• The Korean Journal of Pain
• /
• 제35권3호
• /
• pp.250-260
• /
• 2022

Background: Cranial nerve ganglia, which are prone to viral infections and tumors, are located deep in the head, so their detailed anatomy is difficult to understand using conventional cadaver dissection. For locating the small ganglia in medical images, their sectional anatomy should be learned by medical students and doctors. The purpose of this study is to elucidate cranial ganglia anatomy using sectioned images and three-dimensional (3D) models of a cadaver. Methods: One thousand two hundred and forty-six sectioned images of a male cadaver were examined to identify the cranial nerve ganglia. Using the real color sectioned images, real color volume model having a voxel size of 0.4 × 0.4 × 0.4 mm was produced. Results: The sectioned images and 3D models can be downloaded for free from a webpage, anatomy.dongguk.ac.kr/ganglia. On the images and model, all the cranial nerve ganglia and their whole course were identified. In case of the facial nerve, the geniculate, pterygopalatine, and submandibular ganglia were clearly identified. In case of the glossopharyngeal nerve, the superior, inferior, and otic ganglia were found. Thanks to the high resolution and real color of the sectioned images and volume models, detailed observation of the ganglia was possible. Since the volume models can be cut both in orthogonal planes and oblique planes, advanced sectional anatomy of the ganglia can be explained concretely. Conclusions: The sectioned images and 3D models will be helpful resources for understanding cranial nerve ganglia anatomy, for performing related surgical procedures.

• 대한두개안면성형외과학회지
• /
• 제24권3호
• /
• pp.91-104
• /
• 2023

Unilateral cleft lip is a common congenital anomaly that affects the appearance and function of the upper lip and nose. Surgical repair of cleft lip aims to restore the normal anatomy and functionality of the affected structures. In recent years, several advances have been made in the field of cleft lip repair, including new surgical techniques and approaches. This comprehensive review discusses the surgical management of patients with unilateral cleft lip and palate and provides step-by-step instructions for the surgical procedures.

• Anatomy and Cell Biology
• /
• 제56권4호
• /
• pp.441-447
• /
• 2023

One of the suprahyoid muscles is the digastric muscle which comprises anterior and posterior bellies joined by an intermediate tendon. Because of its close relationship with the submandibular gland, lymph nodes, and chief vessels of the neck, detailed knowledge about the morphometry of the digastric muscle is essential. The objective of the current cross-sectional evaluative study is to record morphometry along with the digastric muscle's origin, insertion, and variability. Forty human cadavers (25 males and 15 females) were dissected, and the head and neck regions were studied in detail. The attachment of the digastric muscle anterior belly to the digastric fossa of the mandible was noted, and the distal attachment of the posterior belly to the mastoid notch was traced. The length of the anterior belly from the digastric fossa to its intermediate tendon and the length of the posterior belly from the intermediate tendon to its mastoid attachment were measured. There is a fair correlation between the length of the neck and the length of the anterior and posterior belly. The study also identified two cases of bilateral accessory bellies of the anterior belly of the digastric. Normal morphometric data is provided by this study on details of the digastric muscle. It is significant from a clinical and surgical point of view as the muscle lies in proximity to the important structures of the neck.

• Journal of Chest Surgery
• /
• 제51권3호
• /
• pp.180-186
• /
• 2018

Background: Endovascular aortic repair (EVAR) is widely performed to treat infrarenal abdominal aortic aneurysms (AAAs), and related techniques and devices continue to be developed. Although continuous attempts have been made to perform EVAR in patients with unfavorable aortic anatomy, the outcomes are still controversial. This study examined the short-term outcomes of EVAR for the treatment of infrarenal AAAs in patients with a 'hostile' neck and unfavorable iliac anatomy. Methods: Thirty-eight patients who underwent EVAR from January 2012 to December 2017 were enrolled in this study. A hostile neck was defined based on neck length, angulation, the presence of an associated thrombus, or a conical shape. Unfavorable iliac anatomy was considered to be present in patients with a short common iliac artery (<15 mm) or the presence of aneurysmal changes. Results: No perioperative mortality was recorded. No significant differences were found depending on the presence of a hostile neck, but aneurysmal sac shrinkage was significantly less common in the group with unfavorable iliac anatomy (p=0.04). A multivariate analysis performed to analyze the risk factors for aneurysmal progression revealed only unfavorable iliac anatomy to be a risk factor (p=0.02). Conclusion: Patients with unfavorable aortic anatomy showed relatively satisfactory short-term outcomes after EVAR. No difference in the surgical outcomes was observed in patients with a hostile neck. However, unfavorable iliac anatomy was found to inhibit the shrinkage of the aneurysmal sac.

• Anatomy and Cell Biology
• /
• 제57권2호
• /
• pp.246-255
• /
• 2024

Knowledge of the superficial radial nerve (SRN) relationship and anatomic variations of the first extensor compartment (1st EC) will contribute to a better outcome of de Quervain tenosynovitis treatment. We dissected 87 embalmed cadaveric wrists to determine the relationship of the SRN, the 1st EC length, distance from the proximal and distal 1st EC borders to radial styloid process (RSP), abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendon slip numbers, and the presence of septum. Our results revealed SRN crossing over the 1st EC in 59.5%. The lateral branch of the superficial radial nerve to the 1st EC midline in most cases (61.9%) except for one specimen, where lateral antebrachial cutaneous nerve was the closest. Distances from proximal and distal 1st EC borders to the RSP were 19.7±4.1 mm and 7.6±1.8 mm, respectively. Extensor retinaculum (ER) width over 1st EC (1st EC length) was 14.8±3.2 mm. Complete and incomplete septa were found in 17.2%, and 42.5%, respectively. The most frequent APL tendon slip number in the compartment was two in overall 47 specimens (54.0%). Almost all compartments (85 specimens; 97.7%) contained one EPB tendon slip. We detected bilateral EPB absence in one cadaver. Moreover, we recorded a tendon slip from extensor pollicis longus traveling into 1st EC bilaterally in one cadaver and observed the EPB muscle belly extension into 1st EC in 9 wrists. Awareness of 1st EC anatomic variations would be essential for successful surgical and nonsurgical outcomes.

