at the level of the superior border of C3. The postoperative sagittal diameter of the spinal canal is the distance from the midpoint of the posterior edge of the vertebral body to the anterior edge of the stimulation electrode. Patients with improved postoperative CRS-R scores greater than 3 or who progressed to the MCS + /eMCS were classified as the improved group and otherwise regarded as poor outcome. We found that more DoC patients had elevated CSF protein levels among those receiving SCS treatment with permanent electrodes than temporary percutaneous electrodes (P = 0.001), and elevated CSF protein levels were significantly associated with a reduced sagittal diameter (P = 0.044). In DoC patients receiving SCS treatment, we found that elevated CSF protein levels (P = 0.022) and preoperative diagnosis (P = 0.003) were significantly associated with poor outcomes at 3 months. Logistic regression analysis showed that elevated CSF protein levels were significantly associated with poor outcomes (OR 1.008, 95% CI 1.001-1.016, P = 0.032). The results suggest that reducing the effect of electrode pads on anatomical changes may help improve the outcomes of DoC patients receiving SCS treatment. CSF protein levels are associated with poor postoperative outcomes and whether they are potential biomarkers in DoC patients receiving SCS treatment remain further exploration.

Evaluating the relation of posterior occlusal plane to ala-tragal line according to age and sex.

Occlusal plane orientation affects the esthetic, function, and success of removable or fixed prostheses. The most prevalent index for determination of this plane is the ala-tragus line while there are controversies in the exact location of tragus reference point.

Radiografía panorámica y tomografía computarizada de haz cónico para medir distancias entre ápices radiculares y estructuras anatómicas

Aim: To compare the accuracy of the panoramic radiography with cone-beam computed tomography (CBCT) scans in measuring the distances between root apexes and the adjacent anatomical structures including the maxillary sinus and the mandibular canal. Material and Methods: A total of 200 CBCT scans (100 maxillary and 100 mandibular) from patients who also had corresponding panoramic radiography were selected. Linear measurements (in mm) presenting centralized image were made between the apexes of the maxillary teeth and the inferior wall of the maxillary sinus, and between the apexes of the mandibular teeth and the superior border of the mandibular canal by using specific software for panoramic radiography and the measurements on the coronal sections in CBCT scans. Data were submitted to inferential statistical analysis and Student’s t-test for comparison between measurements. Results: CBCT scans were significantly more accurate than panoramic radiography to measure the distances between the apexes of the maxillary teeth and the inferior wall of the maxillary sinus (p<0.05) and between the apexes of the mandibular teeth and the superior border of the mandibular canal or mental foramen (p<0.05). Conclusion: CBCT scans present more accurate measurements than panoramic radiography.

Using Molecular Imaging to Create Guidelines for the Optimal Clinical Target Volume for Para-Aortic Lymph Nodes in Prostate Cancer

<h3>Purpose/Objective(s)</h3> Molecular imaging enables improved understanding of the anatomic regions involved with metastatic prostate cancer (PC) due to the improved sensitivity compared to conventional imaging. Consequently, there is increasing awareness that PC metastasizes relatively frequently to the para-aortic (PA) lymph node region, compelling some radiation oncologists to electively cover this area if it is determined to be at high risk or if nodes are already involved. However, the optimal contouring boundaries are unknown. The objective of this study is to use molecular imaging to develop guidelines for contouring the PA clinical target volume (CTV) in patients with PC. <h3>Materials/Methods</h3> We conducted a retrospective cohort study of patients with PC undergoing 18F-fluciclovine (FLU) or 18F-DCFPyL PSMA PET/CT at our institution. Images of patients with PET-positive PA lymph node involvement were imported into the treatment planning system and the avid nodes were contoured. The radial distance from the epicenter of each node was measured in all dimensions relative to the inferior vena cava and aorta, and superiorly relative to the left renal vein. The PA CTV was delineated per the 2021 NRG/RTOG post-operative endometrial/cervical cancer atlas, as principles of these malignancies are frequently used to delineate this region. Descriptive statistics were used to assess the performance of this gynecologic atlas and generate recommendations for contouring in PC patients. <h3>Results</h3> 246 men had molecular PET imaging at our institution from 10/2016 to 1/2022 (48% FLU, 52% PSMA). 31 men (13%) had evidence of PA nodal metastasis. In these patients, 16% had de novo, 52% recurrent, and 32% castration-resistant metastatic PC. The median number of positive PA lymph nodes per patient was 1 (IQR 1-3.5). The distance from central vasculature and left renal vein are shown in the Table. Only 66% of PA nodes were covered using the left renal vein as the superior border and 75% were covered using 1.5 cm above the left renal vein. Overall, the gynecologic atlas missed 25% of nodes (57% due to left sided and 30% due to superior misses), suggesting unique target delineation should be considered for PC patients. We recommend expanding the PC PA CTV in the left lateral and superior dimensions, with detailed recommendations to be included in our presentation. <h3>Conclusion</h3> We used molecular PET imaging to determine the anatomic patterns of PA metastasis to develop contouring guidelines for creating a PA CTV in patients with PC. Although the optimal patient selection and clinical benefits of PA RT remain uncertain, our results will aid in delineating the optimal target and are currently being validated in an independent dataset. Table. Distance from central vasculature and left renal vein (cm)

