Surgical and Radiologic Anatomy : SRA

PURPOSE: The COVID-19 pandemic imposed unexpected disruptions to anatomical educational practice, the teaching of regional anatomy for international students which has changed to an online format and faces various challenges. The challenges include creating online education homogeneous/equivalent to offline education, introducing local culture to international students, and educating students in medical humanities and ethics. METHODS: To address these problems, the teaching staff integrated medical humanities and local culture into nonsynchronous online teaching of regional anatomy...

PURPOSE: The anterior ethmoidal artery is a major surgical landmark that is susceptible to iatrogenic injury during surgery of the anterior ethmoidal sinus, frontal sinus, and skull base. The present study aimed to define the location of the anterior ethmoidal artery in relation to specific anatomical landmarks using radiological imaging and endoscopic dissection. METHODS: Eighty-six anterior ethmoidal arteries were assessed using computed tomography scans (bilateral analyses) and forty anterior ethmoidal arteries were assessed using cadaveric specimens (bilateral analyses)...

INTRODUCTION: A rare variation known as "Moynihan's or caterpillar hump" of the right hepatic artery raises the danger of vascular and biliary injuries during hepatobiliary surgery. This research intends to carefully record every case (i.e., patients undergoing laparoscopic cholecystectomy or cadaver dissections) where the right hepatic artery received a caterpillar hump. METHODS: The literature search was conducted with the medical subject headings (MeSH) and EMTREE (subject headings unique to Embase) keywords...

PURPOSE: Anatomical knowledge of the hypoglossal canal is very important in relation to drilling of occipital condyle, jugular tubercle etc. So, this study was conducted to identify various morphometric and morphological features of the hypoglossal canal and its distance from adjacent structures relative to stable and reliable anatomic landmarks. METHODS: The study was performed on 142 hypoglossal canals of 71 adult human dry skulls. The parameters measured were the transverse, vertical diameter, depth of the hypoglossal canal...

INTRODUCTION: Anatomical variants observed during the posterior approach to the elbow joint require special attention due to their clinical relevance. We aim to present a compendious review of described variants potentially encountered during the posterior approach towards the elbow joint to the experts in the elbow surgery. METHODS: A narrative review of surgical and anatomical textbooks, as well as search of scientific databases was carried out. RESULTS: Variability of the subcutaneous nerves is important during incision planning...

PURPOSE: Sternal foramen is a perforation of the sternum that can be a source of misdiagnosis during radiographic imaging or life-threatening perforations during bone marrow sampling. The aim of this study was to conduct a meta-analysis on the prevalence, morphometrics, and location of foramen in the sternal body and xiphoid process, describe morphometric features of this phenomenon, and thus verify its clinical importance. Moreover, our secondary outcome was to compare effectiveness of various imaging methods in diagnosis of the sternal or xiphoid foramen...

PURPOSE: The tarsal tunnel (TT) is a fibro-osseous anatomical space coursing from the medial ankle to the medial midfoot. This tunnel acts as a passage for both tendinous and neurovascular structures, including the neurovascular bundle containing the posterior tibial artery (PTA), posterior tibial veins (PTVs) and tibial nerve (TN). Tarsal tunnel syndrome (TTS) is the entrapment neuropathy that describes the compression and irritation of the TN within this space. Iatrogenic injury to the PTA plays a significant role in both the onset and exacerbation of TTS symptoms...

PURPOSE: To present two cases of Internal Carotid Artery (ICA) agenesis and conduct a systematic review to assess for associations with other anomalies and intracranial aneurysms. METHODOLOGY: We performed a retrospective review of published cases of patients with ICA agenesis with intercavernous anastomosis in MEDLINE database on August 2022 using search terms "internal carotid artery", "agenesis" and "transcavernous anastomosis". We also included two cases of ICA agenesis with type D collateral that we encountered...

PURPOSE: The Cerebral arterial circle presents multiple individual anatomical configurations which are of the highest importance regarding the pathological processes for intracranial aneurysms development. Previous studies highlighted the importance of geometry and especially arterial bifurcations leading to aneurysms development. The primary objective of this study was to determine whether a flow pattern asymmetry of the P1 segments of the posterior cerebral arteries was associated with a higher risk of basilar tip aneurysm...

PURPOSE: Interosseous tuberosities have been described in adults on the radial and ulnar sides. However, their presence at birth and their development during growth is still unknown. The objective of this work is to establish the age of onset of this tuberosity among a cohort of children aged 1-year-old or older. METHODS: All anterior-posterior and lateral radiographs performed in our hospital during a consecutive period of 6 months were retrospectively analyzed...

