Unusual Anatomical Variation Research Articles

Unusual anatomy of maxillary central incisor with two roots

Introduction: Knowledge of root canal morphology is essential for successful endodontic therapy. Failure to recognize unusual root canal anatomy may lead to unsuccessful endodontic treatment. Case Report: This case report describes the successful endodontic treatment of the maxillary central incisor with unusual anatomy of two roots and two root canals. A 23-year-old male patient was referred for dental consultation with discoloration of the maxillary right central incisor with periapical lesion, which revealed unusual anatomy of root on radiographic examination, and was confirmed upon exploration. Discussion: As described by Vertucci, the maxillary central incisor presents a single root and single root canal in 100% of the cases. However, few cases of maxillary central incisors with two canals were reported in the literature, most of which were associated with developmental anomalies like fusion, germination or dens invaginatus. Clinician should be aware of the unusual anatomical variations that should be detected by the different diagnostic resources available.

Snapping sartorius syndrome: a case report

We report a rare case of painful snapping of sartorius tendon on the anteromedial aspect of the knee associated with bursitis and a very unusual anatomical variation of the saphenous nerve. This patient presented with swelling over the medial aspect of the knee along with painful snapping sensation, which on real-time ultrasound was confirmed to be due to snapping of sartorius tendon. Surgical excision of the bursa and stabilising the sartorius tendon using anchor sutures successfully treated this patient, and he remains asymptomatic 6 months after surgery.

A very unusual anatomical variation and complication of common iliac artery and ureter in retroperitonoscopic ureterolithotomy

Anatomical localization of theureter comes along psoas major muscle and crosses over common iliac artery bifurcation. Common iliac artery aneurysm and impacted atherosclerosis are a rare condition that should be differed from the impacted ureter stone to avoid from undesirable complication. In this case, we present a very unusual anatomical variation and complication of common iliac artery and ureter in retroperitonoscopic ureterolithotomy.

An unusual anatomic variation of dorsal sensory branches of the ulnar nerve: A case report.

Mehmet Bulent Ozdemir, Pamukkale Universitesi Tip Fakultesi, Anatomi Anabilim Dali, Denizli, Turkiye, Tel. 0542 7253674 Email. mehmeto@pau.edu.tr Gelis Tarihi: 11.05.2011 • Kabul Tarihi: 28.07.2011 ABSTRACT In some instances, it is mandatory to know the anatomy of the dorsal sensory branches of the ulnar nerve. The dorsal sensory branches consist of the area of most dense innervations with their anatomical variants. These variations are very important in the surgical and medical procedures dealing with the area. In this paper, we present a case of an unusual variation of the dorsal cutaneous ulnar nerve. The variation was observed in the operation of a right forearm of a 43 year old male following a traffi c accident injury. Dorsal cutaneous Ulnar nerve was observed in an unusual course. It was piercing the fl exor carpi ulnaris muscle’s tendon and then going into the skin superfi cially. To our knowledge, this type of variation has never been published before. The knowledge of this type of variation may be useful during surgeries and electrophysiological examinations of the area.

Internal carotid artery ectasia: the value of imaging studies prior to biopsy of a retropharyngeal mass.

The presence of retropharyngeal tissue mass often raises the suspicion of malignancy, especially in elderly patients. This prompts urgent biopsy to investigate tissue histology. We discuss a case where this is contraindicated as the retropharyngeal mass was illustrated by CT scanning and confirmed with MRI to be a tortuous coursing internal carotid artery. An awareness of this unusual anatomical variation and a careful interpretation of imaging studies both at the stage of differential diagnosis and pre-operative screening are essential to avoid damage to important structures, causing unnecessary complications.

Anomalous vertebral artery origins: the first and second reports of two variants

We present two cases of aberrant origins of vertebral arteries. Case 1 is of a patient undergoing evaluation of an infrarenal aortic aneurysm stent graft. Computed tomography (CT) angiogram revealed...