Optimization of surgical exposure for harvesting gracilis-semitendinosus tendons.

This study was conducted to provide anatomical data and surface markers for the safe and efficient exposure of surgical incisions for harvesting gracilis tendons (GT) and semitendinosus tendons (STT) while avoiding technical pitfalls and nerve injury during harvest for ligament reconstruction. Seventy-four Chinese cadaveric lower limbs were dissected to expose the infrapatellar branch of the saphenous nerve (IPBSN) and pes anserinus (PA). Measurements of the borders and accessory bands of the PA tendons were taken. The arrangement of PA tendons and distribution of the IPBSN were assessed. The PA was roughly shaped like a quadrangle, with its superior border at the horizontal plane of the tibial tuberosity (TT). The GT and STT bifurcation point was located on the medial border of the PA. From medial side to lateral side, the sartorius tendons (ST), GT, and STT fused gradually and formed the lateral border of the PA at the distal end. The tendon arrangement of thePA was primarily affected by ST, which commonly covered GT and STT completely. Variant tendons were found in 41.9% of specimens. The insertion of the accessory bands was distal but close to the inferior border of thePA. Accessory bands were observed only in STT and ST, and STT accounted for the most. The width of the first accessory band of STT was similar to the width of the STT. Additionally, most of the IPBSNs were proximal to the horizontal plane of the TT. For clearly exposing the GT and STT, it is crucial to expose the GT and STT bifurcation point on the medial border of the PA, whether directly or indirectly through the incision.The influence of ST insertion and the variability of tendons within the PA must be paid attention to during the operation. To protect IPBSNs highly, the incision should not behigher than the TT level.

OC-003 PORT POSITIONS IN TEP FOR SHORT PATIENTS: OUR EXPERIENCE

Abstract Introduction Totally extraperitoneal repair (TEP) is a popular technique for repair of inguinal hernia. One common technique of TEP involves placement of one 10 mm port 1–2 cm below the umbilicus just off the midline, one 5 mm port 2–3 cm above the pubic symphysis, and a third 5 mm port between these 2 ports in the midline (Figure 1a). In case the distance from the superior border of the symphysis pubis to the inferior edge of the umbilicus is less than 15 cm, this leads to crowding of instruments and results in ergonomic problems during the operation. Daes has popularized eTEP for this indication. The aim is to shift the first 10 mm port to a position 5 cm superior and 4 cm lateral to the umbilicus (Figure 1b). eTEP has also found application in the repair of ventral hernias. However, for most inguinal hernias, we feel that eTEP is an overkill. Methods We place the first 10 mm port at the level of the superior border of the umbilicus and just lateral to it (Figure 1c). The two 5 mm ports are placed in the midline. Initial dissection is performed telescopically. Results This technique provides 2–3 cm of extra working space, which improves ergonomics while operating on patients with a short pubo-umbilical distance. Other parameters like operating time, postoperative pain and other complications remain the same. Conclusion We recommend placement of the 10 mm port at the superior border of the umbilicus, particularly in short patients.

