Variations Of Fissures Research Articles

Morphological variations of fissures, lobes, and hilar pattern of the lung in a select South African sample.

The lungs are essential respiratory organs divided into lobes by the horizontal and oblique fissures. The hilum, located on the mediastinal surface of each lung, is where the bronchus, pulmonary veins, and pulmonary arteries enter and exit. This study aims to investigate and record the variations in the morphology of lung fissures, lobes, and hilar patterns observed in a South African sample. This cross-sectional observational study employed descriptive analysis. A total of 48 formalin-fixed bodies, comprising 24 females and 24 males from the Department of Human Biology at the University of Cape Town were studied were examined. Fissures were classified according to the Craig and Walker criteria. Incomplete oblique fissures were found in 25 right lungs and 30 left lungs. Incomplete horizontal fissures were observed in 39 right lungs, and one right lung exhibited the absence of both horizontal and oblique fissures. Accessory fissures were present in five right and seven left lungs. Variations in the hilar pattern were noted, including differences in the number and arrangement of structures in both right and left lungs. Variations were observed in the lobes, fissures and the hilar patterns of several lungs. Awareness of these morphological variations is crucial for surgeons and radiologist to avoid misdiagnosis and complications during surgical procedures.

An Analysis of the Anomalous Fissure of the Ligamentum Teres Hepatis: A Morphological Perspective in the North Indian Population.

Background The liver, being the largest internal organ of the body shows a variety of gross morphological variations about lobes, fissures and processes which may be clinically significant. Among various anatomical variations, the most found is the variant fissure for ligamentum teres hepatis.The present study was done to classify, review, compare and discuss the literature for anomalies in fissures for ligamentum teres hepatis. Methods A total of 100 formalin-preserved human livers were obtained from the Department of Anatomy of King George's Medical University, Lucknow, and studied for one year. Result In our study, 15% of the liver showed morphological variations in fissures for ligamentum teres hepatis. These were classified into four types. In type I (2%), the fissure was converted into a tunnel by pons hepatis. In type II (3%), there was an incomplete fissure for ligamentum teres hepatis extending into the diaphragmatic surface.In type III (4%), there was an incomplete fissure for ligamentum teres hepatis present only on the visceral surface. In type IV (6%), the fissure was covered by a thin membrane. Conclusion In this study of the North Indian population, 15% ofliver have gross morphological variations. So thorough anatomical knowledge of the existence of variant or abnormal surface features on the liver isimperativeto understanding the underlying pathology for radiologists and surgeons so that a favorable outcome can be achieved.

Morphological and morphometric analysis of lung: A cadaveric study

Background: The lung is a respiratory organ in which steady development begins during the embryonic period at 0–7 weeks’ gestation and continues into early childhood. Cardiothoracic surgeries and procedures such as lobectomy, segmental resection of bronchoscopy, require a thorough knowledge of the anatomy of the lung. Study of length, fissures and lobes of the lung can guide the surgeons for the above procedures and help them to prevent undue complications during surgery. Many variations are noted by researchers till date in both the lungs in regards to length, breadth, fissures, and lobes. In the current study, we have also observed variations in fissures of lung. Aims and Objectives: To study the normal length, breadth, and thickness of both sides of lungs, variations in the length, breadth, and thickness of both sides of the lungs. To study the normal fissures, lobes and their variations, of both right and left lungs, and also to study the number of bronchi, pulmonary artery, and pulmonary vein. Materials and Methods: 50 Right and 50 left lungs were obtained from embalmed cadavers, used for dissection in the Department of Anatomy, King George’s Medical University, Lucknow, UP, by using measuring tape and measuring scale. Photography was done by a DSLR camera. Results: The left lung shows maximum variations in the hilum. Out of 50 left lungs, 6 showed the absence of oblique fissures, 2 lungs had 2 arteries, 2 lungs had 2 Veins, and 1 had 2 bronchi. Out of 50 right lungs, 2 lungs showed 2 arteries, 2 lungs had 2 veins, and 2 had 3 bronchi. Conclusion: Knowledge of normal measurements of both sides of the lungs and their variations may help cardiothoracic surgeons avoid complications during surgery and it may help radiologists resolve uncertain radiographic findings.