Anomaly of Flexor Digitorum Superficialis Penetrating Through the Median Nerve: Case Report

The median nerve displays frequent anatomic variation. Here, we report an unusual anatomic variation consisting of a penetrated median nerve and the tendon of the flexor digitorum superficialis to the index finger passing through it approximately 4 cm proximal to the wrist crease.

A carotid artery aneurysm with a twist: case report and review

Since their original description in 1687, aneurysms of the extracranial internal carotid artery (ICA) remain rare and account for less than 2% of all carotid operations (Zwolak et al. in: J Vasc Surg 1:415-422, 1984; El-Sabrout, Cooley in: J Vasc Surg 31:702-712, 2000). Cerebrovascular morbidity and mortality rates remain high without intervention (Zwolak et al. in: Vasc Surg 1:415-422, 1984). We report an unusual case of a saccular extracranial ICA aneurysm associated with kinking of the ICA and highlight the potential complications and risks associated with such an extreme anatomical deformation. Extracranial ICA aneurysm can be associated with unusual anatomical variations which can lead to unstable clinical symptomatology due to the variable presence of atherosclerotic material. Despite advances in diagnosis and treatment, surgical repair is not without risks and patients need to be informed of the potential complications.

Large Doubly Septated Concha Bullosa: An Unusual Anatomic Variation.

Partial or total pneumatization of the middle turbinate is called concha bullosa. It's one of the most common anatomic variations of the lateral nasal wall. The exact reason of such pneumatization is not known. It can originate from the frontal recess, middle meatus, sinus lateralis or, less frequently, from the posterior ethmoid cells. Concha bullosa remains usually asymptomatic. However, an extensively pneumatized middle turbinate may constitute space-occupying mass, and thus, it may cause nasal obstruction. We report an extremely rare case of a patient with a large, doubly septated concha bullosa with four different sources of aeration.

Non-sphenopalatine dominant arterial supply of the nasal cavity: an unusual anatomical variation

We present a rare and clinically relevant anomaly of the sphenopalatine artery in relation to its blood supply of the nasal mucosa, with implications for the management of epistaxis. Case report and review of the world literature, using Medline through Pub Med (1950-2005), EMBASE (1980-2005) and Ovid (1958-2005), searching for papers using a combination of terms including 'spheno-palatine artery', 'anterior ethmoidal artery' and 'epistaxis'. In the presented case of refractory epistaxis, endoscopic and subsequent endovascular management failed to identify a significant supply from the sphenopalatine arteries bilaterally. The main supply was found to be from the anterior ethmoidal arteries. After a detailed search, the authors failed to locate any similar case in the English literature.

An unusual variation of deltoid muscle

An unusual anatomic variation of the deltoid muscle was found in a 45-year-old female cadaver during dissection of the right upper extremity. The posterior fibers of the right deltoid muscle were enclosed in a distinct fascial sheet and the deltoid muscle was seen to arise from the middle 1/3 of the medial border of the scapula. There was no accompanying vascular or neural anomaly of the deltoid muscle. To the best of our knowledge, unilateral posterior separation of the deltoid muscle with a distinct fascia has not been described previously. While dissecting deltoid, posterior deltoid, or scapular flaps, the surgeon needs to look out for this variation because it may cause confusion.

Combined unusual anatomical variations of the superior mesenteric and right renal arteries

Combined unusual anatomical variations of the superior mesenteric and right renal arteries

External invasive resorption in a three‐rooted lower first molar*

Several pathoses can be present concurrently in one tooth, and if that tooth has an unusual anatomical variation, the diagnosis and treatment can be further complicated. This case stresses the importance of accurate assessment and diagnosis prior to intervention and their role in identifying cases for referral to a specialist in today's increasingly litigious environment.