OC-063 BASELINE DATA AND NORMAL ANATOMY OF THE ABDOMINAL WALL IN AN OBSERVATIONAL PROSPECTIVE COHORT STUDY OF NULLIPAROUS WOMEN

Abstract Aims The aim of this study was to describe the pre-partum anatomy of the abdominal wall in a cohort of nulliparous women, with the main purpose to use as a reference for management of patients with postpartum abdominal core instability. Materials &amp; Methods Seventy consecutive women were examined with ultrasonography measuring inter-recti distance (IRD), anatomical variations of linea semilunaris and the oblique muscles. Waistline was assessed during activated and relaxed abdominal core. Participant characteristics were registered. Questionnaires regarding habitual physical activity (Baecke), low back pain (Oswestry), physical functioning (DRI), urinary incontinence (UDI-6 and IIQ-7) and quality of life (SF-36) were answered. Results Response rate was 100%. Mean age was 30.5 years (19–50), mean BMI 23.5 kg/m2 (18.4–37.1). Ultrasonography showed a mean IRD 1.02 mm (0.27–2.35) at the superior border of the umbilicus, 0.93 mm (0.36–2.01) three cm above the umbilicus, 0.21 mm (-0.53–0.98) two cm below the umbilicus; mean thickness of the linea alba 0.28 mm (0.15–0.5); mean distance between the lateral lining of the rectus muscle and the external, internal and transverse oblique muscles of respectively 1.19 (-0.99–2.82), 0.09 mm (-1.37–1.3) and 1.46 mm (-1.36–3.19) at umbilicus level. Responses to the questionnaires showed overall low values on DRI, UDI-6, IIQ-7 and Oswestry; and overall values on Baecke and SF-36 similar to the normative population. Conclusions This study provides baseline data on the normal abdominal wall anatomy as well as mean values of activity, physical function, disabilities and quality of life, in a healthy nulliparous female cohort.

GENDER AND AGE DETERMINATION BY RADIOGRAPHIC ANALYSIS OF THE POSITION OF MENTAL FORAMEN IN NAVI MUMBAI POPULATION

Background - In physical and forensic anthropology the skull is extremely informative with regard to the identification of sex and age of an individual. It plays a vital role in establishing the identity of the deceased. The skull has been described as “The bone and core of the fleshy head and face” Gender and age determination plays a crucial role in the identification of human remains as it narrows the possibility for identification by 50 %. Many studies have observed the gender differences based on height of mandible, gonial angle, bigonial breadth and bicondylar breadth. But few studies have been done on gender and age determination based on the position of mental foramen. Aim: To evaluate gender and age differences based on the distance from superior and inferior borders of mental foramen to lower border of the mandible, along with height of the mandible in our population. Material and methods – Retrospective OPGs of subjects aged between 14 to 65 years taken for orthodontic and periodontic purposes were selected for the study. Out of the total 500 radiographs screened, 376 radiographs were considered for the study. The panoramic radiographs of patients were captured using Xtropan 2000 system and digitally processed. The distance from superior border of mental foramen (SMF) and inferior border of mental foramen (IMF) to the lower border of mandible (LBM) and height of mandible (AC – LBM) were measured. Result - The distance from SMF and IMF to LBM and height of mandible was more in males when compared to females, which was statistically significant which is justifying the sexual dimorphism. Also, values were useful for the deriving formula for age determination. Conclusion: The distances from SMF and IMF to the LBM and height of the mandible showed significant sexual dimorphism and helps in age determination

Anatomic safe zones for arthroscopic snapping scapula surgery: quantitative anatomy of the superomedial scapula and associated neurovascular structures and the effects of arm positioning on safety.

Neurovascular anatomy has not been previously quantified for the arthroscopic snapping scapula approach with the patient in the most frequent patient position ("chicken-wing" position). The purposes of this study were (1) to determine anatomic relationships of the superomedial scapula and neurovascular structures at risk during arthroscopic surgical treatment of snapping scapula syndrome (SSS), (2) to compare these measurements between the arm in the neutral position and the arm in the chicken-wing position, and (3) to establish safe zones for arthroscopic treatment of SSS. Eight fresh-frozen cadaveric hemi-torsos (mean age, 55.8 years; range, 52-66 years) were dissected to ascertain relevant anatomic structure locations including the (1) spinal accessory nerve, (2) dorsal scapular nerve, and (3) suprascapular nerve. A coordinate measuring device was used to collect data on the relationships of anatomic landmarks and at-risk structures during the surgical approach. The dorsal scapular nerve was a mean of 24.4 mm medial to the superomedial scapula in the neutral position and 33.1 mm medial in the chicken-wing position (P<.001); the dorsal scapular nerve was 21.7 mm medial to the medial border of the scapular spine in the neutral position and 35.5 mm medial in the chicken-wing position (P<.001). The mean distance from the superomedial angle to the spinal accessory nerve intersection at the superior scapular border was 16.5 mm in the neutral position and 15.0 mm in the chicken-wing position (P=.031). The average distance from the superomedial angle to the closest point of the spinal accessory nerve was 11.6 mm and 10.4 mm in the neutral position and chicken-wing position, respectively (P=.039). Neurologic structures around the scapula vary significantly between the neutral arm position and the chicken-wing position commonly used in the arthroscopic treatment of SSS. The chicken-wing position improves safe distances for the dorsal scapular nerve during medial-portal placement and should be considered as a primary position for arthroscopic management of SSS.