Anatomical Variations in Fissure of the Lung on Computed Tomography

Objective: Lung fissures embryologically separate the bronchopulmonary segments from each other. We aimed to detect anatomical variations in fissures in patients who underwent thoracic computed tomography (CT). Materials and Methods: All the patients underwent a thoracic CT examination between July 1 - July 15, 2022. The patients’ gender, lung fissures continuity, accessory fissures presence, and variation side were recorded. The frequency of fissures was compared between the genders using the chi-square test. Results: The study included a total of 352 patients (211 men, 141 women). A total of 105 variations were detected in 95/352 (26.99%) of the patients, 61/211 (28.91%) were male, 34/141 (24.11%) were female. The right oblique fissure was incomplete in nine (2.6%), and the right horizontal fissure was incomplete in 14 (4%) patients and absent in 14 (4%). The left oblique fissure was observed to be incomplete in 16 (4.5%) patients. A total of 52 (14.8%) accessory fissures were detected. Conclusion: In the literature, a wide variety of fissure variations have been reported. Due to this diversity, having good knowledge of the fissure anatomical architecture is essential when performing surgical procedures and interpreting radiological images to clinically identify the location of bronchopulmonary segments.

Indigenous Cadaveric Variations in Lung Fissures and Lobes

Introduction: Lung fissures are responsible for uniform expansion. These fissures may be complete, incomplete or absent causing lobar variation. A detailed knowledge of variations of classical and accessory fissures is necessary for proper pulmonary radiological interpretation. Patients benefit from accurate assessment of integrity of pulmonary fissures during cardiothoracic surgery as surgeons can perform segmental lung resections and lobectomies safely to have an uncomplicated perioperative outcome. So, the cadaveric study was done to note the morphological variation of the fissures of lung in Pakistan cadaveric population and compare it with the previous study.
 Aims & Objectives: To determine the frequency of variations in fissures and lobes of the lungs on cadaveric Pakistani population.
 Place and duration of study: Anatomy Departments of KEMU and AIMC, Lahore. Duration of study was from 2020 to 2022
 Material & Methods: An observational cross-sectional study was conducted on 160 cadaveric lung specimens from AIMC and KEMU Anatomy Departments. They were preserved in 10% formalin and were studied for morphological details of their lung lobes and fissures. Data was collected and graded using Craig and Walker classification. Data was analysed using SPSS 22 version. p value ? 0.05 was taken as significant
 Results: Out of 160, 77% of the left lung and 75% of the right lungs were normal. Among the variations, horizontal fissure had shown to be more variable as compared to oblique fissure .18% of the right-side specimens were shown to have incomplete horizontal fissures and in 4% of the specimen, they were totally absent. 15% of the left side specimen had incomplete oblique fissures whereas only 2% of the right-side specimen had incomplete oblique fissures. Accessory fissures were more common in the left side specimens as compared to the right-side specimens.
 Conclusion: Morphological variations do occur in normal population, and they must be kept in mind during radiological and surgical interventions.

A study of morphological variations of fissures and lobes of formalin fixed cadaveric lungs

Background: Variation of morphology of lung fissures and lobes affects the interpretation of results of radiological examination as well as line of action in cardiothoracic surgical procedures. A research was done to find out the incidence of variations of fissures and lobes in embalmed cadaveric lungs.
 Materials and methods: This is a cross sectional study. All the formalin fixed lung specimens present in dissection halls and museums of the Anatomy Departments were observed for any abnormal fissures that are adding accessory lobes to lungs. Data was entered and analyzed by using SPSS 22.0. Descriptive analysis was applied by using frequencies and percentages for qualitative variables.
 Results: Total 80 formalin-fixed specimens of lungs were examined and a total of 29 (36.25%) (%) were found to have incomplete fissures. It was observed that 14 (17.5 %) out of 80 lungs had incomplete oblique fissures, and out of these 6 (17.65%) were found in right lungs and 08 (19.05%) were present in left lungs, whereas 15 (39.47%) right lungs showed incomplete horizontal fissure. Among 80 lungs, 6 (7.5%) presented unusual accessory fissures and lobes, whereas 5 (14.7%) showed absent horizontal fissure reducing the number of lobes to two in right lung specimen.
 Conclusion: There is a prevalent incidence of incomplete horizontal fissure that must be kept in mind when investigating and treating any lung pathology.