• Anatomy and Cell Biology
• /
• 제56권3호
• /
• pp.401-403
• /
• 2023

This case report describes a variation of the flexor digitorum brevis (FDB) with a separated muscle belly and tendon at the fifth toe. The narrow tendon and muscle belly for the fifth toe arose from the intermuscular septum between the FDB and abductor digiti minimi adjacent to the arising fibers of the FDB, separating from its other fibers. The tendon and muscle belly for the fifth toe became wider at the base of the metatarsal bones and narrower as it coursed toward the toes in a fusiform shape. The tendon and muscle belly for the fifth toe became thin at the midfoot and coursed just beneath the flexor digitorum longus tendon and entered the digital tendinous sheath. FDB variations including that described herein should be considered when performing various surgical procedures and evaluating the biomechanics of the foot.

• Archives of Plastic Surgery
• /
• 제43권3호
• /
• pp.229-236
• /
• 2016

Recently, diagnoses of and operations for medial orbital blowout fracture have increased because of the development of imaging technology. In this article, the authors review the literature, and overview the accumulated knowledge about the orbital anatomy, fracture mechanisms, surgical approaches, reconstruction materials, and surgical methods. In terms of surgical approaches, transcaruncular, transcutaneous, and transnasal endoscopic approaches are discussed. Reconstruction methods including onlay covering, inlay implantation, and repositioning methods are also discussed. Consideration and understanding of these should lead to more optimal outcomes.

• Anatomy and Cell Biology
• /
• 제56권3호
• /
• pp.350-359
• /
• 2023

The suboccipital triangle (ST) is a clinically relevant landmark in the posterior aspect of the neck and is used to locate and mobilize the horizontal segment of the third part of the vertebral artery before it enters the cranium. Unfortunately, this space is not always a viable option for vertebral artery exposition, and consequently a novel triangle, the inferior suboccipital triangle (IST) has been defined. This alternative triangle will allow surgeons to locate the artery more proximally, where its course is more predictable. The purpose of this study was to better define the anatomy of both triangles by measuring their borders and calculating their areas. Ethical clearance was obtained from the University of Pretoria (reference number: 222/2021) and both triangles were subsequently dissected out on both the left and right sides of 33 formalin-fixed human adult cadavers. The borders of each triangle were measured using a digital calliper and the areas were calculated using Herons Formula. The average area of the ST is 969.82±153.15 mm², while the average area of the IST is 307.48±41.31 mm². No statistically significant differences in the findings were observed between the sides of the body, ancestry, or sex of the cadavers. Measurement and analysis of these triangles provided important anatomical information and speak to their clinical relevance as surgical landmarks with which to locate the vertebral artery. Of particular importance here is the IST, which allows for mobilisation of this artery more proximally, should the ST be occluded.

• Anatomy and Cell Biology
• /
• 제57권2호
• /
• pp.316-319
• /
• 2024

Comprehensive understanding of the variations in the branching of the external carotid artery (ECA) is essential to minimizing vascular complications during cranio-facial and neck surgical procedures. We demonstrate a rare case of unusual branching of ECAs in both carotid triangles and anomalous origin of the left ascending pharyngeal artery (APA) during dissection of embalmed cadaver. The right and left common carotid arteries (CCA) bifurcated at the level of the upper border of the thyroid cartilage. The right superior thyroid artery (STA) originated anterior to the carotid bifurcation (CB), while the left STA originated from the anterior aspect of the left CCA. The right ECA trifurcated into linguofacial trunk, APA, and distal ECA, 15.7 mm from CB. On the left side, lingual artery and APA arose as a short common linguopharyngeal trunk, 1.9 mm from CB. The left facial and occipital arteries originated anteromedially and posteriorly at the same level.

• Anatomy and Cell Biology
• /
• 제57권2호
• /
• pp.204-212
• /
• 2024

In the present study, anatomical assessment of zygomaticofacial foramina (ZFFs) and zygomatic canals communicating with ZFFs were performed using cadaver micro-computed tomography images. It was suggested that all ZFFs were located above the jugale (Ju)-zygomaxillare (Zm) line, which is the reference line connecting the Ju and Zm, and most were located in the zygomatic body area (ZBA). The anteroposterior position of the ZFF in the ZBA was within a middle to posterior region and was most often located slightly posteriorly in males and closer to the middle of the region in females. The mean distance from the Ju-Zm line to the ZFF in the ZBA was 12.36 mm (standard deviation [SD] 1.52 mm) in males and 11.48 mm (SD 1.61 mm) in females. In zygomatic canals communicating with ZFFs, most zygomatic canals were type I canals, communicating from the zygomaticoorbital foramen and harboring the zygomaticofacial nerve, and the others were type II canals, communicating from the zygomaticotemporal foramen and located near the posterior margin of the frontal process. These results provide useful anatomical information for preventing nerve injury during surgical procedures for zygomatic implant treatment.