Anatomical Variations of Anterior Cerebral Artery and Its Cortical Branches through 1.5 Tesla Magnetic Resonance Angiography

Background: Cortical branches of the anterior cerebral artery (ACA) supply the medial surface and superior border of the cerebral hemisphere. Names of distinct cortical branches are according to the regions of the brain supplied by that particular branch. There can be variations in the number, origin, and distribution of these branches. There can also be variations of the ACA like azygous, bi hemispheric, median, aplasia, and fenestration of the ACA. This study aimed to evaluate the anatomical variation of the ACA and its cortical branches taking into consideration their number and site of origin. Methodology: Retrospective cross-sectional analysis of magnetic resonance angigraphs of 80 subjects (42 males and 38 females) without cerebrovascular diseases who was undertaken in the department of radiodiagnosis from July 2021 to August 2022. Results: The cortical branches were seen either being completely absent or present singly or in duplication. The callosomarginal artery (CmA) branch was found to be most commonly absent (51.25% on the right side), paracentral lobule artery most commonly duplicated (10% of cases on the right). CmA gave origin to the maximum number of cortical branches as compared to other cortical branches. The abnormal origin of anterior cortical branches was found to be more than posterior cortical branches. A few rare cases of variations (1.25% cases each) like azygous, bihemispheric, aplastic, and median ACA. Conclusion: In the present study different variations were observed in the cortical branches of ACA. These variations may also result in higher incidence of ischemic stroke in territory of ACA, involving the superior medial part of the parietal lobe and midline of the frontal lobe. Therefore, this study can be of clinical importance to neurosurgeons during cerebral surgeries.

Modified Ni-Nail and C-Nail systems for intra-articular fractures of the calcaneus: A biomechancial study

ObjectivesWe have proposed a novel intramedullary nail (Ni-Nail) by incorporating a sustentaculum tali screw to improve the fixation stability of minimally invasive treatment for calcaneal fractures. This study aimed to evaluate the biomechanical characters of the Ni-Nail system and compare it with traditional C-Nail system. MethodsA finite element model of a Sanders type-IIIAB calcaneal fracture was reconstructed and fixed using two intramedullary nail systems, which was validated by a cadaver study. A vertical loading of 700 N was applied to the subtalar joint surfaces, and 525 N Achilles tendon tension was applied to the superior border of the Achilles tuberosity. The von Mises stresses and fracture displacements of both fixation models were evaluated. ResultsThe maximum von Mises stress of the screws of Ni-Nail and C-Nail were 27.92 MPa and 57.42 MPa, respectively, while that of the main nail were 67.44 MPa and 53.01 MPa. In addition, the maximum fracture displacement of the Ni-Nail was larger than that of C-Nail by 15.6% (0.37 mm vs.0.32 mm). ConclusionsOur static simulation analysis showed that both Ni-Nail and C-Nail demonstrated similar biomechanical stability for calcaneal fixation. The Ni-Nail features a simple structure that is easier to operate and less traumatizing. Future studies may consider to further evaluate the clinical effectiveness by clinical trials and follow-ups.

Analysis of fusion of sphenooccipital synchondrosis using computed tomography in Turkish population

ABSTRACT Ossification centres in the adult skeleton are important markers for age estimation. Sphenooccipital synchondrosis (SOS) is of particular significance in forensic anthropology case work due to its late closure in adolescent age groups. The aim of this study is to evaluate the SOS fusion degree for age estimation of the Turkish population. In this study, images of 298 patients within the age of 5 to 25 years were retrospectively examined. The fusion degree of the SOS was assessed using a 5-stage system. Eight morphological measurements were taken from sagittal images and completely open types. We found that the upper end width of the synchondrosis was significantly lower than the lower end width of the synchondrosis. SOS fusion began at the superior border of the synchondrosis. Fusion starts 2 years earlier in females than in males, and the process of fusion completes at the age of 17 years in males and at the age of 19 years in females in this study. In conclusion, we consider that the differences in SOS fusion among studies are due to racial diversity and different methodologies and the SOS fusion stage is as a supportive evidence for age estimation in the presence of other clues.