Study on Anatomical Variations in Fissures of Lung by CT Scan.

Introduction Refinements in the modern computed tomography (CT) imaging techniques have led to anatomical variations in the fissures of lung being diagnosed more frequently. So far, majority of the studies conducted are cadaveric. There is paucity of studies in this aspect based on chest CT images. Hence, we undertook this study to find the anatomical variations in the fissures. Prior detection of anatomical abnormalities is important to reduce postoperative complications in lung resection surgeries. Materials and Methods This was a cross-sectional study conducted over a period of 2 years. Data were collected from the patients who underwent CT scan thorax. Patients in whom normal anatomy of lung was distorted and cases where both lungs were not visualized completely were excluded from the study. All the CT images were reviewed by a single radiologist. The presence or absence of the normal and accessory pulmonary fissures, as well as the continuity of each fissure, was recorded by the radiologist. Data were compiled and analyzed. Results The study population consisted of 394 (70.4%) males and 166 (29.6%) females, totaling 560 cases. Fissural variations were detected in 22.9% ( n = 128). Also, 17.5% ( n = 98) fissural variations were seen in males and 5.4% ( n = 30) fissural variations were seen in females. Further, 54.7% ( n = 70) of variations were detected in the right lung and 45.3% ( n = 58) in the left lung. The most common fissural variation noted was right incomplete oblique fissure with a frequency of 8.4% cases ( n = 47). The most common accessory fissure detected was inferior accessory fissure. Total 22 cases were detected in both the lungs, 17 cases in male and 5 in female. Conclusion Anatomical variations in fissures were found to be more in the right lung than the left lung. Accessory fissures were detected in higher incidence on the right side.

A Study on Morphological Variations of Fissures and Lobes of Human Lungs with its Clinical Significance

Background: Fissures of lungs facilitate the movement of lobes which helps in expansion of lungs during breathing. The fissures may be complete, incomplete or absence. Sometime the accessory fissures may also present. Awareness of variations is essential during segmental resections as well as during radiological interpretation of lungs. Hence, the present study was aimed to study the morphological variations in fissures and lobes.
 Material and Methods: This study was consisted of sixty nine human lungs with irrespective of sex which were available in the department of anatomy of various medical colleges. All lung specimens were carefully observed and recorded for the presence of any variations in fissures and lobes.
 Results: The present study revealed that the absence of horizontal fissure was observed in 7.89%, while no specimen showed absence of oblique fissure on both sides. 35.48% of left lungs had incomplete oblique fissure compared to 28.95% of the right lungs. In addition, 22.58% of right lungs and 23.68% of left lungs showed presence of accessory fissure and lobes. From above, the incomplete and absent horizontal fissure was the most common abnormalities observed in this study. The accessory fissures were more common in lower lobe of right lung whereas in left lungs it was more common in upper lobe.
 Conclusion: The present study showed the wide range of variations in fissures and lobes of lungs. The knowledge of variations in morphology of lungs would be helpful for clinical diagnosis and pulmonary surgical procedures.

Variations in human pulmonary fissures and lobes: a study conducted in nepalese cadavers.

The fissures of lungs are embryologically separating the bronchopulmonary segments, which later on persist in interlobar planes of fully developed lung. Fifty lungs (23 right side and 27 left side), obtained during routine dissection and preserved in formalin constituted the material for present study. In them, variations in fissures and lobes of lung were observed and compared with the previous studies. Seven right sided and 14 left sided lungs showed incomplete oblique fissure. Incomplete horizontal fissure of right lung was observed in eight lungs while it was completely missing in three specimens. A right lung with “lobe of the azygos vein” separated by a supernumerary fissure in medial surface was found. One of the right lung had both superior accessory fissure and inferior accessory fissure and four other right lungs and one left lung presented only with inferior accessory fissure. A vertical notch was found in middle lobe of one right lung. Eight left lungs exhibited with left minor fissure among them two lungs had lingula appearing as a separate lobe. Knowledge of variations in fissures and lobes is of interest to all medical professionals to exactly interpret radiographs, computed tomography scans, to diagnose, plan and modify a surgical procedure depending on the merit of the case and also in certain classical clinical cases pertaining to lung pathologies.