An aberrant anatomic variation along the course of the ulnar nerve above the elbow with coexistent cubital tunnel syndrome

We report on a patient with an unusual anatomic variation along the course of ulnar nerve above the elbow who had cubital tunnel syndrome. The variation consisted of a cutaneous neural branch that was originating at a distance of approximately 40 mm proximal to the medial epicondyle, and from the radial aspect of the main trunk of ulnar nerve. The branch had a superficial course and it was passing distally, anterior to the medial epicondyle without penetrating the fascia of the flexor muscles origin. Anterior intramuscular transposition of the ulnar nerve was performed leaving the newly found branch over the fascia between the muscles and the adipose subcutaneous tissue.

Surgical Implications of an Unusual Anomaly of the Infraorbital Nerve

The infraorbital nerve is a direct extension of the maxillary division of the Vth cranial nerve. It typically courses anteriorly through a canal within the bone of the orbital floor. We describe an unusual anatomic variation of this canal that to our knowledge has not been previously described in the literature. This anomaly may have significant implications during surgery on the paranasal sinuses and maxillofacial skeleton. Careful preoperative assessment of the course of the infraorbital nerve is necessary to prevent iatrogenic hypoesthesia, paresthesia, or neuralgia.

An unusual anatomic variation of a unicornuate uterus with normal external uterine morphology

To describe a case of a unicornuate uterus with a normal external uterine morphology. Case report. University-based fertility center. A 30-year-old nulligravid woman with a 1-year history of infertility found to have a right proximal tubal occlusion on hysterosalpingogram. Laparoscopy, hysteroscopy, and magnetic resonance imaging. External and internal morphology of the uterus. Laparoscopy showed a normal external uterine morphology and normal fallopian tubes and ovaries, but chromopertubation failed to demonstrate a fill and spill from the right fallopian tube. Hysteroscopy showed a single tubular uterine cavity projecting to the left with a single left tubal ostium, consistent with a unicornuate uterus. Magnetic resonance imaging confirmed a normal external uterine fundal contour and an internal uterine morphology consistent with a unicornuate uterus. This is the first reported case of a unicornuate uterus presenting with a normal external uterine morphology and an internal morphology consistent with a unicornuate uterus, and we propose inclusion of this anomaly in the classification of mullerian anomalies.

Uterine Artery Replacement by the Round Ligament Artery: An Anatomic Variant Discovered during Uterine Artery Embolization for Leiomyomata

The authors report a case of an unusual anatomic variation encountered during uterine embolization, that of absence of a uterine artery, with replacement by an enlarged round ligament artery. This case highlights the importance of understanding the arterial anatomy of the uterus and its potential variations and their potential impact on the outcome of the procedure.

Unusual anatomic variation of palmar sensory branches of the ulnar nerve: A case report

Variant sensory branches of the ulnar nerve were encountered during a routine dissection of the palmar aspects of a cadaver hand. The variant branches were distributed to the ulnar half of the index, ulnar half of the middle, and radial half of the ring fingers. The communicating branch between the superficial ulnar branch and the third common digital branch of the median nerve was absent. Distribution of the median nerve sensory branches was normal. The clinical significance of this variation is discussed.

Large isthmus of the cingulate gyrus: An unusual anatomical variation simulating tumor

The isthmus of the cingulate gyrus connects the cingulate gyrus to the parahippocampal gyrus. This isthmus demonstrates variable morphological appearances ranging from normal to prominent, and very prominent types. One unusual variety is an apparently large isthmus with a potential to be misinterpreted as a tumor, which is the main topic of this paper.

Positive Identification By Post-Surgical Defects from Unilateral Lambdoid Synostectomy: A Case Report

The comparison of pre- and postmortem radiographs as a method of identification of unknown human remains is well established in the forensic and radiologic literature. Identification can be based on a single bony feature when there is evidence of prior surgery, trauma or unusual anatomic variation. We present a case in which a positive identification was made using bony changes in the skull secondary to prior surgery for correction of unilateral lambdoid craniosynostosis. The unusual radiographic appearance of the bony defect initially raised the question of trauma and foul play.