Anatomical Variations of Spleen in South Indian Population

Background: Spleen is the large lymphoid organ that is situated in the left hypochondriac region and is usually wedge shaped. It has two ends, two surfaces and three margins. Superior margin of the spleen possesses characteristic notches. Normally spleen is not palpable. It develops in dorsal mesogastrium during the 5th week of fetal life from a mass of mesenchymal cells. Objectives: The present study explains the morphology of spleen 1.To determine the length of spleen 2.To determine the breadth of spleen 3.To determine the thickness of spleen 4.To determine the variations in notches &amp; shape of spleen 5.To compare the morphometric measurements with previous studies Results: In our study, the length, breadth and thickness of spleen was 9.19 cm, 6.61 cm and 3.25 cm respectively. The length of spleen ranged between 5-8cm in 35% of spleens, 8.1-10cm in 35%, 10.1-12cm in 24%and &gt;12.1cm in 6% of spleens studied. Majority of the length of spleens ranged between 5-8cm and 8.1-10cm. The breadth ranged between 3.5-5.5cm in 25% of spleens, 5.6-7.5cm in 45%, 7.6-9.5cm in 20% and 9.6-11.5cm in 10% of spleens studied. The maximum range of breadth of spleen was 5.6-7.5cm in our study. The thickness of spleen ranged between 1-4cm in 82% of spleens, 4.1-6cm in 10% of spleens and 6.1-8cm in 8% of spleen maximum being 1-4cm. 5 fissures and 6 lobules in one of the spleens were observed. These fissures were from the superior border. A deep fissure on the diaphragmatic surface was also observed. The shape of spleen was wedge shaped in 34 % of the spleens being the maximum and next was oval shaped spleens and heart shaped spleens and crescent shaped spleens were the least found in 1% only. The weight of the spleen ranged between 40-500gms, heaviest being 461.1 gms in one of the spleen and least being 47.8gms. Conclusion: The detailed knowledge on variations of spleen is important in clinical practice to avoid and prevent any complications and to obtain a good operative, as well as diagnostic intervention. Keywords: Splenic notches, Polysplenia, Wandering spleen

Morphometric study for the localization of the mental foramen in relation to the vertical reference plane.

The mental foramen (MnF) is the anatomic landmark where the mental neurovascular bundle exits the mandible. Precisely determining the position of the MnF is necessary before all dentoalveolar therapeutic procedures performed in the mandibular premolar area. For the study, we performed two ex vivo direct morphometric determinations on dry human dentate and edentate mandibles, and two in vivo imaging morphometric determinations through cone-beam computed tomography (CBCT) and orthopantomography (OPG) in dentate human patients. The following landmarks were used to locate the MnF: the distance between the MnF and the superior border of the mandible (MnF-SB), the distance between the MnF and the inferior border of the mandible (MnF-IB), and the position of the MnF in relation to the root apices of the posterior teeth. The results obtained from these data were processed statistically using the analysis of variance (ANOVA). By direct morphometry on dentate mandibles, the MnF was situated closer to the IB and by direct morphometry on completely edentulous mandibles, the MnF was located closer to the SB. In both direct morphometry studies, the MnF transverse diameter was larger than the vertical one, with the MnF having an oval shape. ANOVA for both direct morphometry studies showed that the distances MnF-IB and MnF-SB significantly vary statistically with interactions and depending on age (p<0.00001). The vertical diameter of the MnF significantly varies statistically depending on age, interactions and between studies, and its transverse diameter varies statistically significantly with interactions and depending on age (p<0.00001). According to OPG and CBCT imaging studies, the MnF was located closer to the IB, and the transverse diameter of the MnF was larger than the vertical diameter; such results are similar to the direct morphometry study performed on dry dentate human mandibles. Regarding the position of the MnF in relation to the root apices, it was most frequently located inferior to the root apices in 79.45% of cases, in 19.23% of cases it was located at the root apices level and in 1.31% of cases it was located superior (coronal) to the root apices. ANOVA for both imaging morphometry studies showed that the MnF-IB distance varies statistically significantly with the interactions, the study, the sex of the patients and their age, the MnF-SB distance varies statistically significantly with the interactions, the study and the patients' age (p<0.05), and the MnF diameters vary statistically significantly with interactions and patient age (p<0.05). The results of this study can help dental practitioners in improving dentoalveolar surgery procedures in the posterior mandible.