A cadaveric study on morphological variations of fissures and lobes in the human lungs and its clinical significance

Background: Knowledge of the anatomy and variations of the major fissures are essential to recognize pulmonary abnormalities, for segmental lung resection and radiological interpretations. Objective: To study the morphological variations of fissures and lobes in the human cadaveric lungs. Materials and Methods: One hundred specimens of formalin-fixed adult lungs of unknown gender were studied and the following parameters were measured bilaterally: (a) presence or absence of complete or incomplete fissure, (b) presence of accessory fissure, and (c) length of fissures. The observations and measurements were recorded, compiled, and tabulated and the result was compared with the other studies. Results: Length of oblique fissure was 29.36 ± 5.61cm with range of 17.9 - 42.0 cm on the right side and 26.81 ± 8.18 cm with range of 10.8–38.9 cm on the left side. Length of horizontal fissure was 10.2 ± 8.4 cm with range of 6.1–12.8 cm on the right side. Oblique fissure was complete in 84.0% cases on the right side and was in 82.0% cases on the right side. It was incomplete or absent in 16% (R) and 18% (L) cases. Horizontal fissure was complete in 74% and incomplete or absent in 26% of cases. Accessory fissure was found in a total of eight lung specimens. Conclusions: The knowledge of anatomy of fissures of the lung provides information on lobar anatomy with variations. The present study result and its comparison with other researches confirmed that lobar architecture is not constant. It emphasizes its usefulness in the diagnostic and surgical field.

Cadaveric study of morphological variations of fissures and lobes of lungs and their clinical significance

Cadaveric study of morphological variations of fissures and lobes of lungs and their clinical significance

Variations of fissures and lobes in human lung – A cadaveric study

Variations of fissures and lobes in human lung – A cadaveric study

Anatomical variations of fissures of lung: A cadaver based study

Dysphagia and bolus aspiration are two of the most frequent and invalidating symptoms of various neurological diseases. Swallowing disorders often lead to tracheobronchial aspiration with consequent pneumonia episodes. Aspiration pneumonia per se constitutes the most frequent cause of death in these patients, with mortality rate ranging from 20% to 62%. Oropharyngoesophageal scintigraphy (OPES) permits functional quantitative assessment of the different stages of swallowing, together with the detection and quantitative measurement of bolus aspiration. In this work, we analyzed the role of OPES in patients with different neurological conditions to evaluate swallowing and to detect and quantify bolus aspiration.We enrolled 43 neurological patients (25 women and 18 men, mean age 67.3 ± 12.4 yr) complaining of dysphagia with suspected inhalation. All patients underwent OPES with 99mTc-nanocolloid using a liquid bolus first, followed by a semi-solid bolus. We evaluated the following parameters: Oral, Pharyngeal and Esophageal Transit Time, Oro-Pharyngeal Retention Index, Esophageal Emptying Rate, and Aspiration Rate (% AR).OPES detected some airway aspiration in 26/43 patients. 19 patients had tracheal aspiration (with a mean 18.1% AR) and the remaining 7 patients had bilateral broncho-pulmonary aspiration (mean 44.9% AR).OPES is a feasible, repeatable and noninvasive method that allows quantitative assessment of bolus aspiration into the tracheobronchial tract, thus representing a useful and accurate tool to guide the most appropriate treatment and to monitor response to therapy in neurological patients with dysphagia.La disfagia y la broncoaspiración de comida son 2 de los síntomas más frecuentes e invalidantes de diversas enfermedades neurológicas. Los trastornos de deglución producen una aspiración traqueobronquial y episodios de neumonía. La neumonía por aspiración constituye en sí misma la causa más frecuente de muerte en estos pacientes, con tasas de mortalidad entre 20–62%. La gammagrafía orofaringeoesofágica (OPES) permite la evaluación funcional cuantitativa de los diferentes estadios de la deglución, junto con la detección y la cuantificación de la broncoaspiración. En este trabajo analizamos el papel de la OPES para evaluar la deglución y para detectar y cuantificar la broncoaspiración de comida en pacientes con variadas situaciones neurológicas.Se estudiaron 43 pacientes neurológicos (25 mujeres y 18 hombres, edad media 67,3 + 12,4 años) que presentaban disfagia y sospecha de inhalación. A todos los pacientes se les realizó OPES con 99mTc-nanocoloide usando primero un bolo líquido y después un bolo semisólido. Se evaluaron los siguientes parámetros: tiempos de tránsito oral, faríngeo y esofágico, índice de retención orofaríngea, tasa de vaciamiento esofágico, índice de retención orofaríngea, tasa de vaciamiento esofágico y tasa de aspiración (%AR).La OPES detectó broncoaspiración en 26/43 pacientes. Diecinueve pacientes tuvieron aspiración traqueal (media AR 18,1%) y los restantes 7 pacientes aspiración broncopulmonar bilateral (media AR 44,9%).La OPES es un método no invasivo, factible y repetible que permite la evaluación cuantitativa de la aspiración de comida en el tracto traqueobronquial. Por ello, representa un procedimiento útil y exacto para guiar el tratamiento más apropiado y para monitorizar la respuesta terapéutica en pacientes neurológicos con disfagia.