The radiologic evaluation of the sagittal angulation of the distal humerus is commonly based on standard lateral radiographs. However, lateral radiographs do not allow to examine the lateral angulation of the capitulum and the trochlea, separately. Although this problem could be approached via computed tomography, there are no data available describing the difference between the angulation of the capitulum and trochlea. Therefore, we aimed to assess sagittal angles of the capitulum and trochlea in relation to the humeral shaft based on 400 CT-scans of the elbow in healthy adults...

PURPOSE: This study aimed to delineate three-dimensional (3D) root morphology and topological locations of mandibular third molars (MTMs) by cone-beam computed tomography (CBCT) in a Chinese adult dental population. METHODS: Adult patients with MTMs were retrospectively screened based on CBCT images at our institution between January 2018 and December 2019. Root morphology and spatial locations of these teeth were defined based on CBCT 3D images. Potential associations with epidemiological and clinical/radiological parameters were analyzed using Chi-square or Fisher exact test...

INTRODUCTION: A double aortic arch (DAA) is a rare congenital vascular anomaly. No case of DAA with a direct aortic origin of the right vertebral artery (VA) has been reported in adults. Here, we report a rare case of an asymptomatic DAA accompanied by the right VA directly originating from the right aortic arch in an adult. CASE PRESENTATION: A DAA and right VA directly originating from the right aortic arch were identified in a 63-year-old man using digital subtraction angiography and computed tomography angiography...

PURPOSE: The observation of an accessory bone joined to the sacrum (suggestive of a sacral rib) prompted us to describe the structure's morphology and its anatomic relationships and to consider its morphogenesis and clinical implications. METHOD: A 38-year-old woman underwent computed tomography, to characterize the extension of a thoracic mass. We compared our observations with the literature data. RESULTS: We observed a voluminous accessory bone located behind and to the right of the sacrum...

PURPOSE: The Heschl Gyrus (HG), which includes the Primary Auditory Cortex (PAC), lies on the upper surface of the superior temporal gyrus (T1). It has been the subject of growing interest in the fields of neuroscience over the past decade. Given the considerable interhemispheric and interindividual variability of its morphology, manual labelling remains the gold standard for its radio-anatomical study. The aim of this study was to revisit the original work of Richard L. Heschl, to provide a broad overview of the available anatomical knowledge and to propose a manually labelled 3D digital model...

PURPOSE: The double coronoid process (DCP) is a very unusual feature in patient. The literature, which briefly describes just only one case. Being this a very unusual feature, the aim of the paper is to describe the finding, discuss the anatomic, radiological, and clinical characteristics of a DCP. METHODS: A 61-year-old-woman with no significant medical history, extraoral and intraoral examination was unremarkable. Following panoramic radiography (PR) for assessment of periodontal support and pre-implant planning suspicious radiopaque area in the mandibular notch on the left side was observed...

The middle fossa, cavernous sinus, and paraclival triangles consist of ten triangles. Their use in a surgical approach is vast; most are used as landmarks to access and identify other structures of surgical interest. Multiple labels, borders, and contents mentioned by different authors make understanding and reproduction challenging and confusing. This study aims to organize and clarify recent or most relevant publications and disclose our portrayal of the ten triangles using cadaveric dissection and simple and practical figures...

PURPOSE: The cingulate gyrus is a potential surgical area to treat tumours, psychiatric diseases, intractable pain and vascular malformations. The aim of the study was to define the topographic anatomy and arterial supply of the cingulate gyrus located on the medial surface of the cerebral hemisphere. METHODS: We studied thirty-six hemispheres, each hemisected in the midsagittal plane. The vertical thickness of the cingulate gyrus was measured at the anterior commissure (AC), posterior commissure (PC), and genu levels of the corpus callosum...

Anomalous variants of the extensor tendons in the first and third compartments of the wrist have been described following cadaveric study. Being aware of such variants during either an elective or emergency hand surgery will prove beneficial in the execution of the extensor tendon repairs. A very few clinical reports are available in the literature. We report a rare finding of extensor pollicis brevis tendon accompanying the solitary extensor pollicis longus tendon in the third compartment observed during an emergency trauma surgery...

PURPOSE: Vertebral arteries (VAs) provide blood circulation to the posterior fossa in general and are the main blood supply of the posterior fossa structures of the brain. Our aim in this study is to analyze the segmental volumetric values of cerebellar structures with the voxel-based volumetric analysis system in individuals with unilateral vertebral artery hypoplasia. METHODS: In this retrospective study, segmental volumetric values/percentile ratios of cerebellar lobules were calculated using 3D fast spoiled gradient recall acquisition in steady-state (3D T1 FSPGR) MRI sequence images of the brain in individuals with unilateral vertebral artery hypoplasia (VAH) and in those without bilateral VAH and any symptoms of vertebrobasilar insufficiency as the control group was evaluated in volBrain ( http://volbrain...