MORPHOMETRIC STUDY OF SPLEEN IN CADAVERS OF SOUTH COASTAL REGION

Introduction: The spleen has always been a mysterious organ of seemingly occult function as well as a forbidding organ of extreme vulnerability for the surgeon. But on both fronts, it has yielded considerable ground. The spleen is the largest soft, highly vascularised, lymphatic organ located partially in the epigastrium and mainly in the left hypochondrium. Spleen acts as a lter for blood, storage of lymphocytes and platelets. Old red blood cells are recycled in the spleen. It metabolizes the haemoglobin removed from old senescent RBCs. The knowledge of morphometric variations of spleen helps clinicians, radiologist and surgeons to differentiate it from the various splenic injuries and pathologies The aim of Aims: the study is to nd the morphometric variations of spleen. The present study was done on 68 adult hum Materials and Methods: an spleens of unknown sex. The morphometric features like shape, presence of notches, length, breadth and thickness were noted. Out of 68 spleens Results: studied, ve different shapes of the spleen were observed. 32 spleens were wedge shaped (41%), 20 spleens were triangular shaped (20%), 10 spleens were tetrahedral (12.8%), 16 spleens were oval shaped (20.5%), 0 spleens were irregular shaped (0%). 26 spleens (33.33%) had notches on its superior border, 4 spleens (5.12%) had notches on its inferior border, 32 spleens (41%) had notches both in their superior and inferior borders, 16 spleens (20.51%) were found with absence of notch on either of its borders.The presence of splenic ssure on diaphragmatic surface were noted in 9 (11.53) spleens. The length of the spleen varied between 7cms to 19cms, the breadth of the spleens varied between 4cms to 12cms and the thickness of the spleens varied between 2cms to 8cms The knowledge of morphometric features Conclusion: of the spleen is of great importance to the clinicians, radiologists and surgeons for their surgical procedure

An Ultrasound-based Protocol And Regression Model To Estimate Visceral Fat In Healthy Adults

Although visceral fat (VF) can be quantified via computed tomography or dual-energy X-ray absorptiometry (DXA), their application for frequent VF assessment is limited because both methods are radiating in nature. Research suggests that ultrasound imaging can be used to predict VF safely without the risk of radiation exposure. However, the complexity and/or lack of replicability limits such application. PURPOSE: To develop an easy-to-replicate ultrasound protocol and a regression model that can accurately estimate VF area (VFA, cm2). METHODS: Thirty healthy adults (9 males and 21 females, age: 23.2 ± 7.4 yr, body mass index: 22.3 ± 3.2 kg/m2, body fat percentage: 22.3 ± 5.9 %) fasted for 8 hours or more before a DXA scan and ultrasound imaging were performed to estimate VFA. Ultrasound imaging (with a 3.5-MHz convex-array probe) was used to measure the thickness of 15 different sites within the abdominal cavity. Thickness was defined as the distance in cm from the internal abdominal wall to the anterior aortic wall. Stepwise linear regression was utilized to develop a regression model for VFA using the estimated VFA by DXA as a dependent variable, followed by a Bland-Altman plot and Pearson correlation to compare the technique reliability. RESULTS: The developed regression model (F(4, 25) = 46.869, p = 0.001) was (37.677 + (1.456*Age) - (26.963*Sex) - (11.336*VFT2) + (13.554*VFT4)), where age = years, sex: 1 = male or 2 = female, and VFT2/4 = ultrasound probe placement 2 cm to the left (VFT2) and right (VFT4) of the superior umbilical border, respectively. The regression model had high accuracy (adjusted R2 = 0.864) and test reliability (r = 0.927, p = 0.001) at estimating VFA (31.4 ± 21.4 cm2) when compared to the VFA (31.1 ± 21.1 cm2) estimated by DXA. CONCLUSION: Visceral fat area can be accurately estimated using an easy-to-replicate ultrasound protocol and regression model that eliminates the exposure to radiation caused by other body scanning methods.