Absence of horizontal fissure right lung

Objectives : To examine the dissected cadavaric right lungs for the presence or absence of minor (horizontal) fissure right lung . Design: Descriptive study. (cadavaric study). Place and duration: - The study was conducted in dissection halls of various Medical colleges of Lahore (FMHC, FJMC & KEMC) from January 2003 to February 2004. Material &methods: A total number of 112 cadavaric specimens of right lung were dissected &examined for the presence or absence of minor fissure. Results: - Out of 112 specimens 9(9%) of specimens were showing the absence of minor fissure of right lung whereas 103(91%) of specimens of right lungs were showing presence of minor fissure. Conclusion: The percentage of anatomical variation (absence)of minor fissure of right lung is 09%. The study of anatomical variations of fissures of lungs is important for anatomists, surgeons& radiologists.

Anatomical study on variations of fissures of lung

Aim: This study is conducted to record the variations in fissures and lobes of lung which will be helpful for all clinicians and also of academic interest. Materials and Methods: The study was undertaken in 25 pairs of cadaveric specimens. The lungs were exposed to study the morphological features like number, fissures and lobes. Presence of anatomical variations was observed and photographed. Results: 11 right side lungs showed incomplete horizontal fissure. In 5 right lungs there was no horizontal fissure. Incomplete oblique fissure was found in 7 right lungs. 2 right lungs did not have any fissures. 8 left lungs exhibited incomplete oblique fissure. Conclusion: A detailed knowledge of the anatomy of the fissures of lung is essential for the proper interpretation of radiological images like X- ray, CT scan and MRI for the radiologists, cardiothoracic surgeons performing lobectomies, and segmental resections. Furthermore, the knowledge of fissures and lobes of lungs is important for the surgeons to properly manage the potential problems which may be encounterd during surgery. Keywords: Lungs, Horizontal fissure, Oblique fissure, Variations

A cadaveric study of anatomical variations of fissures and lobes of lung

Abstract Background and aim: The anatomical variations of fissures and lobes of lungs have been described by many research workers on CT scans, whereas, there were fewer studies done on gross anatomical specimens. Materials and methods: In the present study, 30 embalmed cadavers have been dissected and lungs were examined for fissures and lobes. Results: Nine out of 30 left lungs showed incomplete oblique fissures. Eight out of 30 right lungs showed incomplete transverse fissure but oblique fissure was complete, and in two right lungs, incomplete oblique and transverse fissures were found. In one cadaver one accessory lobe and one accessory fissure was present, on right side. Comparative analysis of present work with data in literature suggest that different studies performed on radiological images reported greater prevalence of incomplete or absence of pulmonary fissures as compared to present cadaveric study. Therefore our findings with regard to fissures and lobes are different from many studies but are approximately similar to two. Conclusion: Variation of lung anatomy is important for cardio-thoracic surgeons, radiologists for interpreting x-rays, CT scans and MRI and also it is of academic interest to all medical persons.

Incomplete Oblique Fissure, Absence of Horizontal Fissure: A Case Report

The right Lung classically has one oblique fissure and one horizontal fissure and Three Lobes namely Upper, Lower, and middle Lobes. Variations in the lung fissures and lobes have been described by many authors which have got their Surgical and Radiological importance. During Routine dissection in the Department of Anatomy, S.V. Medical College, Tirupati, we encountered an Incomplete oblique Fissure, Absence of Horizontal fissure in the Right Lung of an Adult male Cadaver. Anatomical Knowledge of the variations of Fissures of Lung are important for C.T. Surgeons performing Lobectomies, and Radiologists I. Introduction Right lung is broader and heavier than the left lung. Two fissures oblique and horizontal , divide it into three lobes namely, upper, middle and lower. The oblique fissure separates the lower lobe from the remaining two lobes. It runs obliquely and crosses the inferior border of the lung about 7.5 cm behind its anterior end. The horizontal fissure separates the upper and middle lobe. It begins from the oblique fissure, runs horizontally and cuts the anterior border at inner end of fourth costal cartilage. The longer and lighter left lung is divided into a superior and an inferior lobe by an oblique fissure which extends from costal to medial .surfaces of the lung both above and below the hilum 3 The fissures facilitate the movement of the lobes in relation to one another, which accommodates greater distention and movement of the lobes during respiration. The fissures may be complete, incomplete or absent. In case of complete fissure the lung lobes are held together only at the hilum by the bronchi and the pulmonary vessels. Parenchymal fusion of varied extent along the floor is found in case of incomplete fissure 4 . Knowledge of the anatomy and variations of the major fissures are essential for recognizing their variable imaging appearances as well as related abnormalities. The cardiothoracic surgeons performing segmental lung resections and the radiologists must have a detailed knowledge of variations of classical and accessory fissures regarding their length, depth, positions etc to have uncomplicated peroperative and postoperative events and proper radiological interpretations respectively.

A cadaveric study of anatomical variations of fissures and lobes of lung

A cadaveric study of anatomical variations of fissures and lobes of lung

Morphological variations of the lungs: a study conducted on Indian cadavers.

Awareness of anatomical variations in lungs is essential during segmental or lobar resections of lungs. We studied the variations of fissures, lobes and hilar structures in 65 right and 73 left isolated lungs from the dissection hall. Horizontal fissure was absent in 3.07% and incomplete in 35.38% of right lungs. Four point six one percentage of right lungs had 3 fissures and 4 lobes. Three point zero seven percentage of right lungs had 3 arteries, 67.69% had 2 arteries, and 29.23% had only one artery in the hilum. Sixty-three point zero seven percentage of right lungs had two veins in the hilum; 32.30% had 3 veins in the hilum; and 4.61% had more than 3 veins in the hilum. Ninety-eight point four six percentage of right lungs showed 2 bronchi in the hilum, and 1.53% of them showed 3 bronchi in the hilum. Two of the right lungs (3.07%) had an artery passing across the oblique fissure. Fifteen point zero six percentage of left lungs showed incomplete oblique fissure and 2.73% showed 2 fissures and 3 lobes. Five point four seven percentage of left lungs showed 2 arteries and 94.52% had only one artery in the hilum. Eighty point eight two percentage of left lungs had two veins in the hilum and 19.17% had 3 veins in the hilum. Twenty-one point nine one percent of left lungs had 2 bronchi and 78.08% had only one bronchus in the hilum. The knowledge of variations in the lobar and hilar anatomy of the lung presented in this study is clinically important while interpreting the radiological images and performing surgical